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In addition to the two indicators, CDC has implemented programs and activities that focus on increasing the proportion of HIV-infected people who know they are infected.
In the United States, CDC estimates 1,039,000-1,185,000 persons are infected with HIV, and that 25% (approximately 250,000) are not aware of their infections and risk for transmitting HIV. As part of the AHP initiative, identifying persons with undiagnosed HIV infection and linking them to medical care and prevention services is a national priority.
Objective 1: Increase the motivation of at-risk individuals to know their infection status and decrease real and perceived barriers to HIV testing .
One of CDC's most promising AHP demonstration projects is the Social Networks. CDC funded nine CBOs to implement a social networks approach to reach high-risk individuals with HIV counseling, testing, and referral services. The project involved training HIV-infected and high-risk individuals in communities of color to reach out through their social, sexual, and drug-using networks and encourage their peers who may be at risk to be tested. Preliminary data from October 3, 2003-September 4, 2004 indicated that of newly identified positives, prevalence rates were highest among MSM (16%), MSM/IDU (15%), and transgender individuals (20%). The recruiters most effective at identifying undiagnosed HIV infections were MSM (15%) and transgender (20%), suggesting that transgender and MSM networks might be more likely to include persons with undiagnosed HIV infection. Additionally, 82% of network associates tested were at high risk (had unprotected sex in the past year, exchanged sex for drugs or money, had an STD, or shared drug injection equipment). Preliminary findings published in the June 24, 2005 MMWR showed that 33 recruiters in seven cities referred 814 high-risk individuals for counseling and testing. Of those, 46 were newly diagnosed as HIV positive, representing a prevalence of 5.7 percent—almost six times that typically seen in publicly funded HIV counseling and testing sites.
This Social Networks demonstration project has proven to be a viable strategy for reaching and providing counseling, testing, and referral services to persons with undiagnosed HIV infection and an efficient and effective route to access HIV-infected persons or those at very high risk for HIV. CDC believes that the Social Networks Project can enhance counseling, testing and referral programs (targeted testing), partner, counseling and referral services, and aid in priority setting for interventions and target populations, such as undiagnosed HIV infections among MSM of color and African-American women. At the September 2005, Executive meeting of the National Alliance of State and Territorial AIDS Directors, CDC provided plans to operationalize the social networks project for implementation in the states. CDC issued a “Dear Colleague” letter to partners in September 2005, and is in the process of developing a social networks toolkit and project information that will be available on the CDC Web site, as well as Grantee Procedural Guidance and a training curriculum that includes technical assistance for grantees targeting MSM and women of color.
Go to Goal 2 Objectives 3 & 4 |
