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Review
. 2021 Nov;61(5 Suppl 1):S130-S142.
doi: 10.1016/j.amepre.2021.05.029.

HIV Cluster and Outbreak Detection and Response: The Science and Experience

Alexandra M Oster  1 , Sheryl B Lyss  2 , R Paul McClung  2 , Meg Watson  3 , Nivedha Panneer  3 , Angela L Hernandez  3 , Kate Buchacz  3 , Susan E Robilotto  4 , Kathryn G Curran  3 , Rashida Hassan  3 , M Cheryl Bañez Ocfemia  3 , Laurie Linley  3 , Stephen M Perez  2 , Stanley A Phillip Jr  3 , Anne Marie France  2
Affiliations
Review

HIV Cluster and Outbreak Detection and Response: The Science and Experience

Alexandra M Oster et al. Am J Prev Med. 2021 Nov.

Abstract

The Respond pillar of the Ending the HIV Epidemic in the U.S. initiative, which consists of activities also known as cluster and outbreak detection and response, offers a framework to guide tailored implementation of proven HIV prevention strategies where transmission is occurring most rapidly. Cluster and outbreak response involves understanding the networks in which rapid transmission is occurring; linking people in the network to essential services; and identifying and addressing gaps in programs and services such as testing, HIV and other medical care, pre-exposure prophylaxis, and syringe services programs. This article reviews the experience gained through 30 HIV cluster and outbreak responses in North America during 2000-2020 to describe approaches for implementing these core response strategies. Numerous jurisdictions that have implemented these response strategies have demonstrated success in improving outcomes related to HIV care and viral suppression, testing, use of prevention services, and reductions in transmission or new diagnoses. Efforts to address important gaps in service delivery revealed by cluster and outbreak detection and response can strengthen prevention efforts broadly through multidisciplinary, multisector collaboration. In this way, the Respond pillar embodies the collaborative, data-guided approach that is critical to the overall success of the Ending the HIV Epidemic in the U.S. initiative.

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Figures

Figure 1.
Figure 1.
Scope of HIV cluster detection and response activities.
See this image and copyright information in PMC

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