Although HIV is preventable, there were more than 1.6 million new HIV infections worldwide in 2019, including 150,000 new infections in children. To control the global HIV epidemic, the rate of new infections must be reduced worldwide. As a key implementing agency of the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), the U.S. Centers for Disease Control and Prevention (CDC) works in more than 45 countries and regions to support evidence-based prevention interventions shown to reduce new HIV infections and tailored to meet the distinct needs of diverse communities.
UNDETECTABLE = UNTRANSMITTABLE/TREATMENT AS PREVENTION
Timely diagnosis of HIV infection and sustained antiretroviral treatment increases the quality of life for a person living with HIV and prevents the spread of the virus. Putting a person living with HIV on antiretroviral treatment is the first step towards achieving viral load suppression – a reduction of HIV in the body to undetectable levels. Research shows that suppressing HIV to undetectable levels virtually eliminates transmission of the virus to sexual partners. As of September 30, 2020 as part of PEPFAR, CDC supported antiretroviral treatment for 10.5 million people living with HIV – more than one third of all people on treatment worldwide.
HIV PREVENTION STRATEGIES
HIV transmission can be prevented through highly effective interventions proven to work independently or in combination. In addition to HIV treatment, CDC supports HIV prevention strategies including:
- Prevention of mother-to-child transmission, which keeps a mother on antiretroviral treatment from the period before birth through the end of breastfeeding to suppress her viral load to undetectable levels and virtually eliminate HIV transmission to her child;
- Pre-exposure prophylaxis, antiretroviral medicine taken daily by an HIV-negative individual to lower his or her risk for acquiring HIV through sexual intercourse;
- Voluntary medical male circumcision, a medical procedure that reduces the risk of heterosexual HIV transmission by up to 60 percent.
HIV PREVENTION FOR KEY AND VULNERABLE POPULATIONS
CDC supports targeted HIV prevention, testing, and treatment services for key populations – including men who have sex with men, people who inject drugs, female sex workers, and incarcerated populations – who face greater risks for HIV infection. Globally, key populations bear a disproportionate burden of HIV compared to the general population, and were estimated to account for more than 62 percent of all new HIV infections in 2019. CDC supports community-based efforts to eliminate stigma, discrimination, and other social inequities that are obstacles to HIV prevention among these key and vulnerable populations.
In sub-Saharan Africa, 67 percent of new annual HIV infections among young people occur in adolescent girls and young women. According to the CDC-supported Violence Against Children Surveys in Kenya, Tanzania, Swaziland, and Zimbabwe, one in three adolescent girls reported experiencing some form of sexual violence during childhood. To address this challenge, CDC supports the DREAMS initiative (Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe). This PEPFAR-supported public-private partnership offers a comprehensive set of interventions addressing factors that make girls and young women vulnerable to HIV – including gender-based violence, social isolation, economic disadvantage, discriminatory cultural norms, orphan status, and high rates of school dropouts.
CLOSING REMAINING GAPS
Sustained effort is needed to empower more people to seek HIV prevention, testing, and treatment services, to scale up HIV prevention programs, and to support vulnerable persons who are at increased risk for HIV infection. While effective HIV prevention interventions exist, they remain inaccessible to many populations. CDC continues to focus on reducing stigma and discrimination faced by people living with or at risk for HIV that prevents them from seeking and utilizing HIV prevention, testing, and treatment services.