World AIDS Day 2018
December 1 is World AIDS Day, an opportunity to unite in our efforts to stop new HIV infections, support those affected by HIV, and remember those who have lost their lives to HIV-related diseases.
World Aids Day: Using Data to Guide Leadership and Partnership
Since the agency first called attention to what we now know as AIDS, CDC has been at the forefront of efforts in the United States and abroad to prevent new infections, treat those with HIV, and stop AIDS-related deaths.
This year, the U.S. government’s World AIDS DayExternal theme reflects how we can all save lives through leadership and partnership. This is also an opportunity to consider the impact CDC has had since both the launch of the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) 15 years ago and also the more than 30 years that have passed since the first World AIDS Day. For example, when PEPFAR was announced in 2003, only 50,000 people in Africa were on HIV treatment. In 2017, 21 million men, women, and children were on HIV treatment globally. CDC supports more than one-third of all people on treatment worldwide, including more than half of those on PEPFAR-supported treatment. People with HIV who take HIV medicine as prescribed and get and keep an undetectable viral load have effectively no risk of transmitting HIV to their HIV-negative sexual partners.
CDC is working with partners in the U.S. and around the world to achieve a future free of HIV.
Using Data to Guide Leadership
Everyone can show leadership by having data-driven conversations on the most effective ways to close testing and treatment gaps. These discussions can lead to new partnerships and innovations that save lives, and this type of leadership is essential to achieving national HIV prevention goals Cdc-pdf[2.17MB]External and the goals in PEPFAR’s strategy. Cdc-pdf[4.98 MB]External
However, data-driven decisions are only as good as the underlying information. This is why, through PEPFAR, CDC is providing expertise for the Population-based HIV Impact Assessments (PHIA) to measure HIV trends and the impact of prevention and treatment programs in Haiti and 13 countries across Sub-Saharan Africa. These surveys combine household visits, in-person interviews, HIV testing, and cutting-edge technologies, including laboratory science and diagnostics. Results from the PHIAs in several African countries show that investments to control HIV are working. The PHIA findings also highlight that we need to do more work in certain places and with certain groups.
Overall, the PHIAs reveal key gaps in treatment and prevention programming for men ages 25 to 34 and women ages 15 to 24. These surveys also emphasize the need to increase the coverage of HIV testing among adult men, adolescent girls, and young women. As new data become available, partner country ministries of health, in collaboration with CDC and on-the-ground partners, are using their PHIA results to reach the populations and areas most in need.
Similarly, in the United States, CDC uses data to promote High-Impact Prevention, a public health approach that uses cost-effective, proven, and scalable interventions targeted to specific populations. As part of this effort, CDC provides national, state, and local surveillance data through AtlasPlus.
Similar to a PHIA overseas, this resource provides domestic surveillance data to help state and local partners understand more clearly where they need to target their efforts. Using these and their own data, many state and local governments have also developed plansExternal for their jurisdictions.
The data also show us that there are regions in the U.S. that have a disproportionate amount of people with HIV. Specifically, southern states account for 38% of the US population but 51% of annual HIV infections, 46% of persons living with HIV, and 51% of undiagnosed HIV. Based on this data, CDC is making HIV prevention in the South Cdc-pdf[747 KB] a priority.
World AIDS Day is a day to unite to end HIV.
Partnerships That Save Lives
The United States and many other countries across the world are making commendable progress in HIV prevention and treatment due to partnership efforts.
CDC works side by side with ministries of health, civil and faith-based organizations, and other on-the-ground partners in more than 45 countries and regions around the world to improve methods for finding, treating, and preventing HIV. As a key implementer of PEPFAR, CDC works with partners to:
- Build surveillance systems, which are necessary to depict and measure the problem and help countries better understand their unique HIV epidemics. The PHIAs are a key example of surveillance efforts led by CDC and partners.
- Strengthen laboratory systems, which are the foundation of the HIV response from making a diagnosis to measuring viral suppression. CDC and partners are expanding HIV screening to ensure more people with HIV are diagnosed. In fact, CDC has developed and is currently evaluating a simple, rapid test that can simultaneously diagnose HIV and identify if an infection is recent. CDC also is expanding viral load testing to monitor the effectiveness of HIV treatment.
- Deliver life-saving antiretroviral medicines to men, women, and children all over the world. CDC and partners are using innovative treatment delivery models, including community support groups, to help more people with HIV get treatment and stay on it.
- Support evidence-based HIV prevention programs to reduce transmission and acquisition of HIV, including voluntary medical male circumcision for men at greatest risk for HIV in 14 African countries and pre-exposure prophylaxis.
To support local organizations, CDC hosts a database of evidence-based, effective interventions. This resource can serve as a starting point for programs that are developing new initiatives. On-the-ground leaders also use CDC’s National Prevention Information Network (NPIN) to collaborate with their peers and access information and resources.
Domestically, to further efforts to control HIV, CDC continued its strong partnerships including
- A new cooperative agreement through which CDC will award state and local health departments about $400 million each year for conducting HIV surveillance activities and providing high-impact prevention programs to the populations and geographic areas of greatest need.
- The Act Against AIDS initiative updated and re-launched efforts to encourage heath care providers to routinely screen everyone for HIV, prescribe PrEP to those who need it, and treat their patients living with HIV.
- NPIN and Emory University integrated data to provide a comprehensive, national directory of health service providers in the U.S. that offer PrEP to help ensure more people can benefit from PrEP.
The United States and other countries across the globe have made great progress in controlling HIV; however, much more needs to happen. Leadership and partnership in all levels of HIV prevention will continue our success to achieve national HIV prevention goals and PEPFAR’s targets and save lives in the U.S. and across the globe.