"World AIDS Day 2010: Time for Optimism and Action"
December 1, 2010
Statement by Dr. Kevin Fenton, Director,
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
Centers for Disease Control and Prevention
This past year marked critical milestones in HIV prevention – including long-awaited research advances, record-high HIV testing rates in the United States and a bold new national HIV/AIDS strategy to reduce the burden of the disease. These advances should make all Americans optimistic about the future of HIV prevention here at home, where one new infection occurs every 9 ½ minutes – totaling 56,000 new infections every year.
These advances should also inspire us to action. With more tools and opportunities to fight the spread of HIV than ever before, now is the time to reverse decade-long trends in infections. Prevention efforts helped cut the number of new HIV infections that occur annually in half since its peak in the 1980s, but those numbers have remained roughly stable, yet still unacceptably high, since the late 1990s. And stark disparities in HIV infection rates persist: men who have sex with men of all races, African-Americans and Latinos are most affected.
On this World AIDS Day, as we work to combat these statistics we must pause – first to reflect on the year’s milestones, and then on the challenges that lie ahead:
First, we know that HIV testing is one of the most critical prevention tools available. Today, CDC released results of an analysis that shows the number of people who have been tested for HIV in the United States has reached a record high of nearly 83 million. In 2006, CDC recommended that HIV testing become a routine part of medical care for adolescents and adults. Since then, an additional 11.4 million Americans have been tested.
This year, we also saw encouraging signs with new research results that give us hope that drugs already used for HIV treatment can play a larger role in prevention. Two landmark studies provided the first evidence that antiretroviral medicines currently used to treat people with HIV can also help prevent HIV infection. The first study showed promise that a new prevention tool may be on the horizon when it found that a vaginal microbicide gel containing the drug tenofovir reduced HIV risk among women. Results of a second study, reported last week, found that a daily dose of a pill containing two antiretroviral medications already used to treat HIV reduced HIV risk among gay and bisexual men, when used in combination with other prevention methods, including condoms. This approach is called pre-exposure prophylaxis, or PrEP. CDC is currently working with partners across federal agencies to develop guidelines for the use of PrEP among gay and bisexual men in the United States.
Another first came in July of this year with the announcement of the National HIV/AIDS Strategy (NHAS), which provides a roadmap to achieve dramatic progress against the disease by 2015. The strategy calls for greater collaboration and renewed action to reduce the number of new HIV infections in the United States. CDC is fully committed to supporting the NHAS, which reflects approaches we believe will make the greatest difference in reducing HIV.
Because there is not yet a cure or vaccine, it is critical that we take action now and build upon the prevention milestones achieved this year in order realize the full potential of these advances. Today, too few people are able to access prevention services, and urgent action is needed to reach those with the greatest needs; including African-Americans, Latinos and men who have sex with men. Greater efforts are also needed to ensure all Americans are tested for HIV and that those who test positive are linked to care. While the number of Americans tested for HIV is at a record high, CDC’s new HIV testing data analysis finds that more than half of Americans have still never been tested. Additionally, surveillance data show that 32 percent of people diagnosed with HIV in the United States progressed to AIDS within 12 months, indicating far too many late diagnoses and missed opportunities to get life-extending treatment and protect their partners.
As we move forward it is important to remember that there is no "one size fits all" approach to effective HIV prevention. We must continue to develop and implement targeted interventions that address the stark racial disparities and socioeconomic factors that contribute to them. Effectively addressing the numerous complex issues facing HIV prevention will require close collaboration among government agencies at all levels, and strong partnerships with communities affected by HIV/AIDS.
World AIDS Day is a time to remember the devastating toll this disease has taken – and continues to take – on people in the United States and around the world. It is also a day to celebrate the strides we have made in preventing HIV, and look ahead to the work we still have to do.
On this important day, I ask that everyone in this country think about what they can do to help end this global epidemic. Your contribution can begin today, and can be as simple as taking a test.
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