CDC’s HIV Prevention Progress in the United States

The Centers for Disease Control and Prevention (CDC) works with other federal agencies, state and local health departments, national organizations, community-based organizations, the private sector, and advocates to reduce the spread of HIV in the U.S. This work encompasses many components, such as:

• Behavioral interventions, which have proven effective in reducing the risk of acquiring or transmitting HIV. Ensuring people have the information, motivation, and skills necessary to reduce their risk continues to be important.
• HIV testing, which is critical in preventing the spread of HIV. Most people change behaviors to protect their partners if they know they are infected with HIV.
• Linkage to treatment and care, which enables individuals with HIV to live longer, healthier lives and reduce their risk of transmitting HIV. It is imperative that individuals with HIV know their HIV status and are linked to ongoing care and prevention services.

Data about transmission rates, incidence, testing behaviors, and linkages to care all contribute to provide the fullest possible picture about progress in the U.S. battle against HIV.

• More than 309 million people live in the U.S. and more than one million of those people are living with HIV (an estimated 1,106,400 adults and adolescents).
• The HIV transmission rate - the estimated annual number of new HIV infections per 100 persons living with HIV- has decreased over the past two decades.
  • Since the mid-1980s, the transmission rate declined approximately 89% (from 44 transmissions per 100 people with HIV in 1984 to 5 transmissions per 100 people in 2006).
• HIV incidence – the annual number of new HIV infections – has decreased from an estimated high of about 130,000 new infections a year in 1985 to about 56,300 in 2006, despite there being more people every year living with HIV.
• Perinatal HIV infections – those transmitted from mother to child – have decreased from 1,000-2,000 per year in the early 1990s to an estimated 138 per year in 2004.
• HIV infections among injection drug users declined by approximately 80% between 1988 and 2006.
• The proportion of persons who know they are infected with HIV increased from 75% in 2003 to 79% in 2006. In October 2007, CDC launched the Expanded Testing Initiative. In two years,
  • CDC grantees conducted nearly 1.4 million tests.
  • 17,000 persons tested positive for HIV.
    • Of these, 10,500 individuals had no previous diagnosis of HIV.
    • Nearly 6,500 of the 17,000 who tested positive had a previous diagnosis of HIV recorded in surveillance records. Yet many of these individuals were unaware of their diagnosis.
  • Of the more than 10,000 persons newly diagnosed with HIV, 86% received their positive HIV test result, 75% were successfully linked to medical care, and 78% were referred to partner services, so that their partners could be advised of their potential exposure to HIV and counseled to receive HIV testing.

HIV prevention saves lives and money. It is estimated that prevention efforts have averted more than 350,000 HIV infections in the United States (a conservative estimate for the period 1991-2006), as well as more than $125 billion in medical costs. For every HIV infection that is prevented, an estimated $355,000 is saved in the cost of providing lifetime HIV treatment – significant cost-savings for the U.S. federal government that spent an estimated $12.3 billion on HIV care and treatment in 2009, and for the U.S. health care system as a whole.

These successes reflect remarkable efforts by people with HIV, communities at risk, health departments, and other CDC partners. However, CDC recognizes there is much work to be done. There are still over 56,000 new HIV infections occurring annually in the U.S. Further, certain populations continue to be disproportionately affected by HIV – gay, bisexual, and other men who have sex with men (MSM), African Americans, Hispanics/Latinos, and injection drug users – and one HIV infection is estimated to occur every nine and a half minutes in the U.S. Only when all Americans are working together, making tough choices, and scaling efforts to match the scope of the epidemic, will the United States successfully turn the tide of HIV infections.