We are now in the third decade of the HIV/AIDS epidemic and although HIV prevention efforts have grown substantially over time and we have made important progress, major unmet needs remain. HIV continues to pose a significant threat to Americans’ health and well-being, with African Americans and men who have sex with men (MSM) of all races most severely affected. While African Americans account for 13 percent of the population, they account for nearly half of HIV diagnoses in 2005 (49% in 33 states with longstanding confidential name-based reporting) and nearly half of the people estimated to be living with HIV (47%). MSM also account for half of new HIV diagnoses in 2005 (49% in the 33 states with confidential name-based reporting) and nearly half of people estimated to be living with HIV (45%).

Reducing the toll of HIV among these groups requires a collaborative and intensive effort by government, partners, and the private and public sectors. The Centers for Disease Control and Prevention (CDC) is intensifying its own efforts to address the epidemic among African Americans and MSM. Targeted initiatives are underway, new HIV testing recommendations have been published, and new partnerships with community leaders have been established. CDC will continue to direct the majority of its resources to strategies, programs, and research for groups disproportionately affected by the epidemic and is working to expand the use of proven interventions and develop new approaches for reaching these populations.

There is no simple solution for eliminating HIV in the U.S. A complex set of historical, structural, environmental, and cultural factors – including racism, discrimination, poverty, denial, stigma, homophobia, and limited access to health care address the HIV/AIDS epidemic among disproportionately affected populations such as MSM and communities of color. Addressing these factors can have an important impact on the HIV epidemic.

CDC’s HIV Prevention Strategic Plan Through 2005 (2001 Plan) has served as a valuable guide for CDC action. CDC has used the 2001 Plan to identify needs for new and expanded prevention programs and initiatives, establish priorities, and direct and target resources. Importantly, the 2001 Plan established a vision not only for CDC, but for the nation as a whole. It set forth an overarching public health goal of cutting new HIV infections in half—providing a vision of what could be accomplished with a significantly expanded investment in HIV prevention in the United States and with the full implementation of the activities outlined. While the 2001 Plan was never fully implemented and progress did not accelerate at the desired rate through 2005, CDC remains committed to the aspirational goal of major reductions in HIV infection. CDC will therefore work with a range of partners to update the 2001 Plan and its overarching goals and develop a new long-range plan to guide the nation through 2020.

In the interim, CDC has developed the HIV Prevention Strategic Plan: Extended Through 2010 (Extended Plan) to guide the agency’s efforts for the next 3 years and to define a realistic, short-term goal at a time when challenges have increased and resources for prevention are not commensurate with prevention needs. Since 2001, HIV diagnoses and risk behaviors have increased among MSM; syphilis rates have increased nationally; and more people are living with HIV than ever before – many of whom are unaware of their infection – which increases the potential for continued HIV transmission. While prevention needs have actually increased, treatment advances have unfortunately contributed to a sense of complacency about the seriousness of HIV/AIDS. An extended strategic plan to address these challenges is essential. The short-term goal and milestones in this Extended Plan were endorsed by the CDC /HRSA Advisory Committee on HIV and STD Prevention and Treatment (CHAC).

This Extended Plan maintains the focus on core prevention priorities expressed in the 2001 Plan: reducing the number of new infections, increasing knowledge of HIV status, and promoting linkages to care, treatment, and prevention services. In addition, new objectives have been added to make urgent priorities more explicit, including: preventing new HIV infections among MSM and African Americans; addressing stigma and discrimination; promoting the use of rapid HIV tests; addressing the role of acute infection in HIV transmission; and increasing routine HIV testing in medical settings.

CDC is dedicated to helping people live longer, healthier lives by preventing new HIV infections and protecting the health of those already infected. While continuing to challenge us as a nation, CDC believes the short-term goal and milestones outlined in this Extended Plan can be achieved through the implementation of refined and targeted approaches.