As a part of its overall public health mission, CDC provides national leadership in helping control the HIV epidemic by working with community, state, national, and international partners in surveillance, research, prevention and evaluation activities. These activities are critically important, as CDC estimates that between 800,000 and 900,000 Americans currently are living with HIV. Also, the number of people living with AIDS is increasing, as effective new drug therapies are keeping HIV-infected persons healthy longer and dramatically reducing the death rate.
CDC's Role in HIV Prevention
What is CDC's HIV/AIDS prevention strategy?
CDC employs a comprehensive approach to preventing further spread of HIV and AIDS. Strategies include monitoring the epidemic to target prevention and care activities, researching the effectiveness of prevention methods, funding local prevention efforts for high-risk communities, and fostering linkages with care and treatment programs. CDC is working in collaboration with many other governmental and nongovernmental partners at all levels to implement, evaluate, and further develop and strengthen effective HIV prevention efforts nationwide. CDC also is providing financial and technical support for disease surveillance; HIV antibody counseling, testing, and referral services; partner counseling and referral services; street and community outreach; risk-reduction counseling; prevention case management; prevention and treatment of other sexually transmitted diseases that can increase risks for HIV transmission; public information and education; school-based education on AIDS; international research studies; technology transfer systems; organizational capacity building; and program-relevant epidemiologic, sociobehavioral, and evaluation research.
How are CDC funds distributed?
In fiscal year 2001, nearly 80 percent of CDC’ s HIV prevention funds were distributed externally through cooperative agreements, grants, and contracts, primarily to state and local agencies. The largest portion of CDC’ s HIV prevention resources is awarded to state, local, and territorial health departments. Some of these funds support more than 200 local and regional HIV Prevention Community Planning groups.
How are prevention activities organized?
The National Center for HIV, STD and TB Prevention
Division of HIV/AIDS Prevention
The Division of HIV/AIDS Prevention is the primary division charged with CDC's HIV mission of preventing HIV infection and reducing the incidence of HIV-related illness and death, in collaboration with community, state, and national partners. Its nine branches oversee a variety of activities in support of this mission.
The National Center for HIV, STD and TB Prevention
Global AIDS Program
The Global AIDS Program (GAP) exists to help prevent HIV infection, improve care and support and build capacity to address the global HIV/AIDS pandemic. GAP provides financial and technical assistance through partnerships with communities, governments, and national and international entities working in resource-constrained countries.
- The Behavioral Intervention Research Branch applies current theory, practice, and empirical findings in designing and conducting research on state-of-the-art interventions to prevent HIV infection. Characteristics of the research include the use of formative studies to develop interventions, such as the examination of psychosocial and cultural determinants of risk behaviors, the collection and analysis of process and outcome data that includes both qualitative and quantitative measures, and the use of rigorous study designs to examine intervention effectiveness. Further, branch staff members assist in translating and replicating research findings for use in HIV prevention programs.
- The Prevention Programs Branch works with State and local public health departments, nongovernmental national/regional and local partners, and others to develop and implement programs, policies, and activities that mobilize affiliates and communities to become involved with and support local and statewide HIV prevention programs and activities. It plans, implements, and manages strategies and resources for HIV prevention in State and local health departments, community-based organizations, and other nongovernmental organizations to build comprehensive public health-private sector partnerships to prevent HIV/AIDS; provides technical consultation and program oversight to State and local health departments, community planning groups, and nongovernmental partners in operational aspects of HIV prevention; establishes guidelines and policies for implementation and continuation of State and local HIV prevention programs; and develops new operational programs and program announcements for HIV prevention.
- The Program Evaluation Research Branch evaluates the processes, outcomes, and impacts of CDC HIV prevention programs, activities, and policies for their improvement and accountability; develops and enhances evaluation methods and systems; and serves as a resource for building evaluation capacity.
- The Technical Information and Communications Branch uses both electronic media and printed materials to communicate scientific, statistical, programmatic, and technical information on HIV/AIDS to health care professionals, public health officials, prevention partners, federal government officials, and the general public.
- The Capacity Building Branch assists providers in enhancing the capacity of individuals, organizations, and communities to conduct more effective and efficient HIV and AIDS prevention services.
