Ending the HIV Epidemic in the US Goals

Why it's needed

With sufficient resources, EHE's goal of reducing new HIV infections in the United States by 90% by 2030 is achievable.

Visit the Partner and Grantee Resources page for tools and resources to support local implementation of EHE strategies.

EHE pillars

Diagnose

Diagnose all people with HIV as early as possible.

Knowing one's HIV status is a critical step in accessing powerful prevention and treatment tools. CDC collaborates with communities and other agencies to expand HIV testing according to CDC guidelines.

Strategies

To decrease the number of new HIV infections and help more people get tested and know their status, CDC is:

• Using the latest systems and technology to increase testing in healthcare facilities, including through routine screening. Locations include emergency departments, incarceration settings, sexually transmitted infection [STI] clinics, and Federally Qualified Health Centers.
• Applying novel approaches to make HIV testing more accessible in nontraditional settings. Includes mobile testing units, co-location of HIV testing with other health services, and self-testing.
• Establishing ways to regularly/frequently test people who may experience higher likelihood of acquiring HIV.
• Operating GetTested, a national testing locator to find nearby free or low-cost HIV, STI, and hepatitis testing.

Find more Diagnose Pillar resources. Learn more about HIV testing.

Treat

Treat people with HIV rapidly and effectively to reach sustained viral suppression.

HIV treatment preserves the health of people with HIV and is one of the most powerful HIV prevention strategies available. People with HIV can live long, healthy lives. They will not transmit HIV through sex if they take medication as prescribed and maintain an undetectable viral load. This is known as treatment as prevention, and is sometimes referred to as "Undetectable = Untransmittable," or U=U.

Strategies

To increase the number of people with HIV who are on treatment and who are virally suppressed, CDC is:

• Supporting early initiation of antiretroviral therapy by rapidly linking people with newly diagnosed HIV to treatment and care.
• Supporting retention in care and adherence to medication by expanding unique models of service delivery. Includes telehealth and long-acting injectable antiretroviral therapy.
• Supporting re-engagement in care by scaling up linkage services and data-to-care programs. Includes expanding the reach of partner programs to engage or re-engage people who are not currently in care.
• Collaborating with partners to optimize resources and synergize approaches to address the needs of people with HIV.
• Identifying evidence-based interventions and strategies made publicly available through the Compendium of Evidence-based Interventions and Best Practices for HIV Prevention.
• Providing training, technical assistance, and educational resources to health departments, community-based organizations, providers, and the public.

Find more Treat Pillar resources. Learn more about HIV treatment and care.

Prevent

Prevent new HIV transmissions by using proven interventions, including pre-exposure prophylaxis (PrEP) and syringe services programs (SSPs).

PrEP and SSPs are highly effective HIV prevention strategies. When taken as prescribed, PrEP reduces the risk of getting HIV from sex by about 99%. PrEP also reduces the risk of getting HIV from injection drug use by at least 74%. Comprehensive SSPs have been shown to dramatically reduce HIV transmission. SSPs also provide an entry point for accessing substance use disorder treatment and prevent overdose deaths and other infectious diseases.

Strategies

To prevent new HIV transmissions and increase access to HIV prevention services, CDC is:

• Supporting state and local communities to expand strategies to increase availability of PrEP. Includes telePrEP, same-day PrEP delivery, long-acting injectable PrEP, and pharmacy-based access to PrEP.
• Maintaining clinical guidelines for prescribing PrEP, supporting PrEPline as a resource for clinicians, and updating the PrEP Locator tool.
• Increasing the number of clinicians offering PrEP and post-exposure prophylaxis (PEP). Includes working with HRSA to train healthcare providers on prescribing PrEP and PEP, and managing PrEP adherence.
• Providing funding flexibilities to funding recipients to allow them to cover the costs of PrEP-related services. Includes laboratory tests and physician visits.
• Developing and delivering education campaigns to increase PrEP awareness and demand and combat stigma associated with PrEP use and HIV. Includes She's Well, a campaign focused on PrEP for women.
• Increasing access to and use of SSPs. Includes working with SAMHSA and communities to implement SSPs where they are needed and permitted by state and local laws.
• Supporting scale-up of SSPs to provide comprehensive care to people who inject drugs. Includes vaccination, infectious disease testing, linkage to care /substance use disorder treatment, and syringes and injection equipment access and disposal.
• Issuing guidance on how to deliver PrEP and SSP services during clinical service disruptions. Includes public health emergencies, such as COVID-19.

