The efforts are focusing on four key strategies that together can end the HIV epidemic in the U.S.
- Diagnose all people with HIV as early as possible.
- Treat people with HIV rapidly and effectively to reach sustained viral suppression.
- Prevent new HIV transmissions by using proven interventions, including pre-exposure prophylaxis (PrEP) and syringe services programs (SSPs).
- Respond quickly to potential HIV outbreaks to get needed prevention and treatment services to people who need them.
Through HRSA's Ryan White HIV/AIDS Program and Health Center Program, the agency has a leading role in helping diagnose, treat, prevent, and respond to end the HIV epidemic in the U.S.
Diagnose
HRSA-supported health centers are a key entry point for people with HIV who are undiagnosed. In 2021, more than 2.8 million health center patients received an HIV test. HRSA’s Health Center Program is increasing the number of new and existing patients tested for HIV in highly impacted areas by expanding outreach within their communities and increasing routine and risk-based HIV testing of health center patients.
HIV Care and Treatment
People with HIV who take HIV medication as prescribed and reach and maintain viral suppression cannot sexually transmit the virus to their HIV-negative partner.. This highlights the importance of getting people with HIV linked to HIV care and treatment and helping them stay in care and on their medication.
HRSA's Ryan White HIV/AIDS Program is continuing to link people with HIV who are either newly diagnosed, or are diagnosed but currently not in care, to the essential HIV care and treatment and support services needed to help them reach and maintain viral suppression. In 2020, 89.4 percent of Ryan White HIV/AIDS Program clients receiving HIV medical care were virally suppressed, compared to 69.5 percent of clients in 2010.
More than 213,000 patients with HIV receive medical care services at HRSA-supported health centers. Of patients who tested positive for HIV for the first time, the majority were successfully linked to treatment within 30 days (83 percent of patients at HRSA-funded health centers; 88 percent of patients at Health Center Program look-alikes).
Prevent
Many health centers provide HIV prevention services, including pre-exposure prophylaxis (or PrEP) for people at high risk of acquiring HIV. Studies show daily PrEP reduces the risk of getting HIV from sex by more than 90 percent. An estimated 1.2 million Americans are at high risk for HIV infection, but fewer than 10 percent use PrEP.
In 2021, more than 88,000 HRSA-supported health center patients received PrEP-associated services. HRSA is expanding access to PrEP for health center patients in key geographic areas. These efforts emphasize outreach, partnerships, and workforce expansion to increase access to and use of PrEP.
Respond
New laboratory methods and disease control techniques allow health departments to see where HIV may be spreading most rapidly. Called "cluster detection," this technique allows community partners to quickly develop and implement strategies to stop ongoing transmission. HRSA’s Ryan White HIV/AIDS Program and Health Center Program support these transmission-ending strategies by providing HIV care and treatment and PrEP to those identified through these important activities.
Community engagement has been fundamental to HRSA’s success since the beginning of the Ryan White HIV/AIDS Program and the Health Center Program. HRSA believes that our collective success in meeting the goals of the EHE initiative depends on how well we engage people with HIV and their communities in the planning, development, implementation, and evaluation of HIV care and treatment strategies.
For this reason, the Ryan White HIV/AIDS Program developed a community engagement framework and identified five guiding principles for our community engagement efforts. Our efforts will be: Intentional, Committed, Sustainable, Flexible and Tailored, and Transformational.
In 2021, HRSA hosted 16 virtual EHE initiative community engagement listening sessions by region. For each region, HRSA HAB offered two sessions: (1) a public health leader roundtable and (2) a community member listening session. These sessions provided a direct line of communication among HRSA, public health leaders, and community members in EHE jurisdictions. Participants included people with lived experience; healthcare providers; community leaders; and organizations involved in HIV prevention, care, and treatment. In total, more than 1,900 people participated.
