AHF: CDC Again Fails to Mention Condoms in Latest HIV Prevention Campaign or Role in 18% Decline in Infections

After announcing that HIV infections in the United States dropped by
18% between 2008 and 2014, the CDC rolled out its new ‘HIP’ (High-impact
Prevention) approach to HIV prevention, which includes HIV testing,
treatment-as-prevention, needle exchange and PrEP, but fails to include
or mention condom use.

CDC tries to tie decrease in HIV infections to use of PrEP—which was
only available for less than two of the six years studied and which very
few people were actually on during that time. In addition, those first
targeted for PrEP use: gay and bisexual men, “…did not experience an
overall decline in annual HIV infections from 2008 to 2014,” according
to the CDC.

The CDC previously released a forecasting study in February 2016 of
plans to prevent 185,000 new HIV infections by 2020, and also failed to
mention or include condoms as a component of that effort.

LOS ANGELES–(BUSINESS WIRE)–AIDS
Healthcare Foundation (AHF) welcomed the news last week of an 18%
decline in HIV infections in the United States between 2008 and 2014,
but is questioning some of the conclusions drawn by Centers
for Disease Control and Prevention (CDC) officials regarding the
role of pre-exposure prophylaxis (PrEP), in particular, in the decline.

In addition, AHF chastised the CDC for overlooking the role that condoms
may have played in the decline and blasted the organization for failing
to even mention or include condom use in the roll out, and as part of
its new ‘HIP’ (High-impact Prevention) approach to HIV prevention, which
includes HIV testing, treatment-as-prevention, needle exchange and PrEP,
but no mention of condoms.

In a CDC press release issued last week timed to coincide with the
annual Conference on Retroviruses and Opportunistic Infections (CROI)
held in Seattle, (“New
HIV infections drop 18 percent in six years” February 14, 2017), CDC
officials rightly tagged treatment-as-prevention as a likely contributor
to the welcome decline in infections, noting:

“CDC researchers believe the declines in annual HIV infections are
due, in large part, to efforts to increase the number of people living
with HIV who know their HIV status and are virally suppressed — meaning
their HIV infection is under control through effective treatment. This
is a top public health priority. Studies have shown that, in addition to
improving the health of people living with HIV, early treatment with
antiretroviral medications dramatically reduces a person’s risk of
transmitting the virus to others.”

However, AHF officials believe that the CDC was on far shakier ground
when it claimed, “Increases in the use of pre-exposure prophylaxis,
or PrEP, may also have played a role in preventing new infections in
recent years.”

First, PrEP was only available for less than two of the six years
studied (Gilead’s Truvada for use for a PrEP indication for HIV
prevention was first approved by the FDA on July 16, 2012) and which
very few people were actually on during that time period. In addition,
the population initially targeted for PrEP use, gay and bisexual men, “…did
not experience an overall decline in annual HIV infections from 2008 to
2014,” according to the CDC press release issued last week. Instead,
the steepest declines in HIV infections were found in injection drug
users (56%) and heterosexuals (36%), populations not targeted or
prioritized for PrEP.

“We are glad that HIV infections are down 18% overall in the six year
period studied; however, STDs are skyrocketing around the country today,
particularly among young people and men who have sex with men,” said AHF
President Michael Weinstein. “Unfortunately, individual and
organizational complacency has set in at the CDC and elsewhere regarding
condoms, which remain the best way to prevent most STDs, including HIV.
So it was disappointing, but not surprising that the CDC failed to
mention or include condoms as part of its new prevention effort: ‘HIP’ –
its ‘High-impact Prevention’ approach focusing on ‘… cost-effective
solutions.’ Inexplicably the new CDC effort again excludes condoms,
which cost pennies and also prevent other STDs, while it includes PrEP,
a prevention protocol which includes a $1,300 per month pill—and offers no
protection against other STDs.”

In February 2016 (timed to last year’s CROI), the CDC released a forecasting
study of plans to prevent 185,000 new HIV infections by 2020, and failed
to mention condoms as a potential tool in that effort.

“We are encouraged by the overall reduction in new HIV infections across
the U.S., but alarmed by clear regional disparities in access to
treatment and prevention services that this report shows,” said Whitney
Engeran-Cordova, Senior Director of Public Health for AHF. “We know
that treatment-as-prevention works well to break the chain of new
infections. These regional disparities are stark and speak to the lack
of access to preventive services and medical care, and must be addressed
by communities and public health officials on both a local and national
policy level if we are to further reduce new infections in the future.”

AHF: CDC should prioritize condom use, place
STDs at forefront of national public health agenda

Regarding the abandonment of the condom culture in the US: advocates
from AHF note that in just a one month period between December 2013 and
January 2014—and with little public review—the CDC changed its
longstanding HIV and STD prevention wording regarding condom use from
using the phrase “unprotected
sex” to describe sex without a condom or some form of barrier
protection to using the phrase, “condomless sex”—a move that may suggest
to some that condomless sex is protected. A further indication of the
erosion of the condom culture came in February 2016, when the CDC
released a plan to prevent 185,000 new HIV infections—and also failed
to even mention condoms as a potential tool in that effort.

All this played out at a time when sexually transmitted infections
(STIs) or diseases (STDs) are increasing dramatically, particularly
among young people, with potentially “…staggering
human, economic costs.” In October 2016, the CDC released a report,
“Reported STDs at Unprecedented High in the U.S.” At the time, AHF
called out the CDC’s own policies—chief among them, the CDC’s
sanctioning of the widespread abandonment of the condom culture for STD
and HIV prevention—as a primary catalyst for skyrocketing STD rates,
particularly among young people.

The CDC
requested less overall funding for 2017 for HIV/AIDS, hepatitis,
sexually transmitted infections (STIs) and tuberculosis (TB) than it did
for 2016. For STIs, the CDC’s funding request has remained stagnant,
while the HIV/AIDS Prevention and Research funding request is $10
million lower than the previous year. While the CDC did request more
funding for 2017 than the agency actually received in 2016, enacted
funding has consistently fallen short of requested funding.

AIDS Healthcare Foundation (AHF), the largest global AIDS
organization, currently provides medical care and/or services to over
696,000 individuals in 38 countries worldwide in the US, Africa, Latin
America/Caribbean, the Asia/Pacific Region and Eastern Europe. To learn
more about AHF, please visit our website: www.aidshealth.org,
find us on Facebook: www.facebook.com/aidshealth
and follow us on Twitter: @aidshealthcare
and Instagram: @aidshealthcare

Contacts

AHF
Ged Kenslea, Senior Director, Communications
+1.323.308.1833
work
+1.323.791.5526 mobile
gedk@aidshealth.org