ENDING THE EPIDEMICS: A NATIONAL, STATE, AND CITY APPROACH Murray Penner Executive Director
MISSION AND VISION
READY TO END THE EPIDEMICS NASTAD s vision is a world free of HIV and viral hepatitis. NASTAD s mission is to end the intersecting epidemics of HIV, viral hepatitis, and related conditions by strengthening domestic and global governmental public health through advocacy, capacity building, and social justice.
COMMITMENT TO SOCIAL JUSTICE 4
COMMITMENT TO SOCIAL JUSTICE Racism has imprinted a legacy of systemic injustices against Black people in the United States. The pervasive undercurrent of White privilege and supremacy exists in the form of obstructed economic, political, and social power for Black people in America. Discriminatory public and political infrastructure, including population health systems, prevents equitable health outcomes. NASTAD believes that to impact the HIV and hepatitis epidemics, health departments must reframe public health approaches to include social justice action. NASTAD commits to combatting health inequities in Black communities by mobilizing governmental HIV and hepatitis public health programs to engage in concerted social justice initiatives. As the voice of state and territorial HIV and hepatitis programs, NASTAD will develop multi sectoral partnerships that support meaningful community engagement and address social policies that negatively affect the lives of Black people. Actualizing the collective visions of NASTAD, the National HIV/AIDS Strategy, and the Viral Hepatitis Action Plan requires an intentional understanding and focus on the needs of Black communities. 5
CHAIRS CHALLENGE 6
STEP 1 Are you ready to end the HIV and hepatitis epidemics?
STEP 2 Assess your readiness.
STEP 3 Create a strategy.
ENDING THE HIV AND HEPATITIS EPIDEMICS We re talking about making HIV and hepatitis epidemiologically rare. For those living with HIV and hepatitis, their care will be seamless with no barriers, including those tethered to stigma and discrimination.
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2 Governor Andrew Cuomo announcing his new initiative to combat the AIDS epidemic before the 2014 NYC Gay Pride Parade. Credit: Michael Appleton for The New York Times Defining the End of AIDS Goal Reduce from 3,000 to 750 new HIV infections per year by the end of 2020. Three Point Plan 1. Identify all persons with HIV who remain undiagnosed and link them to health care. 2. Link and retain those with HIV in health care, to treat them with anti-hiv therapy to maximize virus suppression so they remain healthy and prevent further transmission. 3. Provide Pre-Exposure Prophylaxis for persons who engage in high risk behaviors to keep them HIV negative.
Key Successes An estimated 475 760 infants were born with HIV in 1990 Zero mother to child transmissions for a period of 18 months Decreased new HIV diagnoses due to injection drug use by 96% since the mid 1990s 79% reduction in new AIDS diagnoses. 40% reduction in new HIV cases over last decade 3 New York State is uniquely positioned to be the first state to end its AIDS epidemic
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Pre-Exposure Prophlyaxis (PrEP) www.prepforsex.org
9 Surveillance Report Data to Care ETEDASHBOARDNY.ORG
12 Opioid Overdose Prevention Co located Substance Use Treatment and HIV Prevention and Primary Care Services Continuing to expand syringe exchange services offered statewide 25 SEPs currently 18 agencies funded for Peer Delivered Syringe Exchange targeting young injectors 3,200 ESAP pharmacies
13 The NYS Investment Governor Cuomo also made a series of announcements regarding the next phase of New York State s Plan to End the AIDS Epidemic in the State. First, he announced that in addition to the $2.1 billion that the State currently directs to HIV/AIDS efforts, his administration will make additional financial and programmatic commitments
10 Services Options Redesigning Care Community Service Programs (CSPs) Designated AIDS Centers (DACs) Special Needs Managed Care Plans (SNPs) Fee for Service Enhanced Rates Value Based Payment (VBP) St. Vincent s Hospital http://collections.mcny.org/collection/st. Vincent's Hospital, New York 2F3XC561PFG.html Health Homes
Changing Landscape 11 Governor s Program Bill The purpose of this bill is to support New York s Ending the Epidemic Initiative to decrease the prevalence of HIV infections. Streamline routine HIV testing Eliminate the existing upper age limit for the purpose of offering an HIV test Allow a physician to issue a non patient specific order to allow registered nurses to screen individuals at risk for syphilis, gonorrhea and chlamydia Allow a physician to order a patient specific or non specific order to a pharmacist to dispense a seven day starter kit of PEP
Community Input, Collaboration, Marketing 16 AAC ETE Subcommittee Advisory Groups Focusing on: STDs Data Needs Women Older Adults Young Adults Transgender and Gender Non Conforming Men and Women Black MSM Spanish Speaking, Migrant Workers and New Immigrants
13 2013 2014 Comparison Viral Load Suppression/Any HIV Care 84%
14 Ending the Epidemic Dashboard ETEDASHBOARDNY.ORG