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The Future of HIV Prevention in the United States

Jonathan Mermin, MD, MPH; Kevin A. Fenton, MD, PhD
JAMA. 2012;308(4):347-348. doi:10.1001/jama.2012.8693.
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In the United States, 1.1 million people live with human immunodeficiency virus (HIV), a 60% increase from 15 years ago. The increasing number of people who can potentially transmit HIV makes prevention more difficult. Yet federal domestic HIV prevention funding, after adjustment for inflation, has not increased since 1991, necessitating a different approach to HIV prevention.

The CDC's new strategy, “High Impact Prevention,” involves prioritizing and implementing the optimal combination of cost-effective, scalable interventions based on current science.1 This strategy focuses on the goal of the National HIV/AIDS Strategy (NHAS) of reducing the current annual HIV incidence of about 50 000 infections by 25% in 5 years. If the NHAS goals are realized, it is possible that an estimated 163 000 infections could be prevented along with a corresponding potential projected savings of $48 billion in health expenditures by 2020.2

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