Dr. Jonathan Mermin
Today, the Centers for Disease Control and Prevention (CDC) published online the National HIV Prevention Progress Report and Progress At-a-Glance, a one-page companion. This new report describes progress toward achieving CDC’s key HIV prevention goals and the challenges that continue to threaten our success.
Using data from CDC HIV surveillance systems, the report shows results for 21 indicators that represent planning, monitoring, and program improvement activities related to three key priorities of the National HIV/AIDS Strategy (NHAS). The Office of National AIDS Policy has issued a separate report describing progress toward meeting the NHAS goals.
Although achieving the nation’s HIV prevention goals fully will not be easy, the report shows some encouraging signs of progress. Sixty-two percent of current targets were met or exceeded. Comparing 2008 to 2010, new HIV infections decreased 15% among heterosexuals, 21% among African American women, and 22% among injection drug users. There was also a promising decline in the HIV transmission rate, which decreased about 9% from 2006-2010. During this time, testing efforts succeeded in increasing the percentage of people living with HIV who know their serostatus from 80.9% to 84.2%, which means that five out of six people living with HIV in 2010 knew their status.
The report also draws attention to indicators for which more improvement is necessary. For example, there are an estimated 180,000 people in the United States living with undiagnosed HIV infection, racial/ethnic disparities persist, and new infections remain unacceptably high and are increasing among gay, bisexual, and other men who have sex with men (MSM). Comparing 2008 and 2010, there was a 12% increase in new infections among MSM and a 22% increase among young MSM aged 13-24 years. In 2009, three out of four persons in medical care had a suppressed viral load, but across all racial and ethnic groups, the 2015 goal was met by white MSM only.
The data presented in the National HIV Prevention Progress Report provide important information on which to reflect on our collective progress and show us our successes, and where we need to do better. Achieving meaningful change does not only take time but sustained effort that responds to the current state of the epidemic as it changes over time. The annual targets used to evaluate progress in this and future reports take into account the time needed for program planning, start-up activities, and effects of large-scale programmatic changes. CDC is working with grantees and partners to more fully implement High Impact Prevention (HIP) in the programs conducted by health departments and community-based organizations around the country.
Other CDC activities include innovative testing programs for MSM, HIV testing in pharmacies, tailored awareness campaigns through Act Against AIDS, and interventions aimed at increasing linkage to care and medical adherence as well as working to determine how pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) can most effectively be used in the United States. CDC expects that progress will continue because of the number of prevention and control tools now in place, as well as improved access to health care for people living with HIV and those at-risk for infection through the Affordable Care Act.
To reach the 2015 goals, accelerated progress will be needed nationally and locally. It is critical that we remain collectively vigilant in implementing NHAS and HIP strategies and continue to work together to make every prevention dollar count. Thank you for your ongoing work in HIV and AIDS prevention.