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HIV Prevention in 2009: Success and Challenges to an Effective Global and Domestic Response

In 1981, the first AIDS cases were reported to the Centers for Disease Control and Prevention (CDC). Now, more than 25 years into the epidemic, HIV infection continues to spread worldwide. The World Health Organization estimates that there are approximately 33 million adults and children living with HIV globally and another 2.7 million newly infected in 2007 (WHO). Women account for 50% of those living with HIV worldwide and young people under 25 years of age account for half of all new infections. Turning to the United States, we see a similar trend with approximately 1,106,400 people infected and an estimated 56,000 new infections annually (CDC, 2008). The poor and disadvantaged—populations typically served by social worker and other social service professionals—are disproportionately affected both at home and abroad. Given these statistics, the prevention of HIV remains an urgent priority. The good news is that we know prevention works. Although HIV continues to spread, the rate of new infections would be dramatically higher if there had not been coordinated prevention efforts in the past. In fact, the CDC estimates that prevention interventions have averted more than 350,000 new infections in the United States alone (CDC, 2009). Despite this success, however, the prevention of HIV remains remarkably complex and challenging at both the individual and contextual levels. Gender inequality, ongoing discrimination of vulnerable groups, HIV stigma, and poverty are just some of the contextual factors that affect individuals’ risk reduction efforts. Fortunately, despite this complexity, we have learned a great deal about prevention and what works. Building on what we know about prevention, the CDC in the United States has a three-fold prevention strategy of (1) funding evidence-based interventions, (2) tracking the epidemic to ensure that prevention dollars and interventions are directed to the proper populations, and (3) partnering with researchers to identify and develop innovative interventions to address specific needs of high risk groups (CDC, 2009). Central to this strategy is the CDC’s commitment to the dissemination and utilization of evidence-based HIV prevention interventions. Through the Dissemination of Evidence-Based Journal of HIV/AIDS & Social Services, 8:309–312, 2009 Copyright # Taylor & Francis Group, LLC ISSN: 1538-1501 print=1538-151X online DOI: 10.1080/15381500903455935