Centers for Disease Control and Prevention Burden of HIV in the United States 12 M 50K 12 million people living with HIV Approximately 50000 new infections annually ID: 703228
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Slide1
HIV Prevention:A Winnable Battle
Centers for Disease Control and PreventionSlide2
Burden of HIV in the United States 1.2 M ~50K
1.2 million people living with HIV Approximately
50,000 new infections annually
86% 4 in 10 3 in 1086% of people living with HIV 4 in 10 people living with HIV 3 in 10 people living know their diagnosis are in HIV medical Care with HIV achieved viral suppression Slide3
HIV Prevalence and New Infections1980-2011Number of people living with HIV has grown because
incidence is relatively stable and survival has increased
Hall HI et al.
JAMA
2008 Aug 6;300(5):520-9; Prejean J et al PLoS One 2011;6(8):e17502; MMWR 2012 Mar 2;61(8):133-8Slide4
Burden of HIV in the United States Lifetime treatment costs of ~$400,000
ART
People living with HIV who start antiretroviral treatment (ART) early are now expected to live at least an additional 39 years Slide5
Note.
Data include persons with a diagnosis of HIV infection regardless of stage of disease at diagnosis. All displayed data have been statistically adjusted to account for reporting delays, but not for incomplete reporting.
Rates of Diagnoses of HIV Infection
among People
2011—United States and 6 Dependent AreasN = 50,007 Total Rate = 19.1
American Samoa &
GuamNorthern Mariana Islands
Puerto RicoRepublic of PalauU.S. Virgin Islands
0.00.05.328.6
0.0
39.5
9.6
6.6
3.4
4.6
17.7
3.0
13.3
8.6
24.5
5.0
7.2
20.9
10.0
16.2
33.2
31.4
9.4
36.6
25.3
11.2
20.8
22.0
17.3
9.5
9.6
30.1
12.6
5.7
4.3
6.2
5.1
2.6
3.8
10.7
Rates per 100,000 population
<10.0
10.0 – 19.9
20.0 – 29.9
≥30.0
4.5
22.5
14.0
14.2
21.1
16.7
36.4
177.9
20.0
5.2
14.3
19.2
2.6
8.0
9.5
6.8
2.3
VT
NH
MA
RI
CT
NJ
DE
MD
DCSlide6
Stark disparities in HIV and AIDS among different groups95% of people with HIV are men who have sex with men (MSM), African Americans, Latinos, or injection drug users (IDU)MSM are >40 times more likely to have HIV than other men and women
African American men and women are 8 times more likely than whites to have HIV
Latino men and women are 3 times more likely to have HIV than whites
CDC, HIV Surveillance Report,2008. Published June 2010. www.cdc.gov/hiv/surveillance/resources/reports
MSM = Men having sex with menIDU = Intravenous drug usersSlide7Slide8
Diagnoses of HIV Infection and Populationby Race/Ethnicity, 2013—United States
Note
. Data include persons with a diagnosis of HIV infection regardless of stage of disease at diagnosis. All displayed data have been statistically adjusted to account for reporting delays, but not for incomplete reporting.
a
Hispanics/Latinos can be of any race. Slide9
HIV prevention worksSaves lives and moneyCollective prevention efforts have led to a dramatic reduction in HIV infections130,000 estimated new HIV infections per year in 1985 47,500 new HIV infections in 2010
Conservative estimates are that prevention efforts have:
Averted more than 350,000 HIV infections in the United States
Saved more than $125 billion in medical costs
Reducing incidence by 25% In 10 years would save 62,000 infections and $23 billion In 5 years would prevent 109,000 infections and $42 billionSource: Holtgrave DR. Written testimony on HIV/AIDS incidence and prevention for the US House of Representatives Committee on Oversight and Government Reform. September 16, 2008.Slide10
What can be done to reduce HIV
infections? Slide11
A National Call for HIV PreventionThe White House released the National HIV/AIDS Strategy (NHAS) on July 13, 2010, as a roadmap
for all public and private stake-holders to align their efforts with the following goals:
Decrease
incidence of HIV
Increase access to care and improve health outcomes for people with HIVReduce HIV-related health disparitiesSlide12
High-Impact Prevention (HIP) To achieve the goals of NHAS, CDC and its partners are pursuing a high-impact prevention (HIP) approach to reduce new HIV infections by
using
scientifically proven, cost-effective, and scalable
interventions; and
targeting those interventions to the right populations (men having sex with men, African Americans, Hispanics/Latinos, Injection drug Users and Transgender individuals) in the right geographic areas.Available for download at: http://www.cdc.gov/hiv/policies/hip.html Slide13
HIV Prevention InterventionsHIV testing and linkage to careAntiretroviral therapyAccess to condoms and sterile syringesPrevention programs for people living with HIV and their partnersPrevention programs for people at high risk for HIV infectionSubstance abuse treatmentScreening and treatment for other sexually transmitted infectionsSlide14
