AIDS and Behavior ( C  2006) DOI: 10.1007/s10461-005-9034-x Experts Outline Ways to Decrease the Decade-Long Yearly Rate of 40,000 New HIV Infections in the US Michael M. Copenhaver 1,2 and Jeffrey D. Fisher 1 This paper presents data from a brief, anonymous, open-ended survey of 50 behavioral re- search experts in HIV prevention. Responses were received from 31 participants who pro- vided input regarding the primary reasons they believe the rate of the HIV epidemic in the United States has persisted in recent years, and how they believe we can most efficiently de- crease the current rate of new HIV infections in the United States. Four clusters of reasons suggested for the persistent rate of new infections: Intervention level reasons, Society level reasons, Person level reasons, and Multiple Risk Factor reasons. Three clusters of strategies suggested for decreasing the current rate: Improved Targeting of HIV Prevention efforts, Larg-Scale Changes to HIV prevention, and Integrating HIV Prevention into more aspects of society. Results are reviewed with the objective of providing a fresh perspective on the potential means for addressing the current HIV epidemic. KEY WORDS: HIV prevention; interventions; substance abuse; risk reduction. INTRODUCTION It has been just over 20 years since the first cases of AIDS were reported in the United States. Today, about 950,000 people in the United States live with HIV infection and 450,000 people have died be- cause of AIDS thus far (CDC, 2004; Joint United Nations Programme on HIV/AIDS, 2004). It is es- timated that 237,500 individuals living with HIV in the United States remain unaware of their seropos- itive status (Joint United Nations Programme on HIV/AIDS, 2004) and therefore may now be unwit- tingly transmitting HIV to others. The HIV epidemic in the United States has slowed from approximately 150,000 new infections per year during the mid to late 1980s to a relatively consistent 40,000 new infec- tions per year from the mid 90s to date (CDC, 2004; 1 Department of Psychology, University of Connecticut, Storrs, Connecticut. 2 Correspondence should be directed to Michael M. Copenhaver, University of Connecticut, Department of Psychology, Cen- ter for Health/HIV Intervention and Prevention (CHIP), 2006 Hillside Road, Unit 1248, Storrs, Connecticut 06269-1248; e-mail: michael.copenhaver@uconn.edu. Valdiserri, 2003). Though the spread of HIV contin- ues at an epidemic pace, the current trend appears steady. Given this state prevention efforts must be planned for the coming decades. Here we present re- sults of a survey of prominent HIV behavioral re- searchers that was designed to elicit suggestions for decreasing the current yearly rate of 40,000 new HIV infections in the United States. The current HIV epidemic in the United States is driven by multiple interrelated subepidemics among groups at risk for HIV: Injection drug users (IDUs), Men who have sex with men (MSM), and heterosexuals. A key preventable reason for this stems from drug- and sex-related HIV risk behav- iors among HIV-positive individuals (e.g., see Amico et al., in press; Avants et al., 2004; Copenhaver et al., 2003; Erbelding et al., 2000; Fisher et al., in press; Kalichman, 2000; Margolin et al., 2003; Marks et al., 1999). Many individuals within these groups re- duce or even eliminate HIV risk behaviors follow- ing a positive HIV test result (Avants et al., 2000); however, sufficient numbers of individuals clearly do not and HIV risk behavior is well documented across HIV-positive MSM (e.g., Kalichman, 2000) 1438-2377/06 C  2006 Springer Science+Business Media, Inc.