June 27 is National HIV Testing Day (NHTD), a day to emphasize the importance of HIV testing and make sure everyone knows their status so they can take steps to improve their health, regardless of the result. The 2022 NHTD theme, HIV Testing is Self-Care, encourages people to include HIV testing as part of their self-care routine. The World Health Organization defines self-care as "the ability of individuals, families, and communities to promote health, prevent disease, maintain health, and to cope with illness and disability with or without the support of a health care provider." Self-care has been an important topic during the COVID-19 pandemic, as the need for individual and community actions to promote physical and mental health remain a high priority.
The COVID-19 pandemic led to substantial disruptions in access to traditional HIV testing and some care and prevention-related services, resulting in a 17% decrease in HIV diagnoses during 2020 compared to 2019. This steep decrease is mostly attributed to declines in HIV testing caused by less frequent clinical visits, reduced outreach services, shifting of staff to COVID-19 response activities, and disruptions in services provided by community-based organizations (CBOs).
A new Morbidity and Mortality Weekly Report analyzes the number of HIV tests performed in 2020. Data from the report show sharp decreases in HIV testing during 2020 compared to 2019, particularly among priority populations in CDC-funded jurisdictions. To make up for testing and diagnoses missed during the COVID-19 pandemic, we encourage partners, health departments, and CBOs to expand HIV testing efforts, including HIV self-testing, so that everyone can learn their status and take action to protect their health.
CDC recommends that everyone between the ages of 13 and 64 get tested for HIV at least once. People with certain risk factors should get tested at least once a year, and sexually active gay and bisexual men may benefit from more frequent testing (every 3 to 6 months). CDC's HIV testing guidelines provide comprehensive information on who should get tested for HIV and how often. Yet, despite these recommendations, 1 in 8 people with HIV in the United States still do not know they have the virus and nearly 40% of new infections are transmitted by people with undiagnosed HIV. For people who are unaware of their status, HIV testing is the pathway to engaging in HIV prevention and treatment services.
Everyone needs to know their HIV status. It is particularly important for people with HIV to be aware of their status so they can begin HIV treatment (antiretroviral therapy) to improve their health. People with HIV who take HIV treatment as prescribed and get and keep an undetectable viral load (or stay virally suppressed) can live long, healthy lives and will not transmit HIV to their sex partners. This is also referred to as "Undetectable=Untransmittable" or "U=U." For people who do not have HIV, testing can be the bridge to effective prevention tools such as pre-exposure prophylaxis (PrEP), condoms, and other HIV prevention services.
As part of the 2022-2025 National HIV/AIDS Strategy (NHAS), CDC remains committed to collaborating with public health partners and health care providers to expand HIV testing and implement a status-neutral approach to HIV care. CDC supports many activities to make HIV testing simple, accessible, and routine:
Advancing the Ending the HIV Epidemic in the U.S. initiative by funding health departments in 57 jurisdictions to expand self-test distribution programs in health care and non-health care settings. This effort includes scaling up access to HIV self-tests for people to use or give to others.
Expanding access to HIV self-tests through a new funding opportunity (CDC-RFA-PS22-2210) that is currently live for bid. This 5-year program will provide at least 875,000 free self-tests and access to prevention resources for communities most affected by HIV, including gay and bisexual men, transgender women, and Black/African American cisgender women. Once this funding opportunity has been awarded, CDC's Let's Stop HIV Together campaign will support the promotion of the program.
Funding and supporting state, territorial, and local health departments, and CBOs to conduct HIV surveillance and increase access to prevention services that reach populations most affected by HIV. For example, CDC's cooperative agreement for CBOs awards about $42 million per year to 96 CBOs to implement program components that align with key strategies of the Ending the HIV Epidemic in the U.S. initiative. This award enhances CBOs' capacity to increase HIV testing, link people with HIV to care and treatment, and provide or refer people to HIV prevention and essential support services.
Funding 36 CBOs under PS 22-2203: Comprehensive High-Impact HIV Prevention Programs for Young Men of Color Who have Sex with Men and Young Transgender Persons of Color. Through this award, CBOs will develop and implement high-impact HIV prevention programs for young men of color who have sex with men, young transgender people of color, and their partners regardless of age, gender, and race/ethnicity. This funding opportunity enhances CBOs' capacity to increase HIV testing, link and re-engage people with HIV to care, link people without HIV to PrEP services, increase Partner Services referrals, and provide referrals to prevention and essential support services.
Expanding the implementation of a status-neutral approach to HIV care, where everyone receives ongoing, high-quality health care services regardless of their HIV status.
Leading up to NHTD, we encourage you to download and share HIV testing resources from CDC's Let's Stop HIV Together campaign. If you are a health care provider, you can download HIV testing materials for your practice and patients. You can also raise awareness by sharing social media content from CDC's NHTD digital toolkit using the #HIVTestingDay and #StopHIVTogether hashtags. For local HIV testing services, including self-testing, we ask that you promote CDC's self-testing locator.
The COVID-19 pandemic has presented unique challenges, but the HIV prevention community is resilient. HIV testing is a critical tool to helping us achieve the goals of the Ending the HIV Epidemic in the U.S. initiative. Join us this NHTD in communicating that HIV testing is an act of self-care, and there are many HIV testing options availableincluding HIV self-testing.
Thank you for your support and ongoing commitment.
Demetre C. Daskalakis, MD, MPH, Director Division of HIV Prevention, National Center for HIV, Viral Hepatitis, STD, and TB PreventionCenters for Disease Control and Prevention
Jonathan H. Mermin, MD, MPH, Rear Admiral and Assistant Surgeon General, USPHS, Director, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention
Stay connected: @DrMerminCDC & Connections