HIV Care Continuum Shows Improvements are NeededSlide15
Testing and DiagnosisWhen people learn they are infected, they take steps to protect their own health and prevent HIV transmission to others.14% (168,000) of people with HIV are undiagnosed 86% (1,032,000) have been diagnosed with HIVMore likely than undiagnosed to access prevention and treatment
Sources: CDC National HIV Surveillance System and Medical Monitoring Project, 2011.Slide16
Linkage to and Engagement in CareLinkage to care helps ensure people living with HIV receive life-saving medical care and treatment, and helps reduce their risk of transmitting HIV.40% of people living with HIV have received regular HIV medical care.Once in medical care, people get HIV medicines and prevention services to help them stay healthy and protect their partners.Slide17
Antiretroviral TherapyTreating people living with HIV early in their infection improves their health, prolongs their lives and dramatically reduces the risk of transmitting the virus to others.Only 37% of people living with HIV are prescribed HIV medicinesOf patients in HIV medical care, 92% are prescribed HIV medicinesOnly 30% of people living with HIV have achieved viral suppression
Of patients in HIV medical care, 76% achieve viral suppression
Antiretroviral
drugs (ARVs):
Reduce risk of perinatal transmissionReduce infectiousnessKeep immune systems functioning properlyPrevent opportunistic infections and Slow down the progression of HIV to AIDS Slide18
Access to Condoms and Sterile SyringesIn order for HIV prevention efforts to work, people who are living with, or at risk for, HIV infection need access to effective prevention tools. Research shows that increasing the availability of condoms and sterile syringes is associated with reductions in HIV risk.Slide19
Prevention Programs for People Living with HIV and their PartnersIndividual and small-group interventions reduce risk behaviors among people living with HIV to help ensure they do not transmit the virus to others.Partner services reduce the spread of HIV by confidentially identifying and notifying partners who may have been unknowingly exposed to HIV, providing them with HIV testing, and linking them to care.Slide20
Prevention Programs for High-Risk PopulationsIndividual, small-group, and community interventions for people who are at high risk of HIV infection can reduce risk behavior and play an important role in many HIV prevention strategies. Support targeted efforts to prevent new infections in persons who are lesbian, gay
, bisexual, transgender (LGBT), and other men who have sex with men (MSM),
to ensure they
are diagnosed early and remain in care, when infected
.Slide21
Substance Abuse TreatmentEffective substance abuse treatment that helps drug users stop injecting eliminates the risk of HIV transmission through injection drug use.Slide22
STI Screening & Treatment InterventionsMany sexually transmitted infections (STIs) increase an individual's risk of acquiring and transmitting HIV, and STI treatment may reduce HIV viral load.STI screening and treatment may reduce risk for HIV transmission. Slide23
New Powerful Prevention ToolsPre-exposure prophylaxis (PrEP):Allows
HIV-uninfected people who are at substantial risk of getting
HIV to take
a pill
dailyPotential Users: sexual partner who has HIV, multiple partners, frequent STDs, or other evidence of high riskFederal PrEP Guidelines issued May 2014Non-occupational Post-exposure prophylaxis (nPEP):Involves taking medicines no more than 72 hours (3 days) after you may have been exposed to HIVSlide24
Act Against AIDS™ National Umbrella Program
Provider
Campaigns
Consumer
CampaignsPartnerships & Community Engagement
Increase information-seeking behaviors, knowledge and awareness about HIV
Increase targeted behavior change, including HIV prevention and testing,
for high-risk populations and physicians who serve those populations
Provide national, credible leadership in HIV preventionSlide25
Raising AwarenessCampaign MaterialsAwareness Day Materials
Websites
CDC
Info
Weekly Electronic PublicationsConference ExhibitingSlide26
“The United States will become a place where new HIV infections are rare and when they do occur, every person, regardless of age, gender, race/ethnicity, sexual orientation, gender identity or socio-economic circumstance, will have unfettered access to high quality, life-extending care, free from stigma and discrimination.”—Vision of the National HIV/AIDS Strategy