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Advancing HIV Prevention: New Strategies for a Changing Epidemic

Advancing HIV Prevention: New Strategies for a Changing Epidemic. Sean David Griffiths, M.P.H. National STD Prevention Conference Divisions of HIV/AIDS Prevention Centers for Disease Control and Prevention March 11, 2004. Advancing HIV Prevention (AHP). What is the new initiative?

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Advancing HIV Prevention: New Strategies for a Changing Epidemic

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  1. Advancing HIV Prevention: New Strategies for a Changing Epidemic Sean David Griffiths, M.P.H. National STD Prevention Conference Divisions of HIV/AIDS Prevention Centers for Disease Control and Prevention March 11, 2004

  2. Advancing HIV Prevention (AHP) • What is the new initiative? • Why a new initiative? • What are the strategies? • How does it impact/change our work in HIV prevention?

  3. Advancing HIV Preventionis aimed at reducing barriers to early diagnosis of HIV infection and increasing access to and utilization of quality medical care, treatment, and ongoing prevention services for those living with HIV Goal is to reduce HIV transmission A component of CDC’s overall prevention portfolio What is the Initiative?

  4. Why AHP Now? • Stable morbidity and mortality • Increasing number of persons living with HIV • Concerns about possible increases in HIV incidence and syphilis, particularly among MSM • Lack of knowledge of serostatus • Effect of knowledge of serostatus on behavior • Availability of a simple, rapid HIV test

  5. Cases Deaths Adults/Adolescents 849,780 482,330 9,220 5,342 Children (<13 years) 859,000 487,672 Total AIDS Cases and Deaths Reported 1981 – 2002, United States

  6. 1993 definition implementation Estimated Incidence of AIDS, Deaths, and Prevalence, by Year of Diagnosis/Death, United States, 1981–2002* Incidence Deaths Prevalence Number of Cases/Deaths (Thousands) Prevalence (Thousands) 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 00 01 02 Year *Adjusted for reporting delays

  7. 17% Estimated Number of HIV Diagnoses*, by Mode of Exposure and Year of Diagnosis - 25 States, 1994 – 2002* MSM Heterosexual IDU MSM/IDU Note: Reported through June 2003 * Includes all new HIV diagnoses with and without AIDS. Adjusted for reporting delays and redistribution of exposure for cases reported without information on mode of exposure. + Alabama, Arkansas, Arizona, Colorado, Idaho, Indiana, Louisiana, Michigan, Minnesota, Mississippi, Missouri, New Jersey, Nevada, North Carolina, North Dakota, Ohio, Oklahoma, South Carolina, South Dakota, Tennessee, Utah, Virginia, West Virginia, Wisconsin, and Wyoming.

  8. Awareness of Serostatus among Persons with HIV & Estimates of Transmission Estimated: 850,000-950,000 PLWH in US Estimated: 40,000 new infections/year ~25% unaware of infection 2/3 ~75% aware of infection 1/3

  9. 104,780 persons diagnosed with HIV 43,089 (41%) developed AIDS within a year after HIV positive test Late TestingSurveillance Data 1994-1999 Neal J. 9th CROI, 2002

  10. Number of tests approx. 2,000,000 New HIV diagnoses 18,000 % who didn’t return for results 31% CDC (unpublished) CDC Funded HIV Testing2000

  11. Proportion Reporting Anal Sex Behavior atSeroconversion & Post-Seroconversion Visits Percent Reporting Risk Behavior Colfax et al, AIDS 2002

  12. CDC’s Overall Approach to HIV Prevention CDC will continue to: • Support efforts to keep negative people healthy • Rely on behavioral prevention approaches • Support voluntary testing • Fund community-based organizations (CBOs) – especially those serving minorities • Support community planning • AHP important component of overall strategy.

  13. Four priority strategies: Make voluntary HIV testing a routine part of medical care Implement new models for diagnosing HIV infections outside medical settings Prevent new infections by working with persons diagnosed with HIV and their partners Further decrease perinatal HIV transmission AHP Strategies

  14. Impact and Outcomes of AHP • Expand efforts to help PLWH to learn their HIV serostatus • Expand CDC’s efforts in focusing prevention programs for PLWH • Focus CBO and HD prevention activities to ensure that every person living with HIV has: • The opportunity to get tested • Access to state of the art medical care, and • Access to ongoing prevention services to prevent HIV/STD transmission to partners • Decrease new HIV infections and STD transmission

  15. Additional Information on AHP • www.cdc.gov/hiv/partners/ahp.htm • CDC. Advancing HIV prevention: New strategies for a changing epidemic. MMWR 2003;52:329-332

  16. Contact Information Sean David Griffiths, M.P.H Coordinator, Advancing HIV Prevention Initiative (AHP) Divisions of HIV/AIDS Prevention 1600 Clifton Rd, NE MS E-35 Atlanta, GA 30333 SGriffiths@cdc.gov 404.639.3453

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