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

Dear Colleagues,

Today, the Centers for Disease Control and Prevention (CDC) released a new Vital Signs on HIV transmission in the United States at each stage of HIV care. The results provide powerful evidence that increasing the number of people with HIV who are in care and virally suppressed is key to eliminating new HIV infections in our nation. According to this report, 80% of new HIV infections in 2016 were transmitted by people who did not know they had the virus or knew but were not in HIV care. This Vital Signs includes a 

• Morbidity and Mortality Weekly Report (MMWR), “HIV Transmission Along the Continuum of Care, United States, 2016,” and
• Fact sheet, “Ending the HIV Epidemic: HIV Treatment Is Prevention.” 

The report builds on several studies in which people with HIV who were virally suppressed transmitted no HIV infections to their HIV-negative sexual partners. As those studies showed, people with HIV who take antiretroviral therapy (ART) as prescribed and achieve and maintain viral suppression, defined as less than 200 copies of HIV per milliliter of blood or undetectable levels, have effectively no risk of transmitting HIV through sex.

This report shows the importance of implementing the proposed federal initiative Ending the HIV Epidemic: A Plan for America. We can dramatically improve health outcomes for people with HIV and reduce new HIV infections by increasing early diagnosis and treatment adherence, two of the initiative’s four strategic pillars: 

1. Diagnose all people with HIV as early as possible after infection. 
2. Treat the infection rapidly and effectively to achieve sustained viral suppression. 
3. Protect people at risk for HIV using potent and proven prevention interventions, including pre-exposure prophylaxis (PrEP). 
4. Respond rapidly to detect and respond to growing HIV clusters and prevent new HIV infections. 

Harnessing the power of HIV treatment will be crucial to achieving the initiative’s goals: reduce new HIV infections by 75% in 5 years and at least 90% in 10 years. Health care providers, public health departments, and other partners will play essential roles in meeting these targets. Please visit the Vital Signs website to learn more about how together we can improve engagement in care and treatment adherence and increase the number of people with HIV who stay virally suppressed. We also encourage you to share these materials with your colleagues.

Thank you for the work you are doing to expand HIV testing, care, and prevention. We look forward to continuing our collaborations with you as we move closer 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