Rich’s Report

As I look back on the past year, I can’t help but think that this is a critical point in time for the division and in the history of the domestic HIV/AIDS epidemic. We are facing tremendous opportunities and challenges that require us to step back and take a careful look at what we’re doing—and the impact on the HIV/AIDS epidemic that our work and that of our partners is having. The real and potential opportunities are many, and there is a renewed sense of purpose and commitment to addressing the domestic epidemic within the new administration and among our partners. The White House joined with HHS and CDC to launch the Act Against AIDS campaign, and the president’s budget included a $53 million dollar increase for HIV. The proposed increase was the largest for any program at CDC and is particularly noteworthy given the current economic climate and reductions in the proposed budgets for a number of CDC programs. Details about the president’s proposed use of these funds can be found on page 62 of the budget justification provided to Congress.

Unfortunately, the division is also facing many challenges as well. The number of new HIV infections is much too high, there remain unacceptably high racial/ethnic disparities, and we are seeing steady increases in new HIV infections among men who have sex with men that began more than a decade ago. The ever growing number of people living with HIV also presents a major challenge for both prevention and medical care, as existing resources will have to be spread more thinly to ensure that HIV-positive people receive high-quality prevention and medical services. We must also recognize the broader economic climate as well. We have been relatively isolated from the effects of the economic downturn, but health departments and community-based organizations are experiencing substantial challenges. The National Alliance of State and Territorial AIDS Directors (NASTAD) recently conducted a survey and found that 55% of jurisdictions have had or are expecting cuts to their local HIV prevention budget. Two-thirds of jurisdictions have established hiring freezes, 46% have eliminated positions, and 22% have instituted furloughs. This grim reality is likely to have very real effects on the ability of local communities to prevent new cases of HIV/AIDS and ensure that those who are diagnosed with HIV are linked to appropriate medical and prevention services.

As we address these opportunities and challenges, we will have to do some soul searching and be open to critically re-examining our priorities and our activities. For me, one of the main take-away messages from the external peer review was that we need to look carefully at CDC’s unique mission and what it is that the nation needs most from us as an organization. Three of the questions related to this that I have continued to ask myself over the past year while I have been acting as division director are these:

• Are we trying to do too many different things with the resources we have available?
• Are we sacrificing the quality, feasibility, and timeliness of some of our most important activities because we are spread too thinly?
• Of all that we do, what is truly going to have the biggest impact on reducing HIV incidence and disparities in this country?

I think we’re at the right time to be asking these questions. The recommendations from the external peer review, which will be finalized this summer, should provide us with much food for thought, good discussion, and hopefully insights that provide us with the beginnings of a road map for further improving our work and its impact. Additional food for thought will come from the results of the division’s work on an economic model that will suggest how we might target existing and additional resources to most efficiently decrease new HIV infections. Dr. Jonathan Mermin’s perspectives and experience will also be invaluable to us as we shape our collective future.

It has been an honor to serve as the acting director for the past year. I have learned a lot about the people and the work of the division over the past year, and have an even deeper respect for both. Given what I know about the division and its staff, I am confident that we will continue to grow as an organization during this critical time of increased opportunities and challenges. It is essential that we do this and that we do this in a timely manner. We have a tremendous responsibility to the nation and the communities that we serve. Too many 9½ minutes have already slipped through our fingers.

Rich Wolitski
Acting Director
Division of HIV/AIDS Prevention

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Meet Dr. Jonathan Mermin: A Glimpse at DHAP’s New Director

On July 6, CDC and DHAP officially welcome Dr. Jonathan Mermin as the new director of the Division of HIV/AIDS Prevention. To dig deeper into the thoughts, experiences, and motivations of our soon-to-be director, two of us on the DHAP editorial team interviewed him by phone on May 12.

Known as “Jono” by coworkers and friends, Mermin struck us as a thoughtful, friendly, funny, unpretentious, and very intelligent man who brings to DHAP many years of executive leadership in public health and a passion to combat the domestic HIV epidemic. As director of CDC-Kenya and HHS public health attaché for the U.S. Embassy for the past 3 years, he manages more than 1,000 direct and contract staff and a $220 million annual budget for programs and research on an array of infectious diseases, including HIV/AIDS, malaria, and tuberculosis. He directs communications across many CDC centers and two field stations; works with staff, CDC-Atlanta, and partner institutions to develop and implement new programs; and builds the capacity of communities—whom Mermin considers key partners in the fight against HIV.

