Although progress has not accelerated at the desired rate, there has been significant progress and movement in HIV prevention and hope for the future. Many people – both infected and uninfected – are being reached by prevention programs and engaging in safer behaviors:

• One of the most obvious achievements in HIV prevention is the dramatic decline in mother-to-child HIV transmission. While there were 1,650 documented cases of mother-to-child transmission in 1991, today there are estimated to be fewer than 150 cases each year.
• There have been declines in risk behavior among youth. From 1991-2005, the proportion of youth who reported engaging in sexual intercourse decreased from 54 percent to 47 percent. During the same time period, the proportion of youth who reported using condoms increased from 46 percent to 63 percent.
• In September 2006, CDC published “Revised Recommendations for HIV Testing of Adults, Adolescents and Pregnant Women in Health-Care Settings” to make voluntary HIV testing a routine part of medical care for Americans aged 13-64. These Revised Recommendations are a major step forward in reducing HIV acquisition and transmission and allowing people to know their HIV status.
• Rapid HIV testing technology, combined with innovative approaches, is showing promising results. Several rapid testing demonstration projects funded by CDC as part of the 2003 initiative, “Advancing HIV Prevention: New Strategies for a Changing Epidemic,” report increased numbers of tests and increased proportions of persons receiving their test results, and a high percentage of persons knowing their HIV infection. This is a sign of significant progress in increasing Americans’ knowledge of their HIV status.
• There has been a strong commitment among men who have sex with men (MSM) to address threats to HIV prevention, such as methamphetamine use.
• Studies repeatedly show that the majority of HIV-infected persons take steps to protect partners and prevent HIV transmission, once they know they are infected.

In addition, the focus on eliminating racial and ethnic disparities in new HIV infection rates has led CDC to better target prevention approaches. For example, through the Minority AIDS Initiative (MAI) CDC has continued to directly fund minority- serving community-based organizations (CBOs) for HIV prevention in communities of color. MAI funding has greatly enhanced CDC’s ability to provide resources directly to CBOs located in and serving minority communities, and has enhanced CDC’s ability to provide a range of services to disproportionately affected racial and ethnic communities.

CDC also realigned prevention programs that focus on persons at highest risk for transmitting HIV; conducted applied research to identify and evaluate evidence-based prevention interventions that have been shown to reduce risk behaviors; supported dissemination of effective interventions; implemented population-based behavioral surveillance and an HIV incidence surveillance system to supplement HIV/AIDS case surveillance; established strong linkages for prevention and quality medical care services; promoted rapid HIV testing in both clinical and non-clinical settings; and launched new efforts to enhance prevention services for persons living with HIV and to develop new strategies to diagnose HIV infection. Most recently, CDC directed $45 million of 2007 agency funds to expand access to HIV testing among disproportionately affected populations, particularly African-Americans.