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AIDS 2012 and the Road Ahead

Johnathan MerminToday is the last day of AIDS 2012, the first International AIDS Conference to be held in the United States in more than 20 years. AIDS 2012 helped crystallize the extraordinary opportunities—and serious challenges—that lie ahead as we work to bring about an AIDS-free America.

Since the last International AIDS Conference was held in the United States in 1990, we have seen great strides in fighting HIV in this country: The number of annual new infections decreased 43% from 84,200 to about 48,000.

  • New AIDS diagnoses among people who inject drugs decreased 77%, and estimated perinatal HIV diagnoses by 91%.
  • Prevention efforts averted more than $125 billion in health care costs.

But there is still a long road ahead. Too many Americans are being infected with and dying from HIV every day. One in five Americans living with HIV does not know she or he has the virus, and only a third are receiving effective treatment that can protect their health and reduce the risk of transmission to others. Stark inequities continue to define the U.S. epidemic.

AIDS 2012 has reaffirmed my belief that we can overcome these challenges and reach the end of this road—the end of AIDS in America. As many speakers at the conference have pointed out, we are better equipped to fight HIV/AIDS now than ever before. Recent scientific advances have expanded the prevention toolkit to include not only behavioral interventions, but also antiretroviral therapy and tools that improve outcomes along the continuum of care. Across the country, health departments and community organizations are updating their prevention strategies to take advantage of the latest knowledge.

At CDC, we are implementing a High-Impact Prevention approach that directs the most cost-effective, scalable interventions, to the right populations and aligns those resources with the geographic burden of the epidemic. High-Impact Prevention will help us better address the goals of the National HIV/AIDS Strategy. For example, the Expanded Testing Initiative (ETI) supports HIV testing and linkage programs that reach African Americans, Latinos, men who have sex with men, and injection drug users. In its first three years, ETI diagnosed 18,000 individuals who were previously unaware that they were HIV positive, saving almost $2 in medical costs for every dollar invested.

And we continue to invest in HIV surveillance that provides essential information to guide the national and local response. At AIDS 2012, we presented the first-ever detailed breakdown of the continuum of care, showing how access to care and effective treatment varies by race/ethnicity, risk group, gender, and age. These data will help health departments and community organizations work together to strengthen care and realize the full potential of treatment as prevention.

I am leaving AIDS 2012 convinced that it is possible we can end AIDS in America. Among the thousands of U.S. advocates, scientists, community workers, and policy makers here at the conference, I see a shared sense of urgency, and a growing understanding that we must act quickly to turn the tide of HIV in the United States. Now it’s time to harness that enthusiasm and turn it into action on the ground.

The road ahead is long, but we are well on our way.

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