A Captain in the U.S. Public Health Service Commissioned Corps, Mermin began his career with CDC in 1995 as an Epidemic Intelligence Service (EIS) officer working with the Foodborne and Diarrheal Diseases Branch. As an EIS officer, he investigated a typhoid fever epidemic in Dushanbe, Tajikistan, several outbreaks of E. coli infections here and in Japan, and studied reptile-associated salmonellosis in this country. His involvement in HIV/AIDS began in 1986 as an undergraduate at Harvard University, when he worked on HIV public policy issues “at a time when many policy makers, scientists, and the public were confused about HIV and the best approaches to prevention.” “Then, as now, HIV highlighted cultural, economic, and political disparities in society and raised a clarion call for a person like me who wants to reduce injustice, provide support for people in need, and bring prevention to the forefront of our national consciousness.” His commitment to HIV grew during his internal medicine residency at San Francisco General Hospital caring for hundreds of people with HIV/AIDS when little treatment was available, but there were robust efforts in prevention.

Mermin’s experience working in many CDC divisions and centers, a state health department, and international offices reminds him “that flexibility and an appreciation of staff knowledge at all levels is a critical aspect of successful public health and leadership.” Whether collecting stool samples from reptile cloacas in San Francisco, developing a hepatitis C proposal with community groups and divisions in a state health department, or slogging through mud to interview a woman with HIV, Mermin asserts that “nothing is out of bounds for CDC.” After completing a preventive medicine residency at the California Department of Health Services, he began his almost 10 years of living and working in east Africa.

From 1999 to 2006, Mermin served as the director of CDC-Uganda where he established the CDC program and supervised programmatic, epidemiologic, and administrative activities. In Uganda, he oversaw the collaborative initiation, expansion, and evaluation of many HIV prevention and care programs. HIV is the leading cause of adult death in Uganda and Kenya and is never far from the minds of the average person in these two countries, where most people either have HIV or know a partner, wife, husband, child, or relative who does. People are profoundly poor, infrastructure is limited, and public health workers sorely lack adequate resources. Mermin has lost friends to the disease, and his family has cared for several children orphaned by HIV. He describes feeling an urgency regarding the needs of the average person with HIV in rural Africa. Most live in mud homes and spend about 25 cents per day, 70% of which is used for food—conditions that make living with HIV and implementing prevention interventions very difficult. But for Mermin, “I can’t think of a field that touches so many aspects of society, or keeps one as constantly on one’s toes.”

He feels privileged to join the division as its new director, adding that “DHAP has conducted some of the most important work in HIV prevention in the world.” He lauds staff who are “communicating the accurate and effective messages that change behavior” and who care about translating science to program and policy. Mermin praises Acting Director Rich Wolitski who “has done an excellent job of leading DHAP through a period of transition” and expresses “great admiration for Rich, Rob Janssen, Kevin Fenton, and DHAP senior leaders for steering the division well over the past few years.”

In March and April, Mermin met with DHAP staff and leaders to discuss overall goals, accomplishments, and obstacles to achieving personal, branch, and division objectives. He remarks that DHAP staff are talented, committed to their work, and “continue to conduct some of the most creative and important research and programs in the world.” He reiterates his appreciation of staff knowledge, stressing that “the voices of all staff will be heard” and “all levels of the organization will be involved in decision-making.”

When asked to describe priorities and goals for his first 100 days, Mermin says that he will “nurture an atmosphere of transparent and collaborative decision-making and open communication.” Identifying specific priorities now would be premature, since he supports a formal strategic planning process for DHAP that incorporates suggestions from the recent external review, partner organizations, other divisions, and DHAP staff.

Charged with confronting challenges complicated by the continued complexity of HIV prevention in a world of health disparities, economic difficulties, and limited staffing, Mermin is neither disheartened nor unprepared. He is encouraged by new tools including evidence-based behavioral and biomedical interventions at the individual, group, and community levels, and by DHAP’s demonstrated experience at translating science to practice. When asked if we will ever be able to stop the spread of HIV and reduce its impact on the most severely affected groups, Mermin avows “Yes, we can. And we will.”

Outside of work, Mermin says he runs, reads, hikes, cooks, and plays guitar and sings (“to his family’s considerable embarrassment”). He devotes his spare hours to his wife, Rebecca Bunnell, who has recently accepted a position in the Division of STD Prevention, and their two daughters, aged 7 and 10, who he describes as “sprightly, intelligent, and fun to play with.” Welcome to the division, Jono!

