HIV Cluster and Outbreak Detection and Response
HIV cluster and outbreak detection and response (CDR) is a public health strategy for identifying when and where HIV is quickly spreading.
An outbreak is defined as the occurrence of more cases of a disease than expected in a given geographical area, or among a specific group of persons over a particular period of time. Disease outbreaks can result in significant morbidity (Illness) and associated adverse health outcomes, disruption of services, and anxiety in a community.
A transmission cluster is a group of persons with HIV—diagnosed or undiagnosed HIV—who are connected by HIV transmission (the action of passing something from one person to another). Transmission clusters can represent recent and ongoing HIV transmission in a population, and prevention efforts could prevent new infections.
Transmission clusters can identify risk networks (groups of interconnected people) that are concerning because of ongoing transmission, poor outcomes, or other reasons, such as transmission in a particularly vulnerable or underserved population, or transmission of drug resistance.
A quick and effective response is crucial for saving lives.
DSHS CDR Plan | Tiered Response Plan | Fact Sheets | Information for the Public | Provider Resources | Program Resources
The Evidence Base for Initial Intervention Strategies for Ending the HIV Epidemic in the U.S.
- HIV Cluster and Outbreak Detection and Response: The Science and Experience - This article reviews the experience gained through 30 HIV cluster and outbreak responses in North America during 2000–2020 to describe approaches for implementing these core response strategies.
- Response to a Large HIV Outbreak, Cabell County, West Virginia, 2018–2019 - This article describes the design and implementation of a comprehensive response to a large 2019 outbreak in West Virginia, featuring interventions from all pillars, and includes data to demonstrate outcomes of this response.
- Interdisciplinary HIV Sentinel Case Review: Identifying Practices to Prevent Outbreaks in Philadelphia - This article describes the design, implementation, and early findings of a Philadelphia-based project to systematically assess sentinel cases among priority populations for improving public health infrastructure and preventing future outbreaks.
- Detection and Response to an HIV Cluster: People Living Homeless and Using Drugs in Seattle, Washington - This article describes a response to a geographically concentrated outbreak of HIV among heterosexual people who inject drugs in Seattle, Washington and showed that more rapid receipt and analyses of HIV genetic sequences might have detected this outbreak sooner.
CDC HIV Cluster Detection and Response
- CDR Overview
- CDR Community Spotlights (includes San Antonio; Lawrence and Lowell, MA; and Minneapolis, MN)