The objective of HIV prevention programs is to reduce the number of new cases to as close to zero as possible. All prevention efforts are based on the belief that individuals can be educated in a way that will lead to changes in behavior, which will help bring an end to the spread of HIV/AIDS. However, many AIDS advocacy groups have long been critical of the ways the CDC has communicated the message. In 1987 CDC officials chose to emphasize the universality of AIDS, instead of focusing its efforts on those most at risk: male-to-male sexual contact (MSM) and intravenous drug users (IDUs). According to AIDS advocates, this strategy misdirected the spending of available prevention dollars. In 2007, even though the number of infected people outside of these two groups was growing, HIV/AIDS was still largely a threat to MSM, IDUs, their partners, and their children. Most women with HIV/AIDS were drug users or sex partners of drug users.

Critics claim that this emphasis on the ''anyone can get HIV'' concept has diverted funds from the target populations with the greatest need for preventive health education. In 1995 the federal AIDS prevention budget allocated no funds for programs aimed at MSM or for syringe exchange programs. According to Amanda Bennett and Anita Sharp, in ''Medicine: AIDS Fight Is Skewed by Federal Campaign Exaggerating Risks'' (Wall Street Journal, May 1, 1997), the CDC's $584 million

AIDS prevention budget in 1996 went largely to programs to help fight the disease among heterosexual women, college students, and others who face a relatively low risk of HIV infection.

The CDC's HIV prevention strategy, as described in Comprehensive HIV Prevention: Essential Components of a Comprehensive Strategy to Prevent Domestic HIV 2006 (January 31, 2006), aims to reduce the incidence and prevalence of HIV infection as well as the morbidity (illnesses) and mortality (deaths) that result from HIV infection by working with communities and other partners. The agency's efforts focus on:

-           Tracking the epidemic to monitor HIV-related morbidity and mortality, planning and evaluating prevention programs, and guiding the allocation of HIV program funds

-           Identifying causes that lead to HIV infection and instituting effective approaches to prevent infection

-           Implementing prevention programs, including counseling, testing and referrals, partner notification, and prevention for high-risk populations

-           Building capacity of state and local programs

-           Intensifying program evaluation and policy development

To carry out its strategy, the CDC is working in conjunction with governmental and nongovernmental partners to implement, evaluate, and further develop and strengthen effective HIV prevention efforts nationwide. Along with direct programs and service, the CDC provides financial and technical support for:

-           Disease surveillance

-           HIV antibody counseling, testing, and referral services

-           Street and community outreach

-           Risk-reduction counseling

-           Prevention case management

-           Prevention and treatment of other STDs

-           Public information and education

-           School-based AIDS education

-           International research studies

-           Technology transfer systems

-           Organizational capacity building

-           Program-relevant epidemiological, sociobehavioral, and evaluation research

CDC health education and disease prevention efforts continue to emphasize that the most reliable ways to avoid HIV infection or transmitting the virus are by abstaining from sexual intercourse, maintaining a mutually monogamous, long-term relationship with a partner who is uninfected, and/or to refrain from sharing needles and/or syringes in drug use. Even though seemingly logical, critics contend that the emphasis of the CDC, and of the administration of George W. Bush (1946-) in particular, on abstinence burdens people with an unrealistic expectation. Critics also point to the insistence on abstinence policies as a condition of U.S. government assistance for other countries' health programs to be an ill-advised foreign policy intrusion.

The CDC states in Comprehensive HIV Prevention that the HIV prevention strategy has as its overarching goal to ''reduce the number of new HIV infections in the U.S. from an estimated 40,000 to 20,000 per year, focusing particularly on eliminating racial and ethnic disparities in new HIV infections.'' The agency explains that this goal can be achieved by:

-           Decreasing the number of people who are at high risk for acquiring or transmitting HIV infection

-           Increasing the number of HIV-infected people who are aware that they are infected

-           Increasing the number of HIV-infected people who have access to prevention services and appropriate care and treatment

-           Improving the ability to monitor the epidemic nationwide, develop and implement effective HIV prevention interventions, and evaluate prevention programs

According to the Kaiser Foundation, in the fact sheet ''U.S. Federal Funding for HIV/AIDS: The FY 2007 Budget Request'' (February 2006), in fiscal year 2007 the CDC received $808 million for domestic HIV/AIDS prevention activities conducted by the National Center for HIV, STD, and TB Prevention. The total allocation to the CDC represented a 14%increase over 2006, which was in large part the result of the president's new Domestic HIV/AIDS Initiative, which directs additional funds to the CDC for increased testing activities, particularly rapid testing, for those at high risk. In Comprehensive HIV Prevention, the CDC indicates that 66% of this total was spent on intervention activities including testing programs and other prevention activities carried out by state, local, and community-based organizations; 14% on surveillance activities; 9% on capacity building/ technical assistance efforts; 6% on prevention research; and 5% on program evaluation and policy development.

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