Find more Prevent Pillar resources. Learn more about HIV prevention.

Respond

Respond quickly to potential HIV outbreaks to get vital prevention and treatment services to people who need them.

Real-time cluster detection and response are key to ending the HIV epidemic in the United States. New public health strategies, including epidemiological approaches, help us quickly identify communities affected by rapid HIV transmission. Rapid transmission occurs when affected communities are not being reached by existing services due to social and structural factors. These factors may include stigma, discrimination, racism, poverty, and others.

Strategies

To get vital HIV prevention and treatment services and resources to people who need them, CDC is:

• Providing comprehensive support and technical assistance to ensure jurisdictions have the capacity to detect and respond to clusters quickly.
• Supporting local implementation of public health approaches of HIV cluster detection and response. Includes approaches that identify rapid HIV transmission and address gaps in and mobilize resources for HIV treatment, prevention, and other related services.
• Collaborating with communities and partners to understand local needs. Includes tailoring HIV prevention and other health and social services and programs for communities experiencing rapid transmission.
• Supporting health departments to integrate, protect, and use routinely reported data. Includes identifying affected communities, increasing understanding of community needs, directing resources to where they are needed, and strengthening data protections.

Learn more about HIV cluster detection and response.

Find more Respond Pillar resources.

EHE progress

EHE uses six HIV data indicators to measure progress toward national 2025 and 2030 HIV prevention goals. The United States has made modest progress in recent years, but is not on pace to reach these goals. An increase in dedicated resources is needed to fully scale up EHE strategies.

EHE Goals

Incidence

The estimated number of new HIV infections in a given year. In 2021, there were an estimated 32,100 new HIV infections, 12% lower compared to 2017 (36,500 infections).

Overarching goal: Reduce new HIV infections in the United States by 75% by 2025 and by 90% by 2030.

Knowledge of status

The estimated percentage of people with HIV who have received an HIV diagnosis. In 2021, 87% of people with HIV had received a diagnosis.

Midterm goal: Increase knowledge of HIV status to 95% by 2025.

National indicators

Progress on the indicators below will have the greatest impact on ending the HIV epidemic in the United States.

Diagnoses

The annual number of people diagnosed with HIV, confirmed by laboratory or clinical evidence. In 2021, data showed 36,189 people received an HIV diagnosis.

Goal: Decrease the yearly number of new HIV diagnoses by 75% by 2025 and 90% by 2030.

Linkage to HIV medical care

The annual percentage of people diagnosed with HIV who receive medical care for their HIV within one month of diagnosis. In 2021, data showed 82% of people were linked to care within one month of HIV diagnosis.

Goal: Increase linkage to HIV medical care to 95% by 2025.

Viral suppression

The annual percentage of people diagnosed with HIV who have less than 200 copies of HIV per milliliter of blood. In 2021, data showed 66% of people with diagnosed HIV were virally suppressed.

Goal: Increase the percentage of people with diagnosed HIV who are virally suppressed to 95% by 2025.

PrEP coverage

Defined as the estimated percentage of people with indications for PrEP classified as having been prescribed PrEP. In 2022, preliminary data showed 36% of people who could benefit from PrEP were prescribed it.

Goal: Increase PrEP coverage to 50% by 2025.

America's HIV Epidemic Analysis Dashboard (AHEAD) supports EHE by tracking data on these indicators. CDC's National HIV Surveillance System provides the data for five of the six core indicators. Learn more about the indicators and explore the data.

Find recent data on HIV among populations prioritized by EHE.

Read about how local heroes are using EHE resources to deliver HIV prevention and care to communities who could benefit.