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The Prevention with Positives (PwP) Initiative from the Centers for Disease Control and Prevention (CDC) encompasses activities focused on persons living with HIV to improve their individual health and reduce the risk of HIV transmission to uninfected sex and needle-sharing partners. The Initiative grew out of the CDC’s Serostatus Approach to Fighting the Epidemic (SAFE) program, begun in 2001 to focus prevention efforts and resources on persons living with HIV to improve support for their health and reduction of the risk of HIV transmission. In 2003 this effort was expanded into the CDC’s Advancing HIV Prevention Initiative with four main strategies for prevention activities: increased testing in medical settings, increased use of new testing technologies, prevention with persons living with HIV to impact transmission, and perinatal transmission prevention. This earlier version of the PwP strategy emphasized individual sexual behavior change as well as working with persons living with HIV and their partners to optimize linkage to care, delivery of prevention interventions, and innovative approaches to risk reduction.
Today, compelling evidence that antiretroviral treatment (ART) not only enhances quality and longevity of life but also reduces HIV transmission. This lends urgency to identifying HIV-positive persons and bringing them into a comprehensive continuum of care. The PwP Initiative now incorporates a holistic and system level approach to risk reduction. It brings a renewed focus on prioritizing and concentrating HIV prevention resources and programs with persons living with HIV. As recent research has shown, and this site supports, reducing viral load to minimal levels through antiretroviral treatment of those infected can lead to dramatic reductions in transmission at both the individual and population levels. The Initiative brings together clinical care providers, community-based organizations, HIV service providers, health department staff, and HIV policy makers to create an enhanced continuum of care. This continuum includes ten PwP components: linking every person living with HIV to medical care; retaining patients in care; prescribing ART for all patients; helping patients maintain adherence to treatment; providing partner services; screening patients for risk behaviorsand referring them to risk reduction programs; giving active referrals to other supportive services; screening patients for sexually transmitted disease and supplying related services; delivering appropriate reproductive health care; and taking action to prevent mother-to-child transmission of HIV. These components, which are described on this website, make up the comprehensive and complementary set of PwP strategies in the High Impact Prevention (HIP) plan of action (http://www.cdc.gov/hiv/strategy/hihp/index.htm), the CDC’s operationalization of the United States National HIV and AIDS Strategy (http://www.aids.gov/federal-resources/national-hiv-aids-strategy/overview/). Implementing the PwP integrated family of components offers a cost-efficient and effective road to ending the HIV epidemic.