Ending the HIV Epidemic: A Plan for America

The initiative is focusing efforts in 48 counties, Washington, DC, San Juan (PR), where >50% of HIV diagnoses occurred in 2016 and 2017, and an additional seven states with a substantial number of HIV diagnoses in rural areas. View the list (PDF - 44 kb)

Ending the HIV Epidemic Initiative Geographic Locations

The efforts will focus on four key strategies that together can end the HIV epidemic in the U.S.

1. Diagnose all people with HIV as early as possible.
2. Treat people with HIV rapidly and effectively to reach sustained viral suppression.
3. Prevent new HIV transmissions by using proven interventions, including pre-exposure prophylaxis (PrEP) and syringe services programs (SSPs).
4. 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 plays a leading role in helping diagnose, treat, prevent, and respond to end the HIV epidemic.

Diagnose

HRSA-funded health centers are a key entry point for people with HIV who are undiagnosed. In 2018, over two 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 daily as prescribed, and get and keep an undetectable viral load, effectively have no risk of sexually transmitting the virus (PDF - 390 KB) to their HIV-negative partner. This finding 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 will focus on linking 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 an undetectable viral load.

 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.

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 will allow community partners to quickly develop and implement strategies to stop ongoing transmission. HRSA’s Ryan White HIV/AIDS Program and Health Center Program will support these transmission-ending strategies by providing HIV care and treatment (RWHAP) and PrEP (CHC) to those identified through cluster detection activities.

Community engagement has been fundamental to HRSA’s success since the beginning of the Ryan White HIV/AIDS Program and the HRSA-funded Health Center Program. It is now more important than ever as we look towards ending the HIV epidemic.

HRSA leadership are visiting the geographic locations identified as focus areas of the Ending the HIV Epidemic: A Plan for America and conducting listening sessions to ensure that the communities most effected by the HIV epidemic have a voice in the planning of and implementation of the initiative. Below are the locations that HRSA has visited or is scheduled to visit soon (in order of the visit):

In 2019: