2014 Federal Recommendations for Human Immunodeficiency Virus (HIV) Prevention With Persons With HIV: A New Road Map for High Impact Prevention

Abstract

Background. In 2014, Centers for Disease Control and Prevention (CDC), Health Resources and Services Administration, National Institutes of Health (NIH), and 5 nongovernmental organizations issued Recommendations for HIV Prevention with Adults and Adolescents with HIV in the United States. This evidence-based guideline for clinical providers, nonclinical providers, and health departments updates 2003 federal guidance for clinicians to incorporate HIV prevention into HIV medical care. Methods. The new guideline compiles the latest federal recommendations on biomedical, behavioral, and structural interventions to reduce HIV transmission from persons with HIV. Recommendations address linkage to and retention in HIV care; antiretroviral treatment (ART) and adherence; behavioral risk-reduction strategies; partner services; sexually transmitted disease (STD) services; and reproductive and pregnancy services. Results. Important new recommendations for clinicians include: inform all persons with HIV about the benefits of early ART to improve health and to reduce transmission; help with appointment scheduling, insurance enrollment, and other proactive linkage assistance; offer ART to all patients regardless of CD4 count; support care retention and long-term ART adherence (through patient monitoring, simplified regimens, and advice on managing ART dosing, side effects, and costs); offer evidence-based risk-reduction interventions; routinely screen genital and extra-genital sites for STDs that facilitate HIV transmission; offer reproductive health counseling, family planning, special conception methods, and pregnancy services that reduce sexual and perinatal HIV transmission; and screen partners for HIV, STD, and viral hepatitis. The guideline stresses use of multidisciplinary teams and collaboration of clinical, nonclinical, and public health sectors to improve quality of prevention and care services. Conclusion. Providers who implement these recommendations can advance goals of the National HIV/AIDS Strategy: prevent new HIV infections and reduce HIV-related illness and health disparities. Guideline sponsors are promoting guideline awareness among health professionals and persons with HIV, training, decision-support tools, and expanded access to services. Ongoing evaluations will assess the impact of recommended interventions on delivery of HIV services. Disclosures. All authors: No reported disclosures.