HIV & AIDS in the United States Update: Dear Colleague Letter

Dear Colleague,

March 8, 2019

March 10 is National Women and Girls HIV/AIDS Awareness Day (NWGHAAD), an observance sponsored by the Office on Women’s Health in the Department of Health and Human Services. This year’s theme, “HIV Prevention Starts with Me,” reminds us that everyone, regardless of their HIV status, can make an impact in preventing new HIV infections in women and their partners. The theme encourages women to take charge of their health through prevention measures, such as taking daily medicine to prevent HIV called pre-exposure prophylaxis (PrEP), if they are at high risk for getting HIV.

In recent years, we have seen promising outcomes related to HIV and women. For instance, between 2010 and 2016, there was a 21% decrease in HIV diagnoses among women in the United States. More specifically, there has been a 25% decline among Black women and a 20% decline among Hispanics/Latinas. Rates have remained stable among White women.

Despite promising declines in new HIV diagnoses, there are still opportunities for improvement. In 2017, women accounted for over 7,000 new diagnoses or 19% of diagnoses in the United States. In 2015, 1 in 9 women with HIV were unaware that they had it. Furthermore, even with declines among Black women and Hispanics/Latinas, these populations continue to be disproportionally affected by HIV. For instance, in 2017, Blacks/African Americans made up 13% of the population, but accounted for 59% of diagnoses of HIV infection among females.

These data demonstrate why now is the right time for the proposed federal initiative to end the HIV epidemic in America, which can help improve the health of women and girls in the coming years. The Centers for Disease Control and Prevention (CDC) is committed to working with its partners to support the prevention of HIV transmission and the health of women with HIV.

An important component of the federal initiative is to protect people at risk for HIV using potent and proven prevention interventions. Recent CDC data demonstrate that over 170,000 women in the U.S. are eligible for PrEP, a medicine that can prevent HIV. In addition to encouraging healthy behaviors like condom use and testing, we can use options like PrEP for those at high risk for HIV. If we work together to incorporate these interventions, we can expect even more progress in preventing new HIV infections.

CDC’s prevention and care activities to address HIV among women include:

• Funding for state and local health departments to support HIV surveillance and prevention programs across the United States, as well as interventions that reach the populations most affected by HIV, including women.
• A new cooperative agreement in 2019 to strengthen the capacity and improve the performance of the nation’s HIV prevention workforce. This agreement supports 1) reducing new HIV infections; 2) increasing access to care and improving health outcomes for persons with HIV, including achieving and sustaining viral suppression; 3) reducing HIV-related health disparities and health inequities; and 4) achieving a more coordinated national response to the HIV epidemic.
• Clinical guidelines to inform health care providers about PrEP. CDC is also supporting a telephone hotline that provides free expert clinical advice on PrEP.
• Research that is evaluating where PrEP need is greatest, examining the cost and impact of PrEP, and determining the next generation of PrEP options.
• The Act Against AIDS campaigns and partnerships, including:
• Doing It, a campaign that encourages all adults to get tested for HIV, including women.
• HIV Treatment Works, which encourages people with HIV, including women, to get in care, stay in care, and live well.
• Let’s Stop HIV Together, which raises HIV awareness and fights stigma among all Americans, including women, and provides many stories about people living with HIV.
• Campaigns to help providers offer supportive, patient-centered HIV testing, prevention, and treatment services: HIV Screening. Standard Care., Prescribe HIV Prevention, Transforming Health, and Prevention Is Care.
• Partnering and Communicating Together (PACT) to Act Against AIDS, a partnership with organizations such as the National Urban League and the National Black Justice Coalition to raise awareness among the populations most affected by HIV.

By working together, we can attain a future free of new HIV infections. Thank you for your commitment to improving the health of women.

Sincerely,

/Eugene McCray/
Eugene McCray, MD
Director
Division of HIV/AIDS Prevention
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
Centers for Disease Control and Prevention
www.cdc.gov/hiv

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