The Potential Effect of Ending Centers for Disease Control and Prevention Funding for HIV Tests: A Modeling Study in 18 States.

BACKGROUND

Timely HIV diagnosis and treatment is critical to preventing transmission. The US Centers for Disease Control and Prevention (CDC) provides funding for HIV testing to local health departments and community organizations. We sought to estimate the number of additional HIV infections that would result from ending or interrupting CDC funding for HIV tests in US states.

METHODS

We used a validated model of HIV transmission to simulate HIV epidemics in 18 US states. We projected incidence forward under 3 scenarios where all CDC-funded HIV testing ends in October 2025 and (1) never resumes, (2) returns to previous levels between January and December 2027, and (3) returns from January to December 2029. We calculated the excess incident HIV infections compared to a scenario where CDC-funded testing continues uninterrupted.

RESULTS

If CDC funding for HIV tests were to end on 1 October 2025, we project 12 719 additional HIV infections across 18 states by 2030 (95% credible interval, 4547-21 896)-an increase of 10%. The projected effects varied by state, ranging from a 2.7% increase in Washington (1.0%-4.7%) to a 29.9 increase in Louisiana (9.4%-59.9%). States that perform more CDC-funded tests and states with more rural HIV epidemics were projected to see greater rises in incidence.

CONCLUSIONS

Disruptions to CDC-funded HIV testing would substantially increase new infections, particularly in states with more rural epidemics. These findings demonstrate the value of the CDC's HIV testing activities in curbing the spread of HIV in the United States.