CDC Dear Colleague Letter: National HIV Testing Day

Dear Colleague:

June 27th is National HIV Testing Day (NHTD). As people across the nation fight for racial justice, it is critical that we continue to shine a light on the health disparities that persist in communities of color, with some of the most extreme occurring in HIV and STDs. Every day, we work together to dismantle the systemic barriers to health equity and ensure that everyone in the United States has equal and unfettered access to affordable healthcare, which includes HIV testing.

Approximately 1 in 7 people with HIV in the United States do not know they have the virus. In 2018, of the 161,800 people who did not know they had HIV, 42% were black/African American, 28% were Hispanic/Latino, and 24% were white. HIV testing needs to be more accessible and routinely performed so that everyone with HIV can get a diagnosis as early as possible after infection and start treatment right away.

People with HIV who take antiretroviral therapy as prescribed and stay virally suppressed can live long, healthy lives and have effectively no risk of sexually transmitting HIV to partners. For people who do not have HIV but are at risk for getting it, HIV testing can be the bridge to effective prevention tools such as pre-exposure prophylaxis (PrEP), condoms, and other HIV prevention services.

The 2020 NHTD theme is about the power of “Knowing”— knowing your HIV status, knowing your risk, knowing your prevention options, and knowing your treatment options. In years past, we at the Centers for Disease Control and Prevention (CDC) have promoted NHTD events around the country and asked our partners to join us in encouraging HIV testing and calling for increased action. This call to action and its urgency remain unchanged—but in the context of COVID-19, we will need to modify existing approaches and expand innovative HIV testing services to continue momentum toward Ending the HIV Epidemic. This year, we invite you to join CDC in encouraging all adults and young people to get tested for HIV, which includes HIV self-testing as an option when facility-based services and in-person patient-clinician contact is limited. For example:

• A rapid HIV self-test is available that uses an oral swab and provides results within minutes for people in their own home or other private location. This test is available for retail purchase by consumers and in some circumstances may be available free or at low cost from health departments and community-based organizations.

• Another option is a mail-in self-test, which includes a specimen collection kit that contains supplies to collect dried blood from a fingerstick at home. The sample is then sent to a lab for testing and the results are provided by a health care provider. Mail-in self-tests can be ordered through various online merchant sites. Health care providers can also order a mail-in self-test for patients. This type of self-test is sensitive enough to detect recent HIV infection.

Due to the COVID-19 pandemic, most health departments, CBOs, and other CDC-funded testing sites are not able to offer full-scale services at their usual capacities. HIV testing has decreased substantially across the country as a result. Even in areas with a high burden of HIV and among populations known to be at high risk, HIV testing is well below where it needs to be. Innovative, locally tailored screening strategies are needed to increase HIV testing, and CDC remains committed to collaborating with communities, public health partners, and providers to develop and implement these strategies.

CDC recommends that everyone between the ages of 13 and 64 get tested at least once as part of routine health care. Some people are more at risk for HIV than others and should be tested at least annually. Sexually active gay and bisexual men and transgender persons may benefit from even more frequent testing (e.g., every 3 to 6 months). Comprehensive information about who needs HIV testing and how often they need it is available in CDC’s HIV testing guidelines.

This testing day, please join us in encouraging HIV testing in your community and increased action to end the HIV epidemic. CDC’s Let’s Stop HIV Together campaign includes resources and partnerships aimed at stopping HIV stigma and promoting HIV testing, prevention, and treatment. This campaign is part of the national Ending the HIV Epidemic (EHE) Initiative.

Although it is difficult to come together in person this year, we ask that our partners continue to join CDC in helping us communicate the importance of HIV testing—including self-testing—and renew the commitment to making testing simple, accessible, and routine.

Thank you for your contributions and ongoing commitment to ending the HIV epidemic.

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