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AJPH First Look, published online ahead of print May 30, 2007
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July 2007, Vol 97, No. 7 | American Journal of Public Health 1163-1167
© 2007 American Public Health Association
DOI: 10.2105/AJPH.2006.095182

COMMENTARY

The Magnitude of Key HIV Prevention Challenges in the United States: Implications for a New National HIV Prevention Plan

David R. Holtgrave, PhD, Jean Flatley McGuire, PhD and Jesse Milan, Jr, JD

David R. Holtgrave is with the Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md. Jean Flatley McGuire is with the Institute on Urban Health Research, Bouvé College of Health Sciences, Northeastern University, Boston, Mass. Jesse Milan Jr is with the Center for Global Health Convergence, Constella Group, LLC, Washington, DC.

Correspondence: Requests for reprints should be sent to David R. Holtgrave, PhD, Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health, 624 N Broadway, Baltimore, MD 21205 (e-mail: dholtgrave{at}jhsph.edu).

The Centers for Disease Control and Prevention has undertaken an advisory process to update its national HIV prevention plan. We offer observations on the magnitude of HIV prevention challenges in the United States and reflect on how these challenges might influence the structure of a new HIV prevention plan.

We recommend a plan structure that (1) is based on fundamental principles of prevention, (2) enables accountability and mid-course correction, and (3) if achieved, would result in historic changes in the US HIV epidemic.

The recommended plan structure would differentially prioritize serostatus determination and prevention and care interventions for people living with HIV while retaining goals directed at high-risk HIV-negative and general population members.




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