HIV PREVENTION: NHAS TO HIP

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1 HIV PREVENTION: NHAS TO HIP Vasavi Thomas, RPh, MPH Public Health Advisor, Prevention Program Branch Division of HIV/AIDS Prevention Centers for Disease Control

2 OVERVIEW National HIV/AIDS Strategy (NHAS) Goals HIV Prevention Focus: High Impact Prevention (HIP) CDC s Efforts to support NHAS through HIP

3 HIV care in the United States

4 NHAS Vision The United States will become a place where new HIV infections are rare and when they do occur, every person, regardless of age, gender, race/ethnicity, sexual orientation, gender identity or socio-economic circumstance, will have unfettered access to high quality, life-extending care, free from stigma and discrimination.

5 National HIV/AIDS Strategy Goals 1. Reduce HIV Incidence 2. Increase access to care and improve health outcomes of PLWHAs 3. Reduce HIV-related health disparities 4. Improve cross-agency coordination and collaboration

6 Goal 1. Reducing HIV Infections By Lower annual number of new infections by 25% 2. Reduce HIV transmission rate by 30% 3. Increase percentage of PLWHAs with knowledge of their status from 79% to 90% (reduce to 10% undiagnosed)

7 Three Critical Steps Needed to Reduce HIV Infections Step 1: Intensify HIV prevention efforts in the communities where HIV is most heavily concentrated Step 2: Expand targeted efforts to prevent HIV infection using a combination of effective, evidence-based approaches Step 3: Educate all Americans about the threat of HIV and how to prevent it.

8 Goal 2. Increasing access to care and improving health outcomes for PLWHA By 2015: 1. Increase proportion of newly diagnosed patients linked to care within 3 months of diagnosis from 65% to 85% 2. Increase Ryan White program clients in continuous care from 73% to 80% 3. Increase Ryan White clients with permanent housing from 82% to 86%

9 Critical Steps to Achieving Success in Linking and Retaining Individuals in Care Step 1: Establish a seamless system to immediately link people to continuous and coordinated quality care when they are diagnosed with HIV. Step 2: Take deliberate steps to increase the number and diversity of available providers of clinical care and related services for people living with HIV. Step 3: Support people living with HIV with co-occurring health conditions and those who have challenges meeting their basic needs, such as housing

10 Goal 3. Reducing HIV-related health disparities By 2015: 1. Increase proportion of HIV-diagnosed gay and bisexual men with undetectable viral load by 20% 2. Increase proportion of HIV-diagnosed Blacks with undetectable viral load by 20% 3. Increase proportion of HIV-diagnosed Latinos with undetectable viral load by 20%

11 Steps to Increase the Capacity of Whole Communities and Reduce HIV-related Disparities Step 1: Reduce HIV-related mortality in communities at high risk for HIV infection. Step 2: Adopt community-level approaches to reduce HIV infection in high-risk communities. Step 3: Reduce stigma and discrimination against people living with HIV.

12 Goal 4: Increasing cross-agency coordination 1. Cross-Department planning 2. Equitable resource allocation-shift from AIDS to HIV case reports 3. Data collection-streamlined, standardized 4. Reporting & Evaluation on progress toward goals

13 Steps to Achieve a More Coordinated National Response to the HIV Epidemic Step 1: Increase the coordination of HIV programs across the Federal government and between federal agencies and state, territorial, tribal, and local governments. Step 2: Develop improved mechanisms to monitor and report on progress toward achieving national goals.

14 DHAP Works to Achieve NHAS Vision Supporting state, local, community HIV prevention programs with funding and technical assistance Tracking epidemic and success of service provision through HIV surveillance and program monitoring Identifying new prevention interventions and improving operational implementation National campaigns and prevention efforts Epidemic and economic modeling to improve decision-making

15 Combination Prevention Multiple Disciplines and Approaches Structural interventions Biomedical interventions HIV prevention HIV testing and linkage to care Combining interventions is not enough All interventions are not effective Community interventions Individual and small group Interventions All effective interventions are not equal Adapted from T. Coates. Lancet; 2008

16 Potential interventions Assess efficacy and effectiveness HIGH-IMPACT PREVENTION (HIP) Implement and evaluate programs Prioritize interventions Establish cost and cost effectiveness per infections averted and life-years saved Determine feasibility of full scale implementation Develop epidemic models to project impact of interventions

17 Fulfilling the Promise of HIP Enhanced Comprehensive HIV Prevention Planning (ECHPP) Demonstration Project ( ) Resource allocation modeling New FOAs Prevention FOA (2012) Surveillance FOA (2013) Capacity-building FOA (2014) Care and Prevention in the United States (CAPUS) Demonstration Project ( ) Changing Role of Behavioral Interventions Testing Initiatives

18 1. High-Impact HIV Prevention References 2. National HIV/AIDS Strategy (NHAS) 3. CDC Vital Signs

19 THANK YOU