The Beginning of the End of AIDS

Kevin Fenton of the CDC says new federal strategies and advances in HIV prevention will turn the tide.

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Centers for Disease Control

(The Root) -- For two decades, the International AIDS Conference has played a vital role in assembling the global community to discuss new scientific advances and to mobilize action around fighting the devastating disease. Taking place in Washington, D.C., this week -- the first time in 22 years that the conference has been held in the United States -- the event also creates renewed urgency around the national epidemic.

Despite the staggering 1.1 million people living with HIV in the U.S., Kevin Fenton, director of the Center for Disease Control and Prevention's National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, is optimistic that government and community-based partners are now on the right track to stem HIV's tide.

In an interview with The Root, Fenton discussed the importance of finally confronting the reality that "not everybody is equally affected by the epidemic," new research that underscores the major impact of basic public-awareness campaigns and why he believes that, after decades of merely stabilizing the number of new HIV infections, a new federal strategy and new medical breakthroughs will get the country much closer to an AIDS-free generation.

The Root: Over the past couple of years, CDC has rolled out a range of new HIV initiatives. How do these efforts differ from past approaches?

Kevin Fenton: Everything that you're seeing now is rooted in the National HIV/AIDS Strategy, which was released two years ago. That was the first time that the United States had a documented vision, strategy and plan for addressing the HIV epidemic in a coordinated way in this country. The strategy was clear about what we needed to do: Reduce the number of new infections, improve access to care, address health inequities and work more collaboratively across government and with external partners.

It challenged us to not see the epidemic as "business as usual." We needed more focus, more targeting, more scale and impact. For example, our Enhanced Comprehensive HIV Prevention Planning program focuses on 12 high-burden cities that account for 44 percent of persons living with HIV in the United States. Our new social-marketing campaigns are geared toward raising awareness and addressing stigma and discrimination -- all of which were in the national strategy.

TR: In contrast, how would you describe the "business as usual" prevention approach that CDC used before?

KF: There was a feeling that we had to view everyone as being equally at risk, and we had to cover everybody in the response. The reality is, we don't have the resources to do everything for everyone. And the reality is that not everybody is equally affected by the epidemic. The disease is not randomly distributed in the population, and we need to focus on those communities who are hardest hit. We know that those are gay and bisexual men of all races, African-American men and women, Hispanic and Latino men and women, injection-drug users and the transgender population.

All Americans need the basic tools about HIV to protect themselves. Everybody should know about HIV testing and how HIV is transmitted, and that is work we will always have to do.  But you can target some messages to people who are HIV positive and people who are at high risk of acquiring HIV -- the fact that we have very good treatments which are now available, that people who are living with HIV should be on treatment, suppress their virus and practice safer sex to reduce onward transmissions. There's a balancing act. And that balance is the reality of HIV 30 years into the epidemic.

TR: How is the National HIV/AIDS Strategy tracking so far in terms of results?