CDC's Role in Prevention Planning

The Centers for Disease Control and Prevention (CDC) is the lead federal government agency for HIV prevention in the United States. CDC works with states and communities to provide the information and tools needed to design and implement effective local prevention programs. Each community faces unique prevention challenges, and programs must be locally relevant and workable. HIV prevention works best if designed and implemented by those closest to the problem, with input from the individuals and groups for whom programs are designed.

New Emphasis on Community-Based Prevention

In December 1993, CDC initiated a new process to put more of the decisions about prevention programs in the hands of the communities affected. The process, HIV Prevention Community Planning, represents a significant step forward in planning culturally competent and scientifically sound HIV prevention services that specifically address unique community needs.

The Science to Guide Prevention

HIV is still a relatively new epidemic, and continues to evolve. Prevention programs must keep pace with the epidemic, and lessons learned in one community should be applied in others, with local modifications as needed. CDC's role is to provide the science to guide prevention. To fulfill this role, CDC has several responsibilities, including:

• Tracking the Epidemic: Since the epidemic began, CDC has worked with state and local communities to track the course of HIV and AIDS. CDC has numerous surveillance programs and is constantly working to provide communities the most complete and timely information possible on ongoing and emerging trends.

• Prevention Research: CDC researchers continuously work to evaluate new tools and techniques for preventing HIV transmission. Both biomedical and behavioral interventions are examined, as well as promising integrations of the two approaches. For example, as AIDS increasingly affects women, it is critical that prevention methods be developed that are easily within women's control. CDC researchers are working with scientists worldwide to evaluate the effectiveness of female condoms and to develop effective microbicides that can kill HIV and the pathogens that cause other STDs. As with any new tool for prevention, scientists must also determine what influences people's willingness and ability to use these methods. CDC behavioral scientists are simultaneously working to evaluate the factors that will contribute to women's use of these products and how these new prevention methods can and should be balanced with existing prevention options.

• Evaluating What Works in HIV Prevention: CDC scientists also work with communities to determine the impact of HIV prevention programs and how programs may be improved. By distributing these findings broadly, successful interventions can be built upon nationally and adapted by other communities. It is critical that communities experiencing later waves of HIV infection and AIDS not struggle to develop, implement, and evaluate prevention programs as larger U.S. cities, like New York and San Francisco, had to do early on. Fifteen years into the epidemic in America, information is available that allows second- and third-wave communities to put prevention programs into place quickly, before HIV is firmly established and can be aggressively contained.

In the fall of 1995, the CDC created a new Center--the National Center for HIV, STD, and TB Prevention (NCHSTP)--to coordinate CDC's HIV prevention activities. Dr. Helene Gayle was named Director of NCHSTP and now leads CDC's HIV prevention efforts, as well as the agency's programs to prevent other sexually transmitted diseases and tuberculosis.