The U.S. Centers for Disease Control and Prevention (CDC) has announced a new initiative aimed at reducing the number of new infections caused by Human Immunodeficiency Virus (HIV) each year in the United States. This number is currently estimated at 40,000.

The new initiative - Advancing HIV Prevention: New Strategies for a Changing Epidemic - expands on current prevention strategies, and models on other approaches that have proven effective in the prevention of infectious diseases. It is aimed at reducing barriers to early diagnosis of HIV infection and increasing access to quality medical care, treatment and ongoing prevention services. The new initiative is detailed in the April 17, 2003 issue of the CDC's Morbidity and Mortality Weekly Report.

The new initiative consists of four key strategies:

• Make HIV testing a routine part of medical care. Professional medical associations and other partners in health care are now encouraged to include HIV testing as part of routine medical care on the same voluntary basis as other diagnostic and screening tests.
• Implement new models for diagnosing HIV infections outside medical settings. The CDC will fund new demonstration projects that will use the recently approved rapid test for HIV - OraQuick(r), which provides results in about 20 minutes - to increase access to early diagnosis and referral for treatment and prevention services in high-HIV prevalence settings, including correctional facilities.
• Prevent new infections by working with persons diagnosed with HIV and their partners. The CDC asserts that not all persons infected with HIV modify their behavior to reduce risk of transmitting HIV after they learn they are infected. Due to this, the CDC will work closely with the Health Resources and Services Administration to reach persons in whom HIV infection has been diagnosed but who are not in ongoing medical or preventive care.
• Further decrease perinatal HIV transmission. The CDC is promoting recommendations for routine HIV testing of all pregnant women. As an added safety net, the screening of all infants whose mothers were not screened for HIV during pregnancy is now encouraged. The CDC will also develop new guidance for the use of rapid tests during labor and delivery, or postpartum if the mother was not screened while pregnant.

According to the CDC, an estimated 200,000 of the well over 800,000 people living with HIV in the U.S are unaware that they are infected. "This is an intolerable situation in the minds of the public health officials and certainly in the minds of clinicians", said Julie L. Gerberding, director of the CDC during a telebriefing on the topic, "When individuals are diagnosed late in their course of illness, they have not had the opportunity to benefit from potentially life-saving treatments that we now have available."  

Gerberding and other CDC officials are confident that the implementation of the new initiative and strategies will go a long way to help stem the tide of the AIDS epidemic by helping people overcome some of the barriers they face in getting diagnosed and treated for HIV.