How the response to the epidemic of HIV infection has strengthened the public health system.

Since acquired immunodeficiency virus (AIDS) was first identified in 1981, it has become one of the leading causes of death in men and women 25-44 years of age in the United States. The urgent public health response to the human immunodeficiency virus (HIV) and AIDS epidemic has required the development of new prevention programs; these efforts have significantly strengthened the public health system itself. A major part of CDC's mission is to prevent HIV infection and reduce the incidence of HIV-associated illness. In fighting HIV infection and AIDS, as in all successful public health programs, CDC has four important goals: (a) to assess risks, (b) to develop prevention technologies, (c) to build prevention capacities, and (d) to implement prevention programs. The urgency of the need to prevent HIV infection and AIDS has in many instances added impetus or substance to programs already under way, as well as prompting the development of new initiatives to meet the four goals. Examples of ways in which the public health system has benefited from HIV-related programs and activities are detailed in this article. Although the HIV epidemic has created significant stresses in many areas of public health and medical services, the experience gained in dealing with this epidemic will strengthen the nation's response to other health crises that arise. Despite the huge challenges, lessons learned thus far provide direction and hope for the future.