The previous version focused more narrowly on issues like behavioral risk factors, sexually transmitted infections, needle sharing and partner notification. The new effort stresses that HIV-positive people are central players in the effort to fight the spread of the virus. It includes factors such as prevention through the use of antiretrovirals (ARVs) and the importance of effectively linking people with HIV to medical care and keeping them in care. The new guidelines also address conceiving a child, access to health insurance, stigma, poverty, mental illness, substance abuse, housing and laws criminalizing HIV.

The CDC advises clinicians to offer ARVs to all HIV-positive patients, regardless of CD4 count—not just because treatment greatly reduces the likelihood of transmission, but also because of the apparent health benefits of starting treatment earlier. Additionally, it encourages health care providers to educate patients about pre-exposure and post-exposure prophylaxis (PrEP and PEP) for HIV-negative people.

Praising the new guidelines, Jeff Bailey, director of client services at AIDS Project Los Angeles, says that “integrating prevention in the medical setting” through the various strategies outlined in the CDC document “is an important, viable strategy that’s supported by evidence and which can reduce the incidence of new infections.”