THPE239 - Poster Exhibition
2012 Centers for Disease Control and Prevention (CDC) Health Resources and Services Administration (HRSA) recommendations for HIV prevention with adults and adolescents living with HIV: a status report
K. Irwin1, A. Huang2, A. Patel1, G. Dumitru1
1Centers for Disease Control and Prevention (CDC), National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Division of HIV/AIDS Prevention, Atlanta, United States, 2Health Resources and Services Administration (HRSA), Rockville, United States
Background: More than 1.2 million people are living with HIV (PLWH) in the U.S.; each year this number increases by about 35,000. Ongoing transmission drives HIV incidence; on average each PLWH infects about five other persons over a lifetime. Accelerating HIV prevention with PLWH is pivotal to controlling the U.S. epidemic.
Methods: Since 2010, CDC, HRSA, and other HIV prevention organizations have collaborated to develop recommendations for HIV prevention with PLWH for clinical and non-clinical settings. These recommendations update and expand on CDC/HRSA 2003 recommendations to incorporate HIV prevention into the medical care of PLWH. This presentation will summarize the rationale, methodology, and evidence base for the recommendations and their alignment with CDC's strategic plan and the National HIV/AIDS Strategy. It will highlight new recommendations for non-clinical providers and health departments and long-standing, but underutilized, clinical recommendations and address challenges in delivering prevention services during a period of health reform.
Results: The recommendations were based on scientific evidence, program evaluations, and opinions of stakeholders representing perspectives of PLWH, HIV care providers, community-based organizations, and health departments. Many recommendations were harmonized with other federal recommendations. They address linkage and retention in HIV care, risk assessment, risk-reduction interventions, partner services, antiretroviral treatment and adherence, STI services, referral to other medical and social services, reproductive health, and pregnancy care. They emphasize use of recently evaluated risk reduction interventions, early linkage to HIV care, the option to initiate antiretroviral treatment immediately after HIV diagnosis to prevent HIV transmission, retention in HIV care and adherence support to maximally suppress viral load, and new reproductive options to prevent exposure of the fetus, the newborn, and sex partners.
Conclusions: These new recommendations describe essential functions of clinicians, community organizations, and health departments to accelerate a high-impact HIV prevention strategy that capitalizes on new behavioral and biomedical interventions.
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