Background More than one million people are living with HIV in the US; each year this number increases by ∼30,000. Nearly two-thirds of new infections occur in racial/ethnic minorities. The 2010 National HIV/AIDS Strategy emphasises cost-effective, high-impact strategies that reduce the infectiousness of HIV-infected persons over behavioural interventions for HIV-uninfected persons. To advance this Strategy, the US Department of Health and Human Services consolidated and updated existing federal government recommendations for HIV prevention for persons with HIV.
Objectives Describe guideline development and implementation methods.
Methods HIV prevention, care, and policy experts from CDC, HRSA, NIH and six non-governmental organisations updated existing federal government recommendations for clinicians, non-clinical prevention providers, health departments, and policy makers based on new evidence about biomedical, behavioural, and policy interventions.
Results The updated recommendations emphasise new, and effective, but under-used interventions: evidence-based linkage-to-care strategies, early initiation of antiretroviral therapy, interventions supporting adherence to suppress viral load and reduce infectiousness, and new behavioural interventions. To implement guidelines, CDC and HRSA are coaching “champions” in public and private sectors; disseminating decision-support tools and low-cost implementation resources, aligning federal policies with the guidelines; advising states about regulations that promote implementation; and evaluating guideline adherence and enablers through national studies.
Discussion Implementing these broad, inter-sector recommendations will require long-term engagement of governmental and non-governmental organisations. Successful implementation promises to invigorate America’s HIV prevention strategy, help reduce health disparities, and decrease the nation’s devastating HIV burden.
Implications for Guideline Developers/Users Understanding the benefits of consolidated guidelines that advance national policy.
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