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Abstract
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Since the early 1990s, the incidence of human immunodeficiency virus (HIV) infection in the United States
has been
~40,000 cases per year. Because this rate has not decreased substantially in 115 years, the efficacy
and cost-effectiveness of programs to prevent HIV infection have come under intensifying examination. In
this article, several issues are addressed, including the efficacy of HIV prevention strategies at the national
level in the United States, the status of the goals from the current (albeit expired) national HIV prevention
plan, the role of opt-out HIV testing in a new comprehensive national HIV prevention plan, and a review of
evidence-based prevention strategies that should be emphasized in a new plan.