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Act Against AIDS Updates

Act Against AIDS Launch Draws Wide Media Attention

On April 7, CDC launched the first phase of Act Against AIDS (AAA), a new 5-year communication campaign to refocus national attention on the domestic HIV epidemic. The theme of the first phase, 9½ Minutes, sends a simple message—that right here in the United States, every 9½ minutes, someone’s brother, mother, sister, father, or neighbor is infected with HIV.

The first phase aims to combat complacency about the HIV/AIDS crisis in the United States and raise awareness of the continued severity of the epidemic. The next phases of the campaign are reaching out to specific populations at greatest risk for HIV, starting with African Americans, who—by far—are the racial/ ethnic group that bears the greatest burden of HIV and AIDS. Other phases will focus on gay and bisexual men of all races, Latinos, and other communities disproportionately affected. As described in a subsequent article, Spanish-speaking DHAP staff offered their expertise for the 9½ Minutes viral videos that are part of the campaign’s first phase.

The launch attracted a lot of media attention: Approximately 38 million media impressions were documented by the final media coverage update. Such major national outlets as USA Today, The Washington Post, The New York Times, Wall Street Journal, Reuters, Bloomberg, Fox News, CNN, and the Tavis Smiley Show (radio) covered the campaign launch. Other media successes include:

• Positive news editorials on the AAA campaign and the need to refocus national attention on HIV, including those in The New York Times and The Washington Post.
• Significant coverage of the campaign launch in targeted media, such as gay and African American outlets.
• A campaign op-ed written by Kevin Fenton ran in the Reuters “Great Debate” blog; in addition, Dr. Fenton’s commentary on the importance of the AAA campaign in the African American community posted on AOL Black Voices and ran in several regional African American newspapers.
• Essence Magazine Online (Obama Watch blog) cites the campaign as one of President Obama’s health care achievements during his first 100 days in office.

9½ Minutes Viral Videos Feature DHAP Spanish-Speaking Staff

Twelve Hispanic/Latino DHAP staff offered their Spanish-speaking expertise for the 9½ Minutes viral videos, which are part of the first phase of the Act Against AIDS national communication campaign launched on April 7. The Spanish-language videos are part of the division’s efforts to reach out to the Hispanic/Latino community to make messages directed to the general population more relevant for Hispanics/Latinos.

The Spanish version of the videos, already popular on YouTube, will likely be posted to various Hispanic/Latino Web sites in addition to the Spanish version of the campaign Web site.

DHAP Develops New MSM Campaign Materials

HIV/AIDS surveillance data show that most new HIV infections in the United States are among persons under 30 years old, African Americans, and men who have sex with men (MSM) of all races. To address the growing numbers of young, African American MSM who are becoming infected with HIV, the Prevention Communication Branch (PCB) has been developing a new social marketing effort for this population as part of the Act Against AIDS campaign.

The overarching goal of the MSM phase of the campaign is to increase HIV testing and make it a routine behavior among young African American MSM. To help attain this goal, PCB has convened an external work group of 15 African American MSM experts from a cross-section of academic institutions, community-based organizations, public health institutions, and national associations to provide ongoing technical input for the development of effective messages and materials.

As part of the broader Act Against AIDS national communication campaign, the new social marketing effort is scheduled to begin soon. The first phase will involve evaluation of online banner ads and will be launched in summer 2009.

HNR Evaluation Identifies Areas for Improvement

To examine the objectives, directions, strategies, and activities of the Heightened National Response (HNR) partnership, DHAP leaders directed the Program Evaluation Branch (PEB) to review and evaluate the partnership. Gene Shelley, associate chief for science in PEB, and two coworkers Chantelle Owens, health scientist, and Kathleen Raleigh, behavioral scientist, interviewed 124 internal and external stakeholders for the evaluation.

On March 16, DHAP staff were apprised of the evaluation results at an all-hands meeting. Five major areas were identified for improvement: clarify focus of HNR, stabilize leadership, set priorities for expanding partnerships and track partner accountability, improve both internal and external communication about HNR, and engage more people in HNR.

DHAP Acting Director Rich Wolitski said steps are being taken to address these areas. He emphasized that HNR is only one component of DHAP’s comprehensive efforts to monitor and evaluate HIV/AIDS in African Americans.

To stabilize leadership, permanent staff will be hired to fill the positions of Associate Director for HIV/AIDS Disparities and Coordinator for African American HIV/AIDS Disparities. To improve communications, the first issue of ACT!ON was disseminated to partners and staff on May 15. The bimonthly HNR newsletter promotes awareness of new CDC data affecting African Americans, supports the success of HNR partners, and showcases efforts to monitor and reduce the impact of the epidemic among blacks.

