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HIV Prevention in the United States:

Expanding the Impact

Expanding the Impact
Today’s
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Proven
Prevention
Methods
Progress
To Date
Challenges
in HIV
Prevention
Future
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Prevention

Trends in New HIV Infections


The nation’s investment in HIV prevention has contributed to dramatic reductions in the annual number of new infections since the peak of the epidemic in the mid-1980s, and an overall stabilization of new infections since the mid-1990s (from roughly 130,000 new infections to approximately 50,000 annually).7,8 While new infections per year continue at too high a level, this stabilization is in itself a sign of progress. With continued increases in the number of people living with HIV thanks to effective HIV medications, there are more opportunities for HIV transmission than ever before.9 Yet, the annual number of new infections has not increased, indicating that HIV testing, prevention, and treatment programs are effectively reducing the rate of transmission overall. Declines in new infections have also been documented in several key populations over time, underscoring the impact and importance of concentrated prevention efforts:

  • HIV-infected infants: In 1995, CDC began recommending routine HIV screening of pregnant women, following research findings that HIV medications significantly reduce the risk of transmission from HIV-infected pregnant women to their infants. Since that time, testing of pregnant women and treatment for those who are infected have resulted in a dramatic decline in the number of babies born with HIV, from a peak of 1,650 in 1991 to fewer than 200 per year today.10
  • Individuals who inject drugs: Studies show that comprehensive prevention and drug treatment programs, including needle exchange, have dramatically cut the number of new HIV infections among injecting drug users (IDUs).11-13 In fact, HIV infections among IDUs have dropped from a peak of nearly 35,000 infections annually in the late-1980s to just 3,900 new infections in 2010.7,8
  • Heterosexuals: The number of new infections among heterosexuals in the United States increased during the 1980s and fluctuated somewhat throughout the 1990s, reaching 21,900 per year at its peak.7 Since then, new infections declined and have remained relatively stable in recent years, with 12,100 infections occurring in 2010.7,8
Gay and bisexual men

In addition to working to build on the successes in these populations, it is also critical to accelerate progress in combatting the current HIV crisis among gay and bisexual men. Community and public health prevention efforts led to dramatic success in this population in the early years of the epidemic. After new HIV infections among men who have sex with men (MSM) peaked in the mid-1980s at more than 75,000 new infections a year, the number of new infections plummeted to less than 18,000 per year by the early 1990s. Unfortunately, after years of steady progress, new infections again began to rise among MSM throughout the 1990s.7 While in recent years, prevention efforts may have helped stabilize infections, they are occurring at far too high a level (29,800 per year.)8 Additionally, young MSM are the only risk group in which new infections are increasing. This underscores the need to sustain and re-invigorate prevention efforts for gay and bisexual men of every race and to ensure that each generation is effectively reached.

New HIV Infections by Transmission Category, 1980 – 2010
This column graph shows the number of new HIV infections in the United States, by transmission, from 1980 to 2010. This graph shows new HIV infections among three key populations in the United States, men who have sex with men (MSM), intravenous drug users (IDUs), and heterosexuals. Among men who have sex with men (MSM), annual new infections peaked in 1984-1985 at approximately 75,000, declined until 1991-1993, and then began to rise again. Among injecting drug users (IDUs), annual new infections peaked in 1988-1990 at nearly 35,000 and then declined dramatically, now remaining roughly stable at 4,500 infections per year. Among heterosexuals, new infections increased during the 1980s and fluctuated somewhat during the 1990s, reaching a peak of 21,900 per year. Since then, new infections declined and have remained relatively stable in recent years. Estimates use back calculation methodology for 1980-2006, original incidence surveillance methodology for 2006, and updated incidence surveillance methodology for 2007-2010. Note: Back calculation estimates are for 2-year intervals during 1980-1987, 3-year intervals during 1988-2002, and a 4-year interval for 2003-2006.
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