An estimated 35 million people are living with HIV/AIDS worldwide. New HIV infections are declining globally, with nearly three-fourths of the 2.3 million new HIV infections worldwide occurring in sub-Saharan African countries. As a science-based public health and disease prevention agency, CDC provides support to more than 70 countries to strengthen their national HIV/AIDS programs and build sustainable public health systems through the U.S. President's Emergency Plan for AIDS Relief (PEPFAR). CDC works side-by-side with Ministries of Health in these countries and with other partners to implement sustainable HIV/AIDS interventions and to measure their effectiveness in reducing infections and death from HIV/AIDS.
This year, CDC and PEPFAR celebrate a decade of success in fighting global HIV/AIDS. It's been an incredible journey of progress and renewed hope. For the past few decades, this modern-day plague has been devastating the health of millions of people around the world, bringing despair and creating such social and economic instability—particularly in Africa—that in 2000 the UN Security Council identified HIV as a global security threat.
Today, we have much to celebrate: increased life expectancy in much of Africa; antiretroviral treatment for millions, including HIV-positive parents who are now able to return to work and care for their families; and declining AIDS-related deaths worldwide. In June of this year, Secretary of State John Kerry announced that PEPFAR-supported interventions have led to the prevention of HIV infections in 1 million babies. The annual estimated number of new pediatric HIV infections dropped by nearly 50% over the past 10 years, a significant achievement largely due to evidence-based programming for preventing mother-to-child HIV transmission.
CDC contributions have played a critically important part in these tremendous accomplishments. Throughout the decade, CDC has been advancing science and innovation, and making strategic investments to build the capacity of host countries to lead their own epidemic response.
The next 10 years will be equally pivotal as CDC continues to implement the evidence-based biomedical interventions that will help lead to an AIDS-free generation. This inspiring goal is possible only if all partners share responsibility. CDC continues to work with countries to build their technical and operational capacity for leading and sustaining their national responses. Indigenous partner investments have increased to nearly 60% over the last decade, ensuring shared responsibility. CDC also works with key global partners around the world such as the Global Fund to Fight AIDS, Tuberculosis and Malaria -- to which the United States is the largest contributor -- to ensure complementary programming for maximum impact of investments.
Our Domestic Response
In the United States, efforts to curb the HIV epidemic through testing, prevention, and treatment are bolstered by newer biomedical options. CDC works to promote these efforts in the communities most at risk; however, the overall infection rate is still too high, especially for some groups. Of the 47,500 people newly infected in 2010, for example:
- 63% were men who have sex with men (MSM), who make up only 2% of the population.
- 44% were African Americans, who make up only 14% of the population.
To bring these numbers down, CDC is expanding HIV prevention services for young gay and bisexual men of color, transgender youth of color, and their partners. In 2011, for example, CDC awarded $55 million over 5 years to 34 community-based organizations with strong links to these populations. This funding is being used to provide HIV testing to more than 90,000 young gay and bisexual men and transgender youth of color, with a goal of identifying more than 3,500 previously unrecognized HIV infections and linking those who are HIV infected to care and prevention services. Additionally, CDC's MSM Testing Initiative seeks to identify at least 3,000 MSM with HIV who were previously unaware of their infection and link at least 85% of them to care.
HIV testing in the United States has never been easier. Rapid tests are offered in clinics and in many other settings—like gay pride events or community-based organizations—with results in as little as 20 minutes. Two home testing kits are also available online or from drugstores. CDC recommends that everyone between the ages of 13 and 64 be tested at least once and that those at higher risk get tested at least once a year. Gay and bisexual men may benefit from getting tested more often, such as every 3 to 6 months.
CDC is also encouraging people at high risk for HIV to be aware of biomedical approaches to HIV prevention. Pre-exposure prophylaxis (PrEP), which involves taking antiretroviral medicines before becoming exposed to HIV, can reduce the risk of HIV infection in people who routinely have unprotected sex with someone who may be HIV-positive. Post-exposure prophylaxis (PEP), which involves taking antiretroviral medicines right away after possible exposure to HIV, also plays a role in HIV prevention. Neither PrEP nor PEP should be considered a substitute for other proven prevention methods, such as correct and consistent condom use.
For people who are HIV-positive, ART not only can improve their health dramatically but also has prevention benefits: people whose HIV viral loads are suppressed have a reduced chance of transmitting the virus to their partners. But only one in four HIV-positive people in the United States has a suppressed viral load. Although linkage to care soon after HIV diagnosis is relatively high, more people living with HIV should receive continuous care and antiretroviral treatment that leads to suppressed viral load. The new HIV Care Continuum Initiative will work to reduce the drop-offs along the continuum of care and increase the proportion of people who have the virus effectively controlled.
Domestically, CDC supports efforts to promote testing, prevention, and treatment through its Act Against AIDS communications campaigns. Its newest campaign, REASONS/RAZONES, promotes testing for Latino gay and bisexual men. Other recent campaigns focus on testing and awareness for African American gay men (Testing Makes Us Stronger) and general awareness for all Americans (Let's Stop HIV Together).
On this World AIDS Day, CDC continues to bring the best prevention and treatment tools at our disposal to the communities that need them most, at home and around the world. Looking forward, we must be diligent in building on our successes and together, as a global community, redouble our efforts to achieve what is within our grasp—an AIDS-free generation.