Rates of new HIV acquisition remain unacceptably high in most populations in low-income, middle-income, and high-income settings despite advances in treatment and prevention strategies. Although biomedical advances in primary prevention of new infections exist, systematic scale-up of these interventions has not occurred at the pace required to end AIDS by 2030. Low population coverage, adherence to oral pre-exposure prophylaxis in settings with high rates of HIV acquisition, and the fact that a significant proportion of new HIV infections occurs in populations not identified as high risk and are hence not targeted for prevention approaches impedes current prevention strategies. Although long-acting injectables and monoclonal antibodies are promising approaches to help reduce incidence, high cost and the need for high coverage rates mean that a vaccine or vaccine-like intervention still remains the most likely scenario to produce a population-level impact on HIV incidence, especially in countries with generalised epidemics. Current global efforts are not sufficient to meet 2030 HIV epidemic goals; acknowledgment of this issue is required to ensure persistent advocacy for population-based control of the ongoing HIV pandemic.

中文翻译：

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2030年艾滋病疫情得到控制现实吗？


尽管治疗和预防策略取得了进步，但在低收入、中等收入和高收入环境中的大多数人群中，新感染艾滋病毒的比率仍然高得令人无法接受。尽管在新发感染的一级预防方面存在生物医学进展，但系统性扩大这些干预措施的速度尚未达到到 2030 年消灭艾滋病所需的速度。人口覆盖率低，在艾滋病毒感染率高的环境中坚持口服暴露前预防，而且很大一部分新的艾滋病毒感染发生在未被确定为高风险人群中，因此不属于预防方法的目标，这一事实阻碍了当前的预防策略。尽管长效注射剂和单克隆抗体是帮助降低发病率的有希望的方法，但高成本和高覆盖率的需要意味着疫苗或疫苗类干预措施仍然是最有可能对艾滋病毒发病率产生人口层面影响的情况尤其是在流行病普遍存在的国家。当前的全球努力不足以实现 2030 年艾滋病毒流行目标；需要承认这一问题，以确保持续倡导以人口为基础控制当前的艾滋病毒大流行。