CDC: Progress made in HIV care/treatment, yet continued efforts needed

CDC. MMWR. 2011;60; [published online ahead of print Nov. 29].

Despite the progress that has been made with HIV testing practices and linkage to care in the United States, health care officials and providers should improve engagement in HIV care and monitor progress across communities, according to CDC officials.

“The latest Vital Signs data highlight the challenges we face in helping people with HIV learn their status, receive care and stay in care, so that they are controlling the virus in their own bodies and in their own communities,” Thomas R. Frieden, MD, MPH, director of the CDC, said during a media briefing.

“This is possible, and that’s why we think that it really is a message of hope that we do have the tools, not only to stop the virus from spreading within a person’s body, but to stop it from spreading within the community.”

Vital Signs data

Data pooled from the National HIV Behavioral Surveillance System indicated that approximately 9.6% of US adults were tested for HIV during 2010. Of those aware of their HIV status (n=942,000), about 77% were linked to care; 51% remained in care.

Of those linked to care, 45% received prevention counseling and 89% were prescribed antiretroviral therapy — of whom 77% achieved viral suppression — according to the report.

“The results in this report indicate that progress has been made,” CDC officials wrote in the report. “However, continued and intensified efforts are needed. Only with success at each step in the continuum of HIV care can the ultimate goals of improving health, extending lives and preventing further HIV transmission be achieved.”

New campaign encourages HIV testing

During the media briefing, Kevin A. Fenton, MD, PhD, FFPH, Infectious Disease News Editorial Board member and director of the CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, announced the launch of a new national awareness campaign: “Testing Makes Us Stronger.”

Fenton said the goal of the campaign is to increase HIV testing among black, gay and bisexual men — one of the populations hardest hit by HIV in the United States.

“The need for this new campaign could not be clearer — black [men who have sex with men] account for 22% of all new HIV infections in the United States, and young black MSM are the only group who are currently experiencing an increase in new HIV infections,” he said.

An expert panel consisting of CDC officials and black gay and bisexual men was convened to develop the campaign message and strategy to encourage this population to get tested regularly and to raise awareness through national advertisements and social media. The campaign will be featured in “black pride events” in 15 cities across the country, according to Fenton.

“While this campaign is just one part of the solution, we’re very excited about the role we hope it will play in communicating to black and bisexual men that HIV testing makes us safer, wiser and stronger.”

Treatment is best prevention strategy

Besides the new campaign, the CDC is taking action to maximize the prevention benefits of HIV treatment.

“Now that we have strong scientific evidence that treating people with HIV is among the most effective prevention strategies we have, it is time to act more aggressively,” Jonathan Mermin, MD, director of the CDC’s Division of HIV/AIDS Prevention, said during the briefing.

He said the CDC will soon provide programs in state and local health departments:

• Health departments will be required to have in place a comprehensive prevention program, including activities that link and retain HIV-positive people in care, support the use of and adherence to ART and provide risk reduction counseling.
• Programs will be expanded to help those who are HIV-positive to consistently take their medications as prescribed.
• CDC is collaborating with NIH and local health departments on a study in Washington, D.C., and the Bronx to examine the feasibility of testing as many people as possible in a community, immediately linking those who test positive to HIV care and treatment and providing support so that they take their HIV medicine regularly (results are expected in 2013).
• CDC is conducting modeling studies to explore the potential effect of expanding different components of the continuum of care on prevention of the US epidemic to maximize the prevention effects of activities.

“While these approaches could have a substantial impact on the epidemic, both in terms of prolonging life and preventing new infections, alone they won’t end AIDS in the United States,” Mermin said. “Even if we significantly expand testing and were able to retain everyone with HIV in care, there would still be a substantial amount of HIV transmission that would occur during the early and most infectious stage of the disease — before the vast majority of people know they’re infected.

“For this reason, we will continually need to ensure that we are not only maximizing strategies for people with HIV, but also providing the most effective combination of proven behavioral and biomedical approaches for those who aren’t infected, but are at highest risk for HIV.”

For more information, please visit www.cdc.gov/nchhstp/newsroom. – by Ashley DeNyse

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