Ending the HIV Epidemic in the U.S.

Ending the HIV epidemic initiative geographic locations

The efforts are focusing 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 has a leading role in helping diagnose, treat, prevent, and respond to end the HIV epidemic in the U.S.

Diagnose

HRSA-supported health centers are a key entry point for people with HIV who are undiagnosed. In 2021, more than 2.8 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 as prescribed and reach and maintain viral suppression cannot sexually transmit HIV to their partner and can live longer and healthier lives. This 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 is continuing to link 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 viral suppression. In 2021, 89.7% of Ryan White HIV/AIDS Program clients receiving HIV medical care were virally suppressed, compared to 69.5% of clients in 2010.

More than 213,000 patients with HIV receive medical care services at HRSA-supported health centers. Of patients who tested positive for HIV for the first time, the majority were successfully linked to treatment within 30 days (83% of patients at HRSA-funded health centers; 88% of patients at Health Center Program look-alikes).

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%. An estimated 1.2 million Americans are at high risk for HIV infection, but fewer than 10% use PrEP.

In 2021, more than 88,000 HRSA-supported health center patients received PrEP-associated services. 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 allows community partners to quickly develop and implement strategies to stop ongoing transmission. HRSA’s Ryan White HIV/AIDS Program and Health Center Program support these transmission-ending strategies by providing HIV care and treatment and PrEP to those identified through these important activities.

Community engagement has been fundamental to HRSA’s success since the beginning of the Ryan White HIV/AIDS Program and the Health Center Program. HRSA believes that our collective success in meeting the goals of the EHE initiative depends on how well we engage people with HIV and their communities in the planning, development, implementation, and evaluation of HIV care and treatment strategies. For this reason, the Ryan White HIV/AIDS Program developed a community engagement framework and identified five guiding principles for our community engagement efforts. Our efforts will be: Intentional, Committed, Sustainable, Flexible and Tailored, and Transformational.

In 2023, HRSA is collaborating with CDC to jointly host the next series of virtual Public Health Leader and Community Listening Sessions. Similar to HRSA’s 2021 virtual EHE initiative community engagement listening sessions (PDF - 460 KB), the 2023 CDC/HRSA virtual listening session will be hosted by region with 14 events in total. These events will be co-hosted by HRSA and CDC, and each region will have the opportunity to participate in both a public health leader and community member session. Members of the HIV community are encouraged to register to participate in the community listening session in your region. Each session will be moderator-led, and the seven community listening sessions will be available in both English and Spanish. Below is the full schedule of events. Please note that dates and times are subject to change.