Introduction

HIV Prevention in the United States: Mobilizing to End the Epidemic

Introduction

Today, we have an unprecedented opportunity to end America's HIV epidemic.

HIV prevention and treatment have brought the annual number of new HIV infections to an all-time low since the start of the epidemic.1 People with HIV can live long, healthy lives thanks to improved antiretroviral therapy. Powerful prevention tools – including simple and effective HIV treatment and pre-exposure prophylaxis (PrEP) – can practically eliminate transmission if used by all who need them. Improvements in HIV surveillance mean we can identify and respond to potential outbreaks more effectively than ever.

Yet progress in HIV prevention has slowed. Many people still aren’t getting the prevention and care they need. The nation’s opioid crisis poses a continual threat of new HIV outbreaks due to injection drug use.2 While the full impact of the global COVID-19 pandemic on our HIV prevention efforts is unclear, it has thrown into sharp relief the extent to which longstanding, systemic health and social inequities among different racial/ethnic groups negatively affect health outcomes.

For far too long, these inequities – including discrimination, stigma, income, systemic racism, and mistrust of the health care system – have led to persistent disparities in HIV risk, prevention, treatment, and care, particularly for Black/African American and Hispanic/Latino people. Without bold action to address these challenges today, we could see an increase in HIV in the United States.

As the nation’s lead HIV prevention agency, CDC is working with partners to achieve dramatic new declines in HIV infections.

GOAL:

Reduce new HIV infections by 90% by 2030

Ending the HIV Epidemic Initiative

Launched in early 2019 by the Department of Health and Human Services (HHS), this federal initiative aims to reduce new HIV infections in the United States by 90 percent by 2030.

Through the initiative, CDC and other federal agencies will provide a targeted infusion of new resources, technology and expertise to expand HIV prevention and treatment activities. For the first five years, the initiative prioritizes 50 local areas that account for more than half of new HIV diagnoses (48 counties; San Juan, Puerto Rico; and Washington, D.C.), and seven states with a substantial rural burden.

The initiative focuses on four key strategies:

diagnose

DIAGNOSE all people with HIV as early as possible.

treat

TREAT people with HIV rapidly and effectively to reach sustained viral suppression.

prevent

PREVENT new HIV transmissions using proven interventions, including PrEP and syringe service programs (SSPs).

respond

RESPOND quickly to potential HIV outbreaks to get needed prevention and treatment services to people who need them.

Additional information about the initiative is available at www.cdc.gov/endHIV.

Together with other federal agencies, state and local governments, people with HIV, individuals who could benefit from biomedical and other prevention strategies, and the organizations and leaders in their communities, CDC aims to:

  • Infuse the hardest hit communities with resources, technology, innovation, and expertise to strengthen prevention and care;
  • Ensure that affected communities and people with HIV have a powerful voice in shaping prevention programs;
  • Confront stigma, and other societal barriers to delivering HIV prevention and care; and
  • Monitor our collective impact and hold each other accountable for progress.

The federal initiative, Ending the HIV Epidemic, advances all of these approaches by bolstering CDC’s long-standing partnerships with state and local health departments and affected communities.

But federal initiatives alone will not be sufficient. Ending the HIV epidemic requires leadership from all corners and engagement from local communities. The disease has cost our nation too much – in lives lost and dollars spent – to not embrace today’s opportunity.

The time to act is now.