Cross-posted from Centers for Disease Control and Prevention
November 30, 2020
December 1 is World AIDS Day, a day to unite in the global response to HIV/AIDS, support people living with HIV, and honor lives lost to the HIV epidemic. The U.S. Government’s theme for this year’s observance, “Ending the HIV Epidemic: Resilience & Impact,” calls for greater commitment, greater resilience, and optimized use of expertise from all of us – both in responding to COVID-19 and our ongoing commitment to ending the HIV epidemic.
We owe a debt of gratitude to healthcare providers and essential workers on the frontline of the response to HIV. Worldwide, we’ve witnessed resilience with people balancing HIV work with competing priorities of the COVID-19 response and yet finding innovative ways to protect the public’s health. There is still much to be done. Today, there are an estimated 1.2 million people living with HIV in the United States and an estimated 37 million worldwide.
In countries supported by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), HIV testing and treatment programs were making progress prior to the emergence of COVID-19. Many countries have achieved or are on the cusp of achieving HIV epidemic control. The onset of the COVID-19 pandemic presented a significant challenge, but many HIV programs and partners quickly pivoted and rapidly innovated operations to ensure continuity of services, including delivery of lifesaving antiretroviral therapy (ART). Program innovations and effective policy changes, including multi-month dispensation of ART and community-based services, sustained HIV treatment and ensured compliance with measures implemented to stem the spread of SARS-CoV-2.
Yet we cannot underestimate the impact of disruptions related to COVID-19 on healthcare system delivery and services particularly in resource-limited settings. With funding from PEPFAR, CDC’s current and historical investments in laboratory systems and infrastructure, workforce development, surveillance systems, and field epidemiology training programs in sub-Saharan Africa are being actively used to mitigate the spread of COVID-19 and other infectious diseases. As programs adapted to COVID-19, HIV treatment was prioritized. Now, we must plan for the rapid recovery and resumption of HIV testing and prevention services – in a responsible and safe way given the current landscape and building from what we have learned during this pandemic.
Fighting disruptions to HIV testing and services along with other challenges brought on by the pandemic, many CDC-funded programs in the United States, including health departments and community-based organizations adopted innovative strategies to deliver HIV services. This has included the use of telehealth to ensure people continue to receive HIV testing services, including self-testing, prevention services, and HIV care and treatment. As an example, in DeKalb County, Georgia, PrEP education follow-up over the phone helps reach a very diverse clinic population and respond to client’s needs.
These creative, community-led solutions are a critical part of the Ending the HIV Epidemic initiative. Innovation and resolve are vital to overcome barriers to testing, treatment, and care – both during the COVID-19 pandemic and beyond. People living with HIV who take ART, as prescribed, can stay virally suppressed and live long, healthy lives with effectively no risk of sexually transmitting HIV to partners. For people who do not have HIV, but who are at risk for getting it, HIV testing can be the bridge to effective prevention tools such as PrEP, condoms, and other HIV prevention services.
CDC and PEPFAR-funded programs have demonstrated that our services can be agile and nimble. We must implement and standardize the lessons that we’ve learned about adaptation and how to reach people successfully, which COVID-19 hastened, to ensure resilient health systems.
This World AIDS Day let us reflect on our accomplishments and refocus on the future. Please join us in encouraging HIV testing, prevention, and treatment in your community. Help us get the word out for World AIDS Day with CDC’s Let’s Stop HIV Together campaign.
Jonathan H. Mermin, M.D., MPH
Rear Admiral and Assistant Surgeon General, USPHS
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
Centers for Disease Control and Prevention
Rebecca Martin, PhD
Center for Global Health
Centers for Disease Control and Prevention