The following Dear Colleague letter is cross-posted from the National Center for HIV, Viral Hepatitis, STD, and TB Prevention (NCHHSTP) and the Centers for Disease Control and Prevention (CDC)

Dear Colleague:

December 1 is World AIDS Day, a day to emphasize the urgency of our collective commitment to ending the HIV epidemic and to honor and remember those we have lost to HIV. This year’s theme, “World AIDS Day 35: Remember and Commit,” commemorates the 35th anniversary of this important day and serves as an opportunity to reflect on progress while recognizing remaining challenges.

From the earliest days of the HIV epidemic, passionate, thoughtful action by advocates, communities, clinicians, and public health officials has helped to drive decades of scientific and clinical advances. A recent CDC-led study highlighted the remarkable strides the U.S. made in the prevention of perinatal HIV between 2010 and 2019. During that time, the U.S. met its two-part goal for perinatal HIV elimination: an incidence of fewer than one case of perinatal HIV per 100,000 live births, and a perinatal HIV transmission rate of less than 1%.

In recent years we have reduced HIV incidence, signaling success from our collective commitment to Ending the HIV Epidemic in the U.S. (EHE). Earlier this year, CDC published data that show the estimated number of HIV infections in 2021* decreased 12% compared with 2017, driven by a considerable decrease (34%) among gay, bisexual men aged 13 to 24 years. Another CDC report containing preliminary data indicates that in 2022, for the first time, more than one-third (36%) of the 1.2 million people in the U.S. who could benefit from PrEP had been prescribed it, compared to 23% in 2019. This progress is promising, however substantial and widening disparities persist and efforts must be further strengthened and expanded to reach all populations equitably.

Community engagement has been a key part of HIV prevention work since the beginning of the epidemic, and ongoing community engagement remains core to EHE’s success. Through EHE, CDC and its partners are implementing innovative, whole-person approaches designed to identify and address factors related to inequity and get powerful HIV prevention tools into the hands of every person who needs them. For example, implementation in limited EHE jurisdictions of the pilot #ShesWell: PrEP for Women initiative, part of CDC’s Let’s Stop HIV Together (Together) campaign, showed increases in a range of outcomes, including PrEP knowledge and awareness, and conversations with health care providers about PrEP. For EHE to be successful, the interventions must be brought to scale to address inequity and eliminate longstanding barriers to care that requires a significant and sustained infusion of new resources. However, HIV prevention resources have not kept pace with needs, and allocated funding has consistently fallen short of former and current Presidents’ requests for funding the EHE initiative.

Investing in HIV prevention saves lives. Effective HIV prevention is also cost-saving. Reaching EHE goals by 2030 would prevent over 255,000 HIV cases and save over $100 billion in direct lifetime medical costs. But our ability to make further progress in stopping HIV transmission hinges on our ability to bring to scale innovative approaches designed to address disparities and their drivers, including HIV stigma, racism, and other social and structural determinants of health.

On the 35th anniversary of World AIDS Day, we stand at a crossroads. Without sufficient investment in HIV prevention we risk turning back the clock on the progress we’ve worked so hard as a nation to achieve. Together with ongoing commitment, we can honor the hundreds of thousands of lives lost to HIV-related illness in the United States, and millions worldwide, by ensuring that everyone benefits equally from four decades of groundbreaking scientific advances.

We call on our partners to join us by sharing your HIV success stories, and reminding everyone that we can stop HIV together. Use CDC’s Together campaign resources to reduce HIV stigma and increase awareness about HIV testing, prevention, and treatment. We encourage you to download and share these resources and share social media content from CDC’s digital toolkit using the #WAD and #StopHIVTogether hashtags.

Sincerely,

Robyn Neblett Fanfair, MD, MPH
Captain, USPHS
Acting Division Director
Division of HIV Prevention
National Center for HIV, Viral Hepatitis, STD, and TB Prevention
Centers for Disease Control and Prevention
www.cdc.gov/hiv

Jonathan Mermin, MD, MPH
Rear Admiral and Assistant Surgeon General, USPHS
Director
National Center for HIV, Viral Hepatitis, STD, and TB Prevention
Centers for Disease Control and Prevention
https://www.cdc.gov/nchhstp/
 

This blog post was published November 29, 2023, on HIV.gov.