- The Epidemiology Branch's mission is to conduct biomedical and behavioral epidemiologic research to reduce HIV infection and disease progression. Accordingly, scientists in the Epidemiology Branch design and conduct studies in the United States and internationally to determine risk factors for HIV infection and disease, and to evaluate innovative biomedical and behavioral interventions in adults and children for preventing HIV infection and HIV-related disease. These studies are conducted by four research Sections including the HIV Vaccine Section, the Mother-Child Transmission & Pediatric and Adolescent Studies Section, the Clinical Epidemiology Section, and the Sexual Transmission and Injection Drug Use Studies Section. Domestically, the Epidemiology Branch is currently collaborating with partners in 25 states, and internationally is working with partners in Thailand, Cote d’Ivoire, Kenya, Botswana, Uganda, and Russia.
- The Prevention Services Research Branch conducts research to develop and improve HIV prevention strategies. This includes conducting studies (1) to identify and evaluate specific at-risk populations, (2) of the determinants of risk for HIV infection in specific populations, (3) of HIV counseling and testing activities, and (4) of HIV genotypic variations and antiretroviral drug resistance. This branch also is responsible for collecting data on the extent of HIV prevalence and incidence in the United States, for assisting other Centers within CDC to evaluate new HIV-related tests, and for maintaining a repository of stored sera and cells for studies of HIV infection.
- The Statistics and Data Management Branch provides statistical support, software systems design, and data management support for HIV/AIDS surveillance, HIV serosurveys, epidemiologic studies, and other studies conducted within the division; develops methods and coordinates efforts by statisticians to estimate the incidence of HIV infection; participates in the design, data analysis, and manuscript preparation for epidemiologic and behavioral studies and clinical trials; and conducts data analyses required by law for the allocation of HIV/AIDS prevention and treatment funds. The branch also provides national leadership in the development of statistical and data management planning, policy, implementation, and evaluation.
- The Surveillance Branch conducts a national program of surveillance and research to monitor and characterize the HIV/AIDS epidemic, and its determinants and impact, to guide public health action at federal, state, and local levels. This includes surveillance of HIV infection and AIDS in collaboration with State and local health departments to provide population-based data for research, evaluation, and prevention at the National, State, and local levels. The branch maintains, analyzes, and disseminates information from the national confidential registry of HIV/AIDS cases; monitors HIV-related morbidity and mortality and the use of PHS recommendations for prevention and treatment of HIV infection and AIDS; and conducts population-based surveillance of HIV-related risk behaviors in collaboration with state and local health departments.
What other CDC offices conduct HIV prevention activities?
Additional HIV prevention, education, and research programs are conducted in other CDC centers, institutes, and offices.
The National Center for Infectious Diseases (NCID)
The National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP)
- NCID’s Division of AIDS, STD, and TB Laboratory Research provides laboratory research on HIV and laboratory support for the surveillance, epidemiologic, and clinical activities of NCHSTP. It also conducts laboratory and epidemiologic studies of HIV-infected and uninfected persons with hemophilia and assists in the design, implementation, and evaluation of prevention and counseling programs for them and their families.
- The Division of Healthcare Quality Promotion, also located in NCID, assists the U.S. Public Health Service, state and local health departments, hospitals, and professional organizations worldwide in the prevention and control of nosocomially acquired HIV infection.
The National Center for Environmental Health’ s Clinical Biochemistry Branch operates a multicomponent quality assurance program for laboratories testing dried blood spots for HIV antibodies, provides method development and analytical services for the measurement of zidovudine and other antiretroviral drugs in epidemiological studies, and provides consultative services for emerging concerns in laboratory quality assurance.
The Division of Adolescent and School Health, NCCDPHP, provides support to national, state, and local education agencies and other organizations with the capacity to address adolescent health to assist them in identifying and preventing HIV risk behaviors among youth.
- NCCDPHP’ s Division of Reproductive Health conducts epidemiologic, applied behavioral, and operations research on the prevention of HIV in women at risk for both HIV and unintended pregnancy.
The National Center for Health Statistics collects HIV/AIDS-related data in many of its data systems, including HIV-related deaths from the National Vital Statistics System, use of health services from the National Health Care Surveys, and data on HIV-related knowledge and HIV testing behaviors from the National Health Interview Survey and the periodic National Survey of Family Growth.
The National Institute for Occupational Safety and Health’ s HIV Activity focuses on developing, implementing, and evaluating strategies for the prevention of occupational transmission of HIV, with special emphasis on personal protective equipment, engineering controls, and evaluation of organizational and behavioral factors that influence prevention strategies.
The Public Health Practice Program Office strengthens the community practice of HIV/AIDS prevention by developing and delivering training, improving the quality of clinical laboratory testing, developing computing and telecommunications tools, and conducting research into effective public health practice.