Another critically important step is the Act Against AIDS Leadership Initiative, a CDC partnership with 14 leading African American organizations that expands upon existing mobilization efforts in black communities and represents DHAP’s commitment to partnerships in the fight against HIV and efforts to decrease disparities in minority communities of all races and ethnicities.

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National HIV Testing Day Accents Impact of Testing on Preventing HIV

On June 27, DHAP and NCHHSTP will join their partners throughout the country to support National HIV Testing Day (NHTD). Started in 1995 by the National Association of People with AIDS (NAPWA), this annual health observance is designed to strengthen our collective efforts to increase the number of people in the United States who know their HIV status. Currently, about 21% of HIV-positive persons do not know they are infected.

This year, CDC has additional platforms to extend the reach of NHTD. For example, users visiting the National HIV and STD Testing Resources will be able to link to the 9½ Minutes Web site, which is part of the recently launched Act Against AIDS campaign, to get information they need to protect themselves from HIV infection, live healthier lives if they are infected with HIV, as well as to get more information about HIV testing. Through campaigns and other outreach activities, DHAP and CDC are continually engaging new partners and providing new avenues to reach those at increased risk for HIV.

Other activities will take advantage of innovative online and digital channels to encourage HIV testing. Look for new Web features, Twitter messages, Web badges, and widgets that will direct users to the National HIV and STD Testing Resources and the 9½ Minutes Web sites. In addition, radio interviews, press statements, and public service announcements through various media channels are planned that will reach across the nation and into communities most at risk.

The CDC/DHAP-sponsored African American Media Roundtable in Washington, D.C., on June 11, was another opportunity to promote NHTD. Among the topics discussed were how to cover and pitch stories for the national testing day.

Most importantly, NHTD activities remind Americans that HIV remains a major public health threat and that HIV testing is a critical step in reducing HIV infections. For more information visit NHTD.

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Registration Opens for 2009 National HIV Prevention Conference

The 2009 National HIV Prevention Conference, which will be held August 23–26, 2009, in Atlanta, brings together HIV prevention experts and advocates from various backgrounds and communities throughout the country.

“The conference allows attendees to hear about key HIV advances from scientists, researchers, and outreach specialists who are in the field,” said Bob Kohmescher, conference coordinator and special assistant to the NCHHSTP director. “When leaders from science and programs are given the chance to collaborate and connect, we are able to uncover the most efficient and effective means to reach priority populations with HIV prevention initiatives.” He is also focused on making the conference a “green” event.

Conference tracks include basic prevention research; surveillance and epidemiology; advances in HIV prevention; program planning, implementation, and evaluation; HIV prevention policy; HIV prevention and treatment interface; and program collaboration and service integration. Division FTE staff are encouraged to use ILA funds to cover their registration costs and to register early for the conference. For detailed instructions on registering for the conference, see the registration page.

If you have questions about the conference, visit the website or contact Bob Kohmescher.

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Consultation on Revised Guidelines for HIV Counseling, Testing, and Referral in Non-Clinical Settings

Sponsored by CDC’s Division of HIV/AIDS Prevention, the consultation was held on June 1–2 in Atlanta. Research for and organization of the consultation was facilitated by the Prevention Communication Branch’s Guidelines Development Team. The consultation’s purpose was to develop a set of core recommendations from external consultants to inform a revision of the 2001 Revised Guidelines for HIV Counseling, Testing, and Referral, specifically for use in the non-clinical setting.

Information from the consultation will begin to be shared in August; however, the revised guidelines won’t be available until fall 2010.

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New Publications, Web Sites, and Other Materials

HIV Incidence in Puerto Rico, 2006

Recent estimates of HIV incidence in Puerto Rico in 2006 show important differences between HIV epidemiology in Puerto Rico and the 50 U.S. states and District of Columbia (DC). In 2006, an estimated 1,440 persons aged ≥13 years were newly infected with HIV in Puerto Rico, resulting in an estimated incidence rate of 45.0 cases per 100,000 population—twice the rate for the 50 U.S. states and DC (22.8) and 1.5 times the estimated rate for Hispanics in the United States (29.4). Males accounted for 65% of new HIV infections in Puerto Rico, and 38% of new infections occurred among persons aged 30–39 years; 39% of new infections were associated with injection-drug use, and 37% with high-risk heterosexual contact. Read the June 5 MMWR.

