Models to Prevent New Infections
Preventing new HIV infections is a major focus of HIV programs in the United States. Biomedical advancements, changes in healthcare legislation, and the proliferation of antiretroviral treatments, as well as an increased understanding of routes of transmission have contributed to evidence-based and promising models and strategies for preventing new infections.
Prevention programs in rural communities may be designed to target specific populations or geographic locations, and programs may choose to implement several types of interventions to address different community needs. HIV prevention programs are generally focused on reducing risk of transmission, and can often be organized into one of several categories, including:
- Programs that reduce sexual risk
- Programs that reduce risk from substance use
- Programs that use HIV medicine to reduce risk
- Programs that reduce mother to child risk
Researchers continue to study and develop potential HIV vaccines that could prevent new cases in the future. There are several clinical trials that are ongoing in the U.S. that are making progress towards understanding whether a vaccine can prevent new HIV infections, but currently no vaccine is approved for use.
The Centers for Disease Control and Prevention (CDC) has compiled a Compendium of Evidence-Based Interventions and Best Practices for HIV Prevention that continues to be updated with new effective interventions. Each intervention included in the compendium is evaluated based on established criteria. The compendium is divided into five sections which include chapters on 1) pre-exposure prophylaxis; 2) structural interventions; 3) linkage to, retention in, and re-engagement in HIV care; 4) medication adherence; and 5) risk reduction.
High-risk populations generally targeted by these types of prevention programs include:
Prevention programs also often work with people who are currently living with HIV/AIDS in an effort to reduce transmission.
New HIV infections in the United States are generally driven by a few high-risk behaviors. Programs may target a high-risk group in order to maximize their reach.
Increasingly, HIV testing as well as treatment (which includes retention in care and adherence) have been promoted as highly effective methods of prevention, since a person with a reduced viral load is less likely to transmit HIV to another person. These other types of preventions models will be discussed throughout Module 2, within Models to Diagnose HIV/AIDS Cases, Models to Improve Access to Quality HIV Care, and Models to Improve Retention, Adherence, and Self-Management.