National HIV Prevention Progress Report, 2013 National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention Division of HIV/AIDS Prevention

Acknowledgements Program Evaluation Branch Dale Stratford (Chief), Barb Maciak, Patricia Dietz, Janet Heitgerd, Michelle Van Handel Quantitative Sciences and Data Management Branch Timothy Green (Chief) HIV Incidence and Case Surveillance Branch Irene Hall (Chief), Stacy Cohen, Patricia Sweeney Prevention Communication Branch Nick DeLuca (Chief), Hadiza Buge, Michael LaFlam Behavioral and Clinical Surveillance Branch Buzz Prejean (Chief), Jacek Skarbinski, Gabriella Paz-Bailey, Teresa Finlayson, Emma Frazier DHAP Office of the Director Michael Bonds, Chris Cagle, Janet Cleveland, Laura Coker, Selena Gonzalez, Norma Harris, Amy Lasky, Stan Lehman, Donna McCree, Jono Mermin, Angel Ortiz-Ricard, David Purcell, Wendy Riser, Rich Wolitski

National HIV Prevention Progress Report New report –Released December 2, 2013 –Synthesizes data from CDC surveillance systems to describe progress on key indicators –First report presents baseline and available results for 2011 Available at: CDC HIV Website ( HIV Website (

On-Line Resources Available at: CDC HIV Website ( HIV Website (

On-Line Resources Available at: CDC HIV Website ( HIV Website (

On-Line Resources Available at: CDC HIV Website ( HIV Website (

On-Line Resources Available at: CDC HIV Website ( HIV Website (

National HIV/AIDS Strategy Improving Outcomes: Accelerating Progress Along the HIV Care Continuum Office of National AIDS Policy December 2013 report –State of epidemic –Recommendations of HIV Care Continuum Working Group –Local successes –Public-private partnerships Available at: Office of National AIDS Policy Website ( of National AIDS Policy Website (

National HIV Prevention Progress Report 21 DHAP Strategic Plan Indicators –Reduce new HIV infections –Improve access to HIV care and health outcomes –Reduce HIV-related health disparities

Also Monitored For… National HIV/AIDS Strategy Government Performance and Results Act Healthy People 2020 HHS Core HIV Indicators

Data Sources and Results Based on data from 3 CDC sources –National HIV Surveillance System –Medical Monitoring Project –National HIV Behavioral Surveillance System

Data Sources and Results Describes results Before DHAP Strategic Plan implementation ( ) 1 st year of implementation (2011) In relation to 2015 goals and annual targets Key subgroups Gender, race/ethnicity, age, transmission risk

Baselines, Goals and Targets Baseline years and 2015 goals established in NHAS and the DHAP Strategic Plan were maintained Annual targets established to monitor interim progress –Targets based on expectation that progress will accelerate as the strategic plan is more fully implemented

Annual Targets: Percentage of Total Change

Results Show Encouraging Signs of Progress, Yet Challenges Remain 62% of annual targets were met or exceeded (13 of 21 indicators) Includes 7 NHAS indicators 24% showed no change or moved away from annual target (5 of 21 indicators) 14% could not be compared with annual target (3 of 21 indicators)

Reduce New HIV Infections Compared to 2006, there were 1,100 fewer new HIV infections in 2010 New HIV infections remain unacceptable high

Reduce New HIV Infections Promising progress in some groups –15% decrease among heterosexuals –22% decrease among IDUs –21% decrease among African American women For 2010 versus 2008.

Reduce New HIV Infections 2010 targets not met for Hispanics and gay, bisexual and other MSM Significant increase among MSM –12% overall –22% among youth (13-24 years old) For 2010 versus 2008.

Reduce Sexual Risk Behavior among MSM Serodiscordant sex at last sext did not decline MMWR. November 29, 2013.

More People Are Living with HIV More than 1.1 million people living with HIV Number of people living with HIV increased 9% from

Reduce HIV Transmission HIV transmission rate decreased 9% from –4.2 new HIV infections per 100 PLWH in 2010 Fewer HIV infections are being transmitted on average by PLWH

Increase Knowledge of HIV Positive Status Consistent improvement each year 5 of 6 PLWH in 2010 knew their serostatus –1 of 6 PLWH did not know their serostatus

Increase Linkage to HIV Medical Care Baseline: 65% 2011: 79.8% linked to care –Number of areas with complete data increasing: 13 in in in 2011

Reduce HIV-Related Disparities: Linkage to HIV Medical Care 2015 goal was 75% or greater for all groups Met or exceeded for all groups in 2011 CDC increased 2015 goal to 85% or greater for all groups –Based on revised goal, 2011 target was: Not met for Blacks/African Americans (75.9%) Not met for Hispanics/Latinos (81.8%) Met for Whites (85.1%) Met for Persons of Other Race/Ethnicity (85.9%)

Increase Viral Suppression among Persons in HIV Medical Care About 3 of 4 people in HIV medical care had achieved viral suppression

Reduce HIV-Related Disparities: Viral Suppression Among HIV-Diagnosed Persons 39% of people diagnosed with HIV had suppressed viral load in targets met for MSM, Blacks/African Americans, and Hispanics/Latinos Results showed movement toward the 2015 goal in all 3 groups

Viral Suppression among HIV-Diagnosed Blacks/African Americans

Viral Suppression among HIV-Diagnosed Hispanic/Latinos

Viral Suppression among HIV-Diagnosed Men Who Have Sex with Men

Summary Data show significant progress and continued challenges Achieving 2015 goals will depend on accelerated progress Multiple factors will affect results:  High-Impact Prevention  Increased access to health care –Reduced funding for HIV prevention –Growing number of people living with HIV who need services

Summary CDC is working to accelerate progress toward 2015 goals Success depends on progress made at local level Meaningful change takes time and sustained effort –Monitoring progress and using data to improve outcomes are key Partnerships are critical to success