World AIDS Day

World AIDS Day is a time to come together in the fight against HIV and AIDS, remember those we’ve lost, and look at how far we’ve come. Since 1988, treatment and prevention have improved greatly, turning HIV into a condition people can live with for many years. But the work isn’t finished.

Today we have tools that help stop HIV transmission and allow patients to live long, healthy lives. Still, stigma and discrimination remain in workplaces, schools, housing, and even healthcare. These barriers keep people from getting the care they need.

World AIDS Day is a chance to learn more, speak up, and support efforts to end HIV. One major effort is the Ending the HIV Epidemic in the U.S. (EHE) initiative. Its goal is to cut new infections by 75% by 2025 and 90% by 2030, preventing about 250,000 infections HIV.gov.

Key Facts About HIV in the U.S.

• More than 700,000 American lives have been lost to HIV since 1981
• More than 1.2 million Americans are currently living with HIV and many more are at risk of HIV infection
• In 2022, an estimated 31,800 people acquired HIV in the U.S.
• New HIV infections decreased 12% from 36,300 in 2018 to 31,800 in 2022
• HIV diagnoses are not evenly distributed — the South continues to have the highest rates of new diagnoses
• HIV disproportionately impacts racial and ethnic minorities and gay, bisexual and other men who have sex with men
• While new HIV diagnoses have declined significantly from their peak, progress has stalled. About 38,000 Americans are newly diagnosed each year, 400,000 more Americans could be diagnosed over the next decade.
• The U.S. government spends $20 billion annually on HIV prevention and care
• There is a real risk of HIV resurgence due to several factors, including injection drug use, stigma, homophobia, and lack of access to HIV prevention and treatment. HIV remains a major public health threat (HIV.gov: U.S. Statistics).

According to CMS, expanded coverage for essential HIV/AIDS care across programs has strengthened the continuum of care for people with these diagnoses. Access to Pre-exposure Prophylaxis (PrEP) — FDA-approved antiretroviral drugs that help prevent HIV infections in people at higher risk — has been expanded under Medicare.

Medicare Part B now covers:

• PrEP for HIV
• Counseling related to HIV, including risk reduction, medication compliance and HIV screening

These services are without cost sharing, deductibles or copayments. For details, see MLN Matters®: MM13843 (PDF) which includes important billing and coding information for these services.

Provider Checklist: What You Can Do Today

• Offer HIV screening to patients and part of routine care
• Discuss PrEP with patients at increased risk for HIV
• Provide counseling on risk reduction and medication adherence
• Review Medicare coverage rules for PrEP and related service; see MLN Matters®: MM13843 (PDF)
• Ensure accurate billing and coding for HIV-related services
• Create a stigma-free environment by using inclusive, respectful language

Resources

• U.S. Centers for Disease Control and Prevention (CDC) Ending the HIV Epidemic in the US (EHE)
• CMS.gov World AIDS/HIV Day Fact Sheet
• HIV.gov
• Medicare.gov Pre-exposure prophylaxis (PrEP) for HIV prevention
• Medicare Preventive Services Hepatitis B Screening
• Medicare Preventive Services HIV Screening
• Medicare Preventive Services PrEP Using Antiretroviral Therapy to Prevent HIV
• National Coverage Analysis (NCA) CAG-00464N
• National Coverage Determination (NCD) 210.15 PrEP for HIV Prevention
• Social Security Act Section 1861 (ddd)(1) Prevention Service
• World AIDS Day