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The release of the first estimates from our nation’s new
HIV incidence surveillance system reveal that the HIV
epidemic in the United States is—and has been—worse than
previously estimated. CDC estimates that 56,300 new HIV
infections occurred in the United States in 2006.
Even though the 2006 estimate does not represent an actual
increase in the annual number of new infections, but rather,
a better way of estimating this number, it is a sobering
reminder that the HIV/AIDS epidemic is far from over
in this country. A separate CDC historical trend analysis
suggests that the number of new HIV infections was never
as low as the previous estimate of 40,000 new infections
annually and has been roughly stable since the early 2000s.
The new estimates provide a profile of HIV/AIDS in the
United States that is primarily young, male, and African
American. The epidemic also disproportionately affects
Hispanic and Latinos; particularly Hispanic and Latino men
who have sex with men (MSM). Indeed, gay and bisexual
men of all races and ethnicities are the most affected of any
group of Americans.
We, as a nation, must all agree that it is not acceptable for
HIV and AIDS to become a rite of passage for gay and
bisexual young men; that it is not acceptable for HIV and
AIDS to continue to over-burden African American and
Hispanic/Latino communities; and that it is not acceptable
for any young American to grow up without the knowledge,
skills, confidence and motivation necessary to protect
themselves against HIV for their entire lifetimes. To guard
against these unacceptable outcomes, the HIV/AIDS
epidemic in the United States must be met with an even
greater sense of commitment, purpose, and urgency by all
Americans.
What CDC is Doing Now
CDC, working in partnership with state and local health
departments, national and regional organizations, and
community-based organizations, is already engaged on many
fronts in fighting the HIV/AIDS epidemic. CDC supports a
wide range of science-based activities to monitor the course of HIV/AIDS in the United States, expand the reach of HIV
testing, increase the number and reach of effective HIV
prevention programs for persons living with HIV and at risk
for HIV infection, and assess the impact of these efforts. For
example CDC is working to:
- ensure that the allocation of resources at state and local
health departments matches the local epidemics and to
provide health departments with resources that can fill in
chronic gaps in their prevention programs. For example,
additional funds were provided to health departments in
2008 to build capacity of prevention efforts for gay and
bisexual men.
- reduce the number of infected Americans who do not
know their HIV status, including increasing HIV testing
in the areas with the highest rates of HIV/AIDS among
African Americans.
- strengthen our prevention focus regarding the
HIV epidemic in Latino communities, including
the establishment of a Hispanic/Latino Executive
Committee (HLEC) in May 2007.
- increase the number of behavioral interventions with
proven effectiveness by conducting research to develop
new behavioral interventions for communities hardest
hit by the epidemic. D-Up!, which was developed by
black MSM for black MSM to reduce HIV risk by
promoting healthy social norms, is an example. CDC
is also expanding training and technical assistance for
interventions already proven effective.
- develop and widely implement social marketing
campaigns designed to increase knowledge of HIV
status and to promote HIV risk reduction. One such
campaign - Take Charge, Take the Test - has been
shown to increase HIV testing among African American
women. Another campaign for gay and bisexual men
is underway.
- develop effective biomedical interventions that can
reduce HIV transmission, by studying the feasibility and
effectiveness of pre-exposure prophylaxis in various
populations and evaluating microbicides and circumcision
to determine the role they can play in HIV prevention.
- build and sustain effective partnerships, such as the partnerships formed as a part
of the Heightened National Response to the Crisis of HIV/AIDS among African
Americans (HNR), in order to mobilize communities against HIV/AIDS, change
community perceptions about HIV/AIDS, challenge the stigma associated
with HIV/AIDS, motivate people to seek early HIV diagnosis and
treatment, and encourage healthy behaviors that prevent the spread of
HIV.
- improve the implementation of a comprehensive program monitoring system that
will increase our nation’s ability to monitor HIV prevention programs and their
impact, and to increase accountability for ensuring that scarce prevention resources
are being directed to those areas most in need of prevention interventions and
services.
- continue working with health economists to develop a resource allocation model
that uses information from the new HIV incidence surveillance system to evaluate
ways we can achieve a greater impact with the prevention strategies and resources
currently available.
What CDC Will Do
In addition to these efforts that are already underway, CDC is taking additional steps
to respond to the more urgent picture of the U.S. HIV/AIDS epidemic provided by the
new HIV incidence estimates.
- CDC has already begun work on appointing an independent panel of national
experts who will review our HIV surveillance, research, and program efforts and
make recommendations for the future. This review will be initiated in 2008 and
will be completed by mid-2009. A report from this review will be made available
to the public.
- These recommendations will form the foundation for the development of a clear
and strategic road map for HIV prevention, with measurable objectives, that will
guide CDC’s efforts through the year 2020.
- In addition, recognizing the need for a more comprehensive national plan to
address HIV/AIDS in the United States, CDC supports the call for development
of a comprehensive national HIV plan for the United States and looks forward to
actively participating in its development.
- CDC is committed to continue to expand, reassess, and improve its efforts to
address HIV/AIDS among African Americans, Hispanics and Latinos, and gay and
bisexual men of all races and ethnicities by intensifying efforts to reach out to and
mobilize members of these disproportionately affected communities.
- CDC will work to further expand HIV testing and implement HIV testing programs
in ways that most efficiently and cost-effectively reach persons with undiagnosed
HIV infection and successfully link them to partner services and medical care.
And yet, even with all of these activities, more needs to be done. We know how to
end the US HIV epidemic in our lifetimes – hundreds of studies have shown that
current prevention strategies work. The problem is one of scale. Only by scaling up
prevention efforts to match the magnitude of the epidemic will we be able to ensure
that HIV isn’t a fact of life for so many Americans. We all must agree that it is possible,
firmly commit to making it happen, and work together to transform our collective
commitment into reality.
For more information on HIV incidence estimates, visit
HIV Incidence website.
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