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Prevention Strategies for Individuals With HIV

The CDC has launched a new strategy for HIV prevention called the Serostatus Approach to Fighting the Epidemic (SAFE) (Figure 1). SAFE is aimed at those who are infected with HIV-including those currently unaware of their serostatus-as well as those who have been tested and found to be uninfected but are at continued high behavioral risk (Table 1). This commentary presents the CDC's strategies for individuals with HIV, which consist of 5 action steps that focus on diagnosing HIV infection in all infected individuals, linking them to appropriate high-quality care and prevention services, and supporting them in adhering to treatment regimens and in adopting and sustaining HIV risk reduction behavior. To make the best use of limited resources, such efforts must use accurate surveillance data, including HIV incidence and prevalence; HIV, AIDS, and sexually transmitted disease (STD) case data; and behavioral data to focus care and prevention efforts on the communities and localities where HIV transmission is most intense.

Figure 1—Blueprint for a serostatus approach to fighting the HIV/AIDS epidemic.

Note. Shaded boxes indicate activities for which the Centers for Disease Control and Prevention does not have the lead government role.

Table 1—Serostatus-Specific HIV Prevention Interventions

Population HIV Prevention Interventions
Unaware of serostatus; behavioral risk of infection Provide current, essential HIV-related information
Encourage voluntary HIV counseling and testing among those at increased risk, including anonymous testing
Reduce stigma of HIV disease and services
Recently tested HIV negative; no apparent behavioral risk of infection Educate to provide HIV prevention messages to family, friends, partners
Recently tested HIV negative; behavioral risk of infection Offer intensive individual or small-group counseling
Develop community-level interventions
Establish linkages to STD, substance abuse, mental health, hepatitis, and social services as needed
Provide prevention case management for those at highest risk
Develop structural interventions (e.g., sterile syringe access)
Tested HIV positive Provide intensive prevention services
Offer partner counseling and referral services
Establish linkages to STD, substance abuse, mental health, hepatitis, and social services as needed
Provide prevention case management
Develop structural interventions (e.g., decrease discrimination)

Note. STD=sexually transmitted disease.

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