BACKGROUND: People who inject drugs (PWID) face increased risk for HIV, but experience multiple challenges accessing HIV prevention, testing, and treatment services. These challenges often result from stigma, discrimination, and the criminalization of drug use, which limits their access to health services. Through the United States (US) President’s Emergency Plan for AIDS Relief (PEPFAR), the US Centers for Disease Control and Prevention (CDC) has supported the delivery of HIV testing, prevention, and treatment services to PWID to address their disproportionately high HIV risk. We describe CDC’s achievements in supporting HIV-related health services to PWID and their progress along the HIV clinical cascade toward reaching the UNAIDS 95-95-95 goals to end HIV by 2030.
METHODS: Using PEPFAR’s Monitoring, Evaluation and Reporting (MER) data, we describe the number and percentage of PWID receiving HIV testing, prevention, and treatment services delivered by CDC-funded and supported implementing partners (IPs) between October 2021 and September 2022 (fiscal year 2022) in 22 PEPFAR countries.
RESULTS: In fiscal year 2022, CDC-supported IPs provided HIV prevention outreach for 55% (214,859) and HIV testing for 54% (191,178) of all PWID beneficiaries engaged in 22 PEPFAR countries. CDC-supported IPs contributed 56% (12,276) of new HIV diagnoses among all PWID and initiated 53% (16,865) of the HIV-negative PWID on PrEP. Furthermore, CDC-supported IPs linked 56% (11,322) of all HIV-positive PWID to antiretroviral therapy (ART). CDC-supported IPs provided 75% (59,946) of total viral load testing among PWID in PEPFAR-supported countries; of those PWID tested for viral load, 96% were virally suppressed. Finally, CDC-supported IPs provided medication-assisted therapy (MAT) for at least 6 months to 90% (24,621) of all PWID in the 22 PEPFAR countries.
CONCLUSIONS: Despite the persistent structural barriers to access HIV services, CDC and its supported IPs in 22 PEPFAR countries have reached this marginalized population and provided substantial levels of medication-assisted therapy as well as HIV testing, prevention, and treatment services. CDC supports crucial service provision to PWID.

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