CDC’s Role in Ending the HIV Epidemic in the U.S.
CDC works closely with state and local governments, people with and at risk for HIV, and federal partners to coordinate efforts on expanding the use of the highest-impact HIV prevention strategies: Diagnose; Treat; Prevent; and Respond. As needed, CDC will assist each jurisdiction to address gaps in their local workforce.
Ending the HIV Epidemic in the U.S. (EHE) infuses priority areas with additional resources, technology, and expertise that scale up the four strategies. EHE is also working to address racial, ethnic, and geographic disparities that have contributed to HIV prevention gaps for far too long.
In July 2020, CDC awarded approximately $109 million to begin the first year of a five-year funding program entitled, “Integrated HIV Programs for Health Departments to Support Ending the HIV Epidemic in the United States (PS20-2010).”
In July 2021, CDC awarded the second major round of EHE funding — approximately $117 million — to help state and local health departments rebuild and begin to expand access to the initiative’s four major strategies and reduce health disparities as the U.S. recovers from COVID-19. CDC will also invest additional funds in reaching people where they are, including expanding the capacity of front-line community-based organizations to deliver self-testing; enabling transgender health providers to deliver HIV prevention and treatment; and modernizing data collection and evaluation for the EHE initiative.
EHE jurisdictions have developed local plans that outline the foundation for how they will apply strategies in ways that meet local needs and address disparities. With support from CDC and other federal agencies, local organizations will build and lead strengthened, culturally competent, multi-disciplinary teams to carry out activities in their communities.
Local activities must be informed by input from longstanding and new voices in HIV prevention and treatment, including people with and at risk for HIV; primary and HIV-specialty care providers; pharmacists; substance abuse providers; domestic violence centers; tribal governments and/or tribally designated organizations; community- and faith-based organizations; education agencies and institutes of higher education, including historically Black colleges and universities; and others.
An Increased Focus on STD Clinics
HIV intersects with other health conditions, including sexually transmitted infections (STIs), to form interconnected epidemics, or syndemics. Syndemics contribute to excess disease and ongoing health disparities and inequities.
As part of EHE, CDC is investing resources to scale up quality HIV prevention services in sexually transmitted disease (STD) clinics. These clinics play a vital role in the EHE initiative for several reasons. In particular, they serve a high volume of racial, ethnic, sexual, and gender minorities, as well as people who may not otherwise have access to healthcare services. STDs are also associated with a higher risk of acquiring and transmitting HIV and indicate a potential need for pre-exposure prophylaxis (PrEP).
In January 2020, CDC awarded $3 million in EHE funding to seven state and local health departments in support of this effort. In July 2021, CDC awarded $11.1 million in EHE funding to 19 state and local health departments to focus on five strategies to scale up PrEP, HIV testing, viral load assessment and other HIV prevention services in STD clinics.
In addition to working on HIV, awardees receiving funding are also continuing to confront COVID-19. CDC recognizes that EHE-related activities may need to adapt to effectively balance the responses to COVID-19 and HIV. CDC is committed to moving forward with EHE and to providing state and local communities with the support and flexibility they need to address new and evolving challenges.
While the specifics of implementation will differ by jurisdiction and funding, each community will be working to scale up the four key strategies that together can end the epidemic:
Prevent new HIV transmissions by using proven interventions, including PrEP and syringe services programs (SSPs).