To view recent MMWR articles with HIV/AIDS content, consultation summaries, and new surveillance reports, fact sheets, and slide sets, check out the What’s New? section on the DHAP Internet.

2008 Compendium Updated

The 2008 Compendium of Evidence-Based Behavioral Interventions (EBIs) was updated on May 7 to include 6 new EBIs, bringing the total number of EBIs to 63.

Of the 63 EBIs listed in the Compendium, 35 EBIs are specific to African Americans, and 13 EBIs target men who have sex with men (MSM).

National HIV Behavioral Surveillance System Results

On April 8, at a meeting for DHAP staff, Amy Lansky, new deputy director for surveillance, epidemiology, and laboratory science, and Elizabeth DiNenno, behavioral scientist in the Behavioral and Clinical Surveillance Branch (BCSB), discussed the results from the National HIV Behavioral Surveillance System among Injecting Drug Users (NHBS-IDU) study. Groups targeted in this study were MSM, IDUs, and heterosexuals at high risk. Information from this study was published in the April 10 MMWR.

To view other recent MMWR articles with HIV/AIDS content, consultation summaries, and new surveillance reports, fact sheets, and slide sets, check out the What’s New? section on the DHAP Internet.

Peer-Reviewed Journal Articles

CDC Thailand staff member Dr. Wanitchaya Kittikraisak (June); Frits Van Griensven and Mike Martin, both of the Epidemiology Branch (EB); Janet McNicholl of the Laboratory Branch; Rutt Chuachoowong, Jordan Tappero, Tim Mastro, Dale Hu, all currently or formerly of CDC; and co-authors recently had “Blood and Seminal Plasma HIV-1 RNA Levels Among HIV-1-Infected Injecting Drug Users Participating in the AIDSVAX B/E Efficacy Trial in Bangkok, Thailand” published online in the Journal of Acquired Immune Deficiency Syndromes (JAIDS). The paper examines the effect of vaccine on viral load in participants who became infected with HIV during the 1999 to 2004 study period. Read the abstract.

Linda Koenig of the Prevention Research Branch (PRB), Renee Stein of the Program Evaluation Branch (PEB), and co-authors recently had “Characterizing Social Support: Global and Specific Social Support Experiences of HIV-Infected Youth” published in AIDS Patient Care and STDs. Their article examines the global concept of social support to identify the specific actions that lead to support perceptions. The authors document the different support needs of adolescents infected through perinatal transmission compared with those of adolescents infected later in life. Read the abstract.

Claudia Vellozzi of the Global AIDS Program (GAP), Lois Conley of EB, Tim Bush of the Quantitative Sciences and Data Management Branch (QSDMB), John Brooks of EB, and colleagues had their article, “The Study to Understand the Natural History of HIV and AIDS in the Era of Effective Therapy (SUN Study),” published in the American Journal of Epidemiology. The study monitors the clinical course of HIV-infected persons treated with combination antiretroviral therapy in 4 U.S. cities. Read the abstract.

John Brooks of EB, Jon Kaplan of GAP, and their colleagues at the National Institutes of Health and the HIV Medical Association of the Infectious Diseases Society of America had an invited editorial, “HIV-Associated Opportunistic Infections—Going, Going, But Not Gone: The Continued Need for Prevention and Treatment Guidelines,” published in Clinical Infectious Diseases (2009 Mar 1;48(5):609–11). Their editorial underscores that, even though antiretroviral therapy has dramatically reduced the incidence of opportunistic infections, they remain a leading cause of death and hospitalization among persons with HIV.

In their study, Late HIV Diagnosis and Determinants of Progression to AIDS or Death after HIV Diagnosis among Injection Drug Users, 33 US States, 1996–2004, Anna Grigoryan, former DHAP employee; Irene Hall of the HIV Incidence and Case Surveillance Branch (HICSB); Tonji Durant, formerly of HICSB; and Xiangming Wei, formerly of HICSB, show that a substantial proportion of injection drug users (IDUs) living with HIV received their HIV diagnosis late. To improve survival of IDUs, the authors conclude that HIV prevention efforts must ensure early access to HIV testing and care, as well as encourage adherence to antiretroviral treatment to slow disease progression. Read the study.

