CDC’s New Risk Reduction Tool: Exploring Prevention Options

New biomedical approaches to HIV, such as routine use of ART to treat and prevent HIV, and the use of PrEP and PEP, require changes and greater precision in how we communicate about HIV prevention. In December 2015, at the National HIV Prevention Conference in Atlanta, CDC launched a pilot version of a new tool that provides updated information about the many prevention methods now available. It’s called the HIV Risk Reduction Tool (HRRT). I would like to tell you how we arrived at the new messages contained in the tool and to invite you to help us continue to improve it.

In 2013, CDC stopped using the terms "protected" or "unprotected" sex in relation to HIV risk. “Protected” once only meant wearing a condom, but now, “protected” can include other HIV prevention strategies, such as biomedical options (e.g. PrEP) in addition to condoms. CDC now uses more specific language and integrated prevention messages in all of its communication channels: on the web, in research, and in campaigns.

One example of this change is the integrated message in “Start Talking. Stop HIV,” an HIV prevention campaign for gay and bisexual men. The campaign’s call to action is: "Protect yourself and your partner. Talk about testing, your status, condoms, and new options like medicines that prevent or treat HIV." This campaign is inclusive of the many options available to reduce HIV risk, and it presents them in a clear, simple, and engaging way.

The HIV Risk Reduction Tool, developed through a systematic scientific process, provides a comprehensive update of CDC's HIV prevention messages. This tool brings together all of our prevention messages for different populations. It also enables users to compare the risks created by different sexual activities and to see how one or a combination of prevention methods – such as condoms, PrEP, or ART – could reduce the risk of HIV. With the interactive tool, users can:

• Customize the information to see risks for discordant couples;
• Personalize the content they get by gender, HIV status, and gender of sex partner;
• Go into greater depth and seek additional resources;
• Compare HIV risk associated with sex acts and how risk changes according to the act (oral versus anal sex), risk factors (STDs and acute HIV infection), and choice of prevention options (ART, PrEP, condoms, etc.) and
• Get estimated risks in numeric form by using tables that contain per-act transmission by behavior, the effectiveness of prevention options to reduce risk, and factors that increase risk.

The tool is especially timely given CDC’s recent data release that noted 1 in 6 gay and bisexual men, 1 in 2 black gay and bisexual men, and 1 in 4 Latino gay and bisexual men will be diagnosed with HIV during their lifetime if current trends continue. By enabling people to understand and reduce their risk of acquiring HIV, the tool has great promise, made more so by the plan to systematically update it. Issued as a beta release, CDC will refine the tool as we get feedback and update the information as advancements are made in prevention science. I encourage you to take time to review the tool, available at https://wwwn.cdc.gov/hivrisk/, and provide your feedback through the button located on each page . Every page of the tool includes a user feedback button. Your input along with usability testing, formal evaluation of users, and engaging external and internal stakeholders, will inform improvements to this beta version. We look forward to hearing from you!