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Establishing a holistic framework to reduce inequities in HIV, viral hepatitis, STDs, and tuberculosis

This resource is available in English only.

Populations who live in situations of low socioeconomic status; unequal access to health services; lack of education; and stigmatization due to racism, homophobia and other forms of systemic discrimination are both at higher risk of a number of infectious diseases and underserved by preventive and treatment efforts.

In this document, the National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention (NCCHHSTP), part of the Centers for Disease Control and Prevention (CDC) in the United States, outlines its strategy to reduce the incidence of these infectious diseases among groups experiencing a disproportionate burden of disease risk and rates. The strategy attempts to address the imbalance through action on socioenvironmental roots on disease transmission and health.

Priority action areas

This report describes which population groups are disproportionately affected by HIV, viral hepatitis, STDs and tuberculosis and how this relationship intersects with the social determinants of health (SDH).
Six priority action areas for the NCCHHSTP are outlined based on the World Health Organization (WHO) theoretical framework for how the social determinants of health influence health inequities. These include:

  • research and surveillance;
  • health communication;
  • health policy;
  • prevention programs;
  • capacity-building; and
  • partnership activities.

Actionable priorities are outlined for each of these areas, including tasks related to program development and implementation, surveillance to inform policy priorities and resource allocation strategies. Monitoring and evaluation activities are also discussed, as well as how partnership activities can incorporate a social justice lens into their work.


The intended audience for this document includes public health practitioners, community organizations, health professionals across disciplines and other research and government agencies working towards the elimination of HIV, viral hepatitis, STDs and tuberculosis.

Use this resource to

  • facilitate discussion about intersectoral approaches to address inequities in rates of HIV, viral hepatitis, STDs and tuberculosis;
  • develop actions based on the six priority areas to address SDH that affect infectious disease;
  • incorporate monitoring and evaluation components to programs designed to eliminate infectious disease among populations negatively affected by SDH; and
  • advocate for resource reallocation and reprioritization to address inequities in disease.


Centers for Disease Control and Prevention. (2010). Establishing a Holistic Framework to Reduce Inequities in HIV, Viral Hepatitis, STDs, and Tuberculosis in the United States. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. Atlanta, GA.

Tags: Infectious disease, Report / Document