CDC funds expand HIV prevention effort

Hard hit areas, risk groups targeted

The Centers for Disease Control and Prevention is issuing $11.6 million in grants to support demonstration projects that implement a combination approach to HIV prevention — inclusive of treatment, care, and social services — in 12 hard-hit areas across the country.

Each funded jurisdiction will work with CDC to determine what mix of HIV prevention approaches can have the greatest impact in the local area, supplementing existing programs in these communities and helping jurisdictions to better focus efforts on key at-risk populations and fulfill unmet needs. Efforts will follow a basic approach of intensifying prevention for persons at greatest risk, and testing them to reduce undiagnosed HIV infection; prioritizing linkage to prevention, care, and treatment services for people living with HIV; and directing these intensified efforts to communities with the highest burden of HIV.

The remainder of the resources will allow CDC and our partners to expand upon successful existing efforts, as well as fill knowledge gaps to help guide evidence-based policies and approaches as a part of the NHAS by

  • Increasing HIV testing: $4.4 million will allow CDC to further expand its successful HIV testing initiative.
  • Filling critical data gaps: $5.6 million will enhance local area data collection, and provide critical information to better monitor and target future HIV prevention and treatment programs.
  • Supporting evaluation for new activities: $6.6 million will support evaluation and monitoring of combination prevention approaches and other activities. Funding will also establish a web-based survey to more quickly identify and respond to trends in risk behavior and exposure to HIV prevention services among gay and bisexual men.
  • Prioritizing underserved populations: $1 million will support work with tribal communities to improve HIV prevention and program integration for American Indians and Alaska Natives.

Expanded testing

In other HIV funding developments, on September 30, 2010 health departments in 30 jurisdictions with the highest burden of AIDS among populations hardest hit by the HIV epidemic began using funds awarded under FOA PS10-10138: Expanded HIV Testing for Disproportionately Affected Populations. The purpose of this program is to expand routine HIV testing services for African American and Hispanic men and women, men who have sex with men (MSM) and injection drug users (IDUs) of all races and ethnicities. This program represents one of the ways the CDC is trying to help state and local health care providers:

  • make HIV testing routine and advance diffusion and implementation of CDC's 2006 Revised Recommendations for HIV Testing of Adults, Adolescents, and Pregnant Women in Health-Care Settings;
  • identify more HIV-positive persons in these disproportionately affected populations, and increase the proportion of persons who are aware of their infection;
  • expand HIV counseling, testing, and referral services in non-clinical settings or venues — such as homeless shelters, bars, syringe exchange programs, and Gay Pride events — where members of these populations at highest risk for HIV infection can be reached; and
  • integrate HIV testing with testing and prevention services for other infections, such as other sexually transmitted diseases (STDs), hepatitis B and C viruses, and tuberculosis.

The program — by placing greater emphasis on post-test services for both persons who are newly diagnosed with HIV infection and persons who have previously tested positive for HIV, but were not successfully linked to or retained in care — can better address the continuum of services and programmatic activities needed to translate increases in routine HIV screening into community-level decreases in HIV transmission, undiagnosed infections, and HIV-associated morbidity and mortality.

This phase substantially extends the geographic and demographic reach of the initial phase of CDC's expanded testing program, first funded in 2007. More funding boosts the number of funded jurisdictions from 25 in 2007 to 30 for the three-year project period that has just begun. These jurisdictions now have greater support to monitor and evaluate their programs; market routine HIV screening to both patients and providers; and link persons diagnosed with HIV infection to critical prevention, treatment, and social services.

In the first two years of the initial three-year testing program, more than 1.4 million persons were tested for HIV infection; of the more than 10,500 HIV-infected persons newly diagnosed, 75% were linked to care.