Evidence map›Paper›PMID 42427078›Full record

ReviewJournal of the International AIDS Society2026

What Tools Do We Have to End the US HIV Epidemic? A Review of Structural, Biomedical and Implementation Interventions and Their Potential Population Impact.

Micah Piske, Brenda Carolina Guerra-Alejos, Minh Tri Van, Benjamin Enns, Melanie G Medina, Xiao Zang, Wendy S Armstrong, Czarina Behrends, Carlos Del Rio, Eva Enns and 10 more

Abstract readReview
In one paragraph

Review in Journal of the International AIDS Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors.

Micah PiskeCentre for Advancing Health Outcomes, Vancouver, British Columbia, Canada.
Brenda Carolina Guerra-AlejosCentre for Advancing Health Outcomes, Vancouver, British Columbia, Canada.
Minh Tri VanCentre for Advancing Health Outcomes, Vancouver, British Columbia, Canada.
Benjamin EnnsCentre for Advancing Health Outcomes, Vancouver, British Columbia, Canada.
Melanie G MedinaFaculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada.
Xiao ZangDivision of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA.
Wendy S ArmstrongDepartment of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.
Czarina BehrendsDepartment of Population Health Sciences, Weill Cornell Medical College, New York, New York, USA.
Carlos Del RioDepartment of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.
Eva EnnsDivision of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA.
Elvin H GengDivision of Infectious Diseases, Department of Medicine and Center for Dissemination and Implementation, Institute for Public Health, Washington University in St. Louis, St. Louis, Missouri, USA.
Matthew R GoldenCenter for AIDS and STD, University of Washington, Seattle, Washington, USA.
Brandon D L MarshallDepartment of Epidemiology, School of Public Health, Brown University, Providence, Rhode Island, USA.
Shruti H MehtaDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Lisa R MetschDepartment of Sociomedical Sciences, Columbia University, New York, New York, USA.
Bruce R SchackmanDepartment of Population Health Sciences, Weill Cornell Medical College, New York, New York, USA.
Steffanie A StrathdeeDivision of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, California, USA.
Hansel E TookesDivision of Infectious Diseases, Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida, USA.
Bohdan NosykCentre for Advancing Health Outcomes, Vancouver, British Columbia, Canada.ORCID https://orcid.org/0000-0003-2513-3718
Localized Economic Modeling group

Funding

Localized economic modeling to support implementation of the Ending the HIV Epidemic initiativeR01DA041747 · NIDA · SIMON FRASER UNIVERSITY · PI NOSYK, BOHDAN · 2016 to 2025
$5.5M
NIDA NIH HHS R01 DA041747NIDA NIH HHS R01DA041747
6 · The paper itself

Abstract

introductionThe United States Ending the HIV Epidemic (EHE) initiative was always challenged by structural and implementation barriers to HIV care. On top of that, since 2025, there are additional political and policy barriers that make this goal seem increasingly difficult to achieve. This review identified evidence-based structural, implementation and biomedical interventions available to support each of the EHE pillars and estimated their potential population-level impact, accounting for potential barriers.

methodsWe conducted a targeted literature review of US studies presenting data on efficacy or effectiveness of interventions pertaining to the EHE pillars-prevention, diagnosis, treatment and response-published as of September 2025. We searched interventions included in the US Centers for Disease Control and Prevention HIV Compendium and Response Evidence Brief, all publicly available EHE jurisdictional plans, and the peer-reviewed literature. Potential population impact of an intervention was determined as the product of its effectiveness and scale of delivery. Scale was the product of population reach, provider adoption and structural barriers.

resultsOf 570 studies identified, 57 met the inclusion criteria. We estimated that pre-exposure prophylaxis (PrEP) uptake could increase as much as nearly two-fold (risk ratio [RR]: 1.93, 95% CI: 1.30, 1.96) through pharmacies integrated in primary care clinics. Online HIV self-testing kits were among the most promising interventions to increase testing uptake by two-fold (RR: 1.99, 95% CI: 1.56, 2.57) Finally, a clinic-based education app offering tailored health education could result in a 45% absolute increase (RR: 1.45, 95% CI: 1.29, 1.70) in viral suppression among people living with HIV.

conclusionsInterventions that address barriers to PrEP, HIV testing and adherence to treatment have substantial population-level impact on HIV care outcomes across EHE pillars through changing the context of how care is offered, understood and delivered.

Indexed as

EpidemicsHIV InfectionsHumansUnited StatesdiagnosisEnding the HIV EpidemicHIVimplementation sciencepreventionRE‐AIMresponsestructural interventionstreatment

Identifiers

PMID42427078
PMCPMC13351116

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.