Prevent

Prevent Pillar: HIV Prevention in the United States

The Ending the HIV Epidemic in the United States (EHE) initiative aims to reduce new HIV infections by 90% by 2030. The initiative includes four pillars: DIAGNOSE, TREAT, PREVENT, and RESPOND, and will scale up science-based strategies for each that can end the epidemic.

To prevent new HIV transmissions, CDC is supporting proven interventions, including preexposure prophylaxis (PrEP) and comprehensive syringe services programs (SSPs).

PrEP pills icon

PrEP is medication that is highly effective in preventing HIV.

About 25 percent who could benefit from PrEP are prescribed it. More than 1.2 million people could benefit from PrEP.
PrEP coverage by Race/Ethnicity and Sex at Birth 2020

In a study among transgender women who were HIV negative, PrEP awareness is high but use is low. 92% had heard of PrEP but only 32% had used it in the last 12 months.†

SSPs are associated with approximately 50 percent decline in HIV transmission risk.
New users of SSPs are 5x more likely to enter drug treatment and 3x more likely to stop using drugs than people who don't use the programs.

SSPs are community-based programs that provide access to sterile needles and syringes, facilitate safe disposal of used syringes, and provide a link to other important health and social services and programs.

CDC is accelerating efforts to increase availability and use of PrEP, particularly for disproportionally affected populations with the highest rates of new HIV diagnoses and low PrEP use.

Strategies:

Increase availability of PrEP and TelePrEP services in community health centers and sexual health and STD clinics
Work with health departments and CBOs to link people who could benefit from them to PrEP services ideally on the same day
Increase number of clinicians offering PrEP and PEP (post-exposure prophylaxis), including through TelePrEP
Create peer networks that build trust and improve uptake of PrEP
Increase PrEP awareness among clinicians and the public via social marketing and text messaging campaigns

CDC is working to increase the availability, use, and access to and quality of comprehensive SSPs using innovative delivery options when feasible.

Strategies:

Support enhanced technical assistance (TA) to ensure the provision of high-quality, comprehensive harm reduction services
Partner with other federal agencies and working with local communities to help implement SSPs where they are needed and permitted by state and local laws
Where SSPs are established, help scale up delivery of a range of services including testing for HIV, sexually transmitted infections (STIs), and hepatitis C virus; linkage to substance use disorder and infectious disease care; and vaccination

Ending the HIV Epidemic Goals

PrEP Coverage  Increase PrEP coverage to 50 percent by 2025

* Centers for Disease Control and Prevention. Core indicators for monitoring the Ending the HIV Epidemic initiative (preliminary data): National HIV Surveillance System data report­ed through June 2021; and preexposure prophylaxis (PrEP) data reported through March 2021. HIV Surveillance Data Tables 2021;2(No. 4). https://www.cdc.gov/hiv/library/reports/surveillance-data-tables. Published October 2021. Accessed November 30, 2021.
** Transmission category data are presented based on sex at birth and include transgender persons.
† Centers for Disease Control and Prevention. HIV Infection, Risk, Prevention, and Testing Behaviors Among Transgender Women—National HIV Behavioral Surveillance, 7 U.S. Cities, 2019–2020. HIV Surveillance Special Report 27. http://www.cdc.gov/hiv/library/reports/hiv-surveillance.html. Published April 2021. Accessed January 19, 2022.
‡ Hagan H, McGough JP, Thiede H, Hopkins S, Duchin J, Alexander ER, “Reduced injection frequency and increased entry and retention in drug treatment associated with needle-exchange participation in Seattle drug injectors”, Journal of Substance Abuse Treatment, 2000; 19:247–252.

Page last reviewed: June 15, 2022