In June 2017, the O’Neill Institute established an HIV Prevention Project to understand what is working in HIV prevention, identify issues and opportunities for progress, and describe future directions for HIV prevention. The goal of the project is to engage with federal, state, and local policy and program staff, people living with HIV, researchers and others to explore these issues and describe a vision for future progress. This project is supported by a grant from Gilead Sciences.
This project is guided by an advisory group consisting of:
- Carl Baloney, AIDS United
- Natalie Cramer, NASTAD
- Bambi Gaddist, South Carolina HIV Council/Wright Wellness Center
- Greg Millett, amfAR
- Carlos Rodriguez-Diaz, Milken Institute School of Public Health, George Washington University
- Ivy Turnbull, AIDS Alliance for Women, Infants, Children, Youth & Families, The AIDS Institute
HIV and drug use are inextricably intertwined. Today, one in ten new HIV diagnoses in the U.S. are attributed to people who inject drugs, with other forms of drug use contributing to additional transmissions. New HIV cases among people who use drugs increased 9% from 2014 to 2018. Success at achieving the goals of the Ending the HIV Epidemic (EHE) Initiative in the United States depends on improving the health of people who use drugs. The following policy actions are recommended: (1) Develop tailored plans with the meaningful participation of people who use drugs to respond to the unique challenges in each jurisdiction; (2) Deploy effective interventions at greater scale; and (3) Decriminalize substance use and re-orient drug use policy to enhance prevention, harm reduction, and treatment of addiction.
This one-page document summarizes the above Big Ideas brief.
Released in May 2020, this Quick Take document describes what contract tracing is, who does it, and why it is important. Drawing lessons from the response to HIV and other STIs, the document also discusses recommendations for what to do and not to do in responding to the COVID-19 crisis, best practices for the use of technology in contact tracing, partnerships between health departments and community-based organizations, and problems with law enforcement and criminalization. By protecting rights, partnering with communities, and expanding a well-trained workforce, public health can implement effective contact tracing for COVID-19.
Released in November 2019, this Big Ideas brief discusses key actions for HIV programs to reduce the public health impact of sexually transmitted infections (STIs). Sexually transmitted infections (STIs) are on the rise in the United States. While great strides have been made in promoting the health of people living with HIV and preventing new HIV infections, more can be done to enhance STI prevention, screening, and treatment. The following key actions are recommended: (1) HIV prevention and care programs need to conduct more STI screenings, (2) HIV and STI programs can jointly adopt best practices for promoting sexual health, and (3) HIV surveillance and research initiatives need to strengthen the STI response.
Released in August 2019, this Big Ideas brief explains how policy makers need to think differently about PrEP with a greater emphasis on achieving sufficient scale of PrEP use among high-need communities. To achieve population-level impact with PrEP, the authors state that PrEP programs need to be able to effectively serve a larger volume of clients and need service models that make it easier for users and providers to maintain PrEP engagement. This brief was informed by a stakeholder consultation in March 2019.
Released in August 2019, this Quick Take document provides a brief introduction to HIV cluster detection and highlights both its promise and risks. Cluster detection a public health tool that uses molecular data about the HIV virus reported to health departments by laboratories that conduct drug resistance testing as a part of routine clinical care. This tool enables health departments to identify clusters where HIV transmission is occurring rapidly and tailor public health responses to these clusters. However, this tool also raises concerns about privacy and the potential use of cluster detection information to prosecute people living with HIV for exposing others to HIV.
Released in August 2019, this Big Ideas brief highlights four critical actions where community stakeholders and public health officials can work together to minimize risks associated with cluster detection and broaden support for its use. This brief was informed by a stakeholder consultation in June 2018. The list of consultation participants can be found here. The views expressed in this brief are those of the authors and not necessarily those of consultation participants.
Released in April 2019, this Quick Take document provides an overview of the sexually transmitted infection (STI) crisis in the United States. The number of STIs is rising: From 2013-2017, syphilis increased 80%, gonorrhea increased 67%, and chlamydia increased 22%. The document describes the disproportionate burden of STIs for different populations and by geography. It also discusses the importance of sexual health and the need for increased investment and innovation in STI prevention, care, and treatment.
In March 2019, the O’Neill Institute released the policy brief, Bolstering Latinx Gay and Bisexual Men to Promote Health and Reduce HIV Transmission. This policy brief explores the health and social factors that contribute to HIV risks among Latinx gay and bisexual men. One in five new HIV diagnoses in 2017 in the United States were among Latinx gay and bisexual men. While HIV rates are stable, or falling in other groups, they rose by 12% among these men from 2012-2016. Developed in partnership with Bienestar Human Services, this brief highlights strategic actions that policy makers and others can take to ensure that Latinx gay and bisexual men are benefitting from the exciting advances in HIV prevention and care.
Released in January 2019, this Quick Take document provides an overview of the HIV epidemic in the United States and describes the range of tools and approaches used to prevent HIV infection, including HIV testing and linkage to care, treatment as prevention, pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP), and syringe and harm reduction services. The document also discusses the need for continued support for and new investment in HIV prevention.
At a time when many policy makers are asking fundamental questions about the impact of public investments on various programs, this issue brief examines the dynamic nature of the HIV epidemic in the United States to assess what our country has accomplished, where things stand, and where continued federal leadership and funding are needed to keep reducing the size and scope of the HIV epidemic.
HIV Prevention in the United States: Federal Investments are Saving Lives and Strengthening Communities
Jeffrey S. Crowley and Sean E. Bland (March 2018)
Thematic Area: Infectious Diseases
- Infectious Diseases
- National HIV/AIDS Initiative
- Implementing the National HIV/AIDS Strategy for the United States
- Supporting People Living with HIV in a Changing Health Care Landscape