Strategy Implementation

STEP 1.A: Intensify HIV prevention efforts in the communities where HIV is most heavily concentrated.

• Allocate public funding consistent with geographic distribution of the epidemic.
• Focus on high-risk populations.
• Maintain HIV prevention in populations at risk but that have a low national burden of HIV.

STEP 1.B: Expand efforts to prevent HIV infection using a combination of effective, evidence-based approaches.

• Design and evaluate innovative prevention strategies and combination approaches for preventing HIV infection in high-risk populations and communities, and prioritize and promote research to fill gaps in HIV prevention science among the highest risk populations and communities.
• Support and strengthen integrated and patient-centered HIV and related screening (sexually transmitted infections, substance use, mental health, intimate partner violence, viral hepatitis infections) and linkage to basic services (housing, education, employment).
• Expand access to effective prevention services, including pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP).
• Expand prevention with persons with HIV.

STEP 1.C: Educate all Americans with easily accessible, scientifically accurate information about HIV risks, prevention, and transmission.

• Provide clear, specific, consistent, and scientifically up-to-date messages about HIV risks and prevention strategies.
• Utilize evidence-based social marketing and education campaigns, and leverage digital tools and new technologies.
• Promote age-appropriate HIV and STI prevention education for all Americans.
• Expand public outreach, education, and prevention efforts on HIV and intersecting issues, such as intimate partner violence.
• Tackle misperceptions, stigma, and discrimination to break down barriers to HIV prevention, testing, and care.

STEP 2.A: Establish seamless systems to link people to care immediately after diagnosis, and support retention in care to achieve viral suppression that can maximize the benefits of early treatment and reduce transmission risk.

• Ensure continuity of high-quality comprehensive health care coverage to support access to HIV care.
• Ensure linkage to HIV medical care and improve retention in care for people living with HIV.
• Support and strengthen capacity to implement innovative and culturally appropriate models to more effectively deliver care along the care continuum.
• Prioritize and promote research to fill gaps in knowledge along the care continuum.
• Provide information, resources, and technical assistance to strengthen the delivery of services along the care continuum, particularly at the State, Tribal, and local levels.

STEP 2.B: Take deliberate steps to increase the capacity of systems as well as the number and diversity of available providers of clinical care and related services for people living with HIV.

• Increase the number of available providers of HIV care.
• Strengthen the current provider workforce to ensure access to and quality of care.
• Support screening for and referral to substance abuse and mental health services for people living with HIV.

STEP 2.C: Support comprehensive, coordinated patient-centered care for people living with HIV, including addressing HIV-related co-occurring conditions and challenges meeting basic needs, such as housing.

• Address policies to promote access to housing and supportive services for people living with HIV.
• Improve outcomes for women in HIV care by addressing violence and trauma, and factors that increase risk of violence for women and girls living with HIV.

STEP 3.A: Reduce HIV-related disparities in communities at high risk for HIV infection.

• Expand services to reduce HIV-related disparities experienced by gay and bisexual men (especially young Black gay and bisexual men), Black women, and persons living in the Southern United States.
• Support engagement in care for groups with low levels of viral suppression, including youth and persons who inject drugs.

STEP 3.B: Adopt structural approaches to reduce HIV infections and improve health outcomes in high-risk communities.

• Scale up effective, evidence-based programs that address social determinants of health.
• Support research to better understand the scope of the intersection of HIV and violence against women and girls, and develop effective interventions.

STEP 3.C: Reduce stigma and eliminate discrimination associated with HIV status and services.

• Promote evidence-based public health approaches to HIV prevention and care.
• Strengthen enforcement of civil rights laws, and assist States in protecting people with HIV from violence, retaliation, and discrimination associated with HIV status.
• Mobilize communities to reduce HIV-related stigma.
• Promote public leadership of people living with HIV.

STEP 4.A: Increase the coordination of HIV programs across the Federal government and between Federal agencies and State, territorial, tribal, and local governments.

• Streamline reporting requirements for Federal grantees.
• Strengthen coordination across data systems, and the use of data to improve health outcomes and monitor use of Federal funds.
• Ensure coordinated program planning and administration.
• Promote resource allocation that has the greatest impact on achieving the Strategy goals.

STEP 4.B: Develop improved mechanisms to monitor and report on progress toward achieving national goals.

• Strengthen the timely availability and use of data.
• Provide regular public reporting on Strategy goals.
• Enhance program accountability.