The Georgia Prison Epi-Aid Team, consisting of Peter McElroy of the National Center for Zoonotic, Vector-Borne, and Enteric Diseases (NZVED); Craig Borkowf (QSDMB); Robin MacGowan and Andrew Margolis (PRB); Ae Saekhou Youngpairoj of the Laboratory Branch (LB); Dale Stratford of PEB; and Krishna Jafa, Ken Robbins, Lisa Fitzpatrick, and Alan Greenberg, all formerly of CDC, recently published “HIV Transmission in a State Prison System, 1988–2005.” The paper adds to the sparse information available on HIV transmission within large state prison systems. Read the full article.

Peter Kilmarx, EB, Katrina Kretsinger, EB, and Greg Millett, PRB, had their review paper titled “Considerations in the Role of Male Circumcision in the Prevention of HIV Transmission in the USA” published online in the journal HIV Therapy (2009 May; 3(3):241–254). The paper reviews information on the potential role of male circumcision for HIV prevention in the United States where, compared with the three African countries where male circumcision clinical trials were conducted, the prevalence of HIV infection is lower, the main route of HIV transmission is male-male sex rather than heterosexual sex, and the prevalence of male circumcision is higher.

In their paper, “Gay Identity-Related Factors and Sexual Risk Among Men who have Sex with Men in San Francisco” published in AIDS Education and Prevention (2009 Apr;21(2):91–103), Steve Flores, formerly of PRB, now at GAP; Gordon Mansergh of PRB; and Gary Marks of EB studied the degree of connection between MSM from three ethnic groups: white, black, and Latino. The research concluded that the white MSM were more attached to the gay community than the other two ethnic groups. As in other studies, the degree of connection to the gay community in San Francisco is associated with higher sexual risk. Differences in this association by race/ethnicity are also reported. Read the abstract.

Ann O’Leary of PRB and Rich Wolitski, acting director, DHAP, had their article, “Moral Agency and the Sexual Transmission of HIV,” published in the Psychological Bulletin (2009:135(3):478–494). The article reviews the literature on sexual transmission risk behavior within Albert Bandura’s theoretical framework of moral agency. First, evidence is reviewed for the operation of moral agency in transmission risk behavior and HIV disclosure. Next, suggestive evidence is presented for the operation of mechanisms of moral disengagement described by Bandura. Finally, through the lens of moral agency, the authors review a small number of interventions shown to be effective in reducing transmission risk behavior and make recommendations for future intervention research. Read the abstract.

In “Factors Associated with Adherence to Highly Active Antiretroviral Therapy in Homeless or Unstably Housed Adults Living with HIV” published in AIDS Care (April 2009:21(4):448–455), Rich Wolitski and co-authors evaluated homeless or unstably housed persons living with HIV/AIDS in three U.S. cities who were enrolled in the Housing and Health Study. Using baseline data and controlling for gender, race, age, and education, the authors examined associations between self-reported 2- and 7-day adherence and access to healthcare, mental health, substance use, and attitude toward HIV medical therapy. Results confirm that coexisting problems of access to healthcare, higher risk of mental health problems, and poorer attitudes toward treatment are associated with increased likelihood of missing doses. The authors conclude that comprehensive models of HIV care that include a continuum of medical and social services are essential for treating this population.

DHAP scientists and contractors contributed to a theme issue of the American Journal of Public Health (AJPH), which focuses on intervention strategies that address the HIV/AIDS epidemic among African Americans with an emphasis on HIV transmission among heterosexuals and men who have sex with men. First available online in April, the issue became available in print on June 1 (volume 99, issue 6). Donna Hubbard McCree of PRB was the lead editor of the special issue, which includes important articles that advance scientific discourse on new intervention strategies; HIV testing; and the implementation, adaptation, or evaluation of existing intervention strategies. Several key articles were authored/coauthored by DHAP scientists and contractors, including Donna Hubbard McCree, Pilgrim Spikes, David Purcell, Kim Williams, Helen Ding, Kenneth Jones, Wayne Johnson, and Sekhar Thadiparthi of PRB; Lisa Kimbrough, formerly of DHAP; Holly Fisher of PEB; and Sam Dooley, associate deputy director for prevention programs. View the Table of Contents and abstracts.

Web Site on Male Circumcision for HIV Prevention Launched

The World Health Organization, in conjunction with Family Health International, the Joint United Nations Programme on HIV/AIDS (UNAIDS), and the AIDS Vaccine Advocacy Coalition, recently developed the Clearinghouse on Male Circumcision for HIV Prevention. Designed to produce and share authoritative information about male circumcision and its role in HIV prevention, the site provides evidence-based guidance that supports the delivery of safe male circumcision as a part of HIV prevention services.

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