Ready to End the HIV and Viral Hepatitis Epidemics Chair’s Challenge: Success Story Profiles

In recognition of the important work of health department HIV and viral hepatitis programs, NASTAD has released a series of success stories highlighting local programs that address individual, community, and systems level needs and are advancing progress towards this year’s Ready to End the HIV and Viral Hepatitis Epidemics Chair’s Challenge

Our success stories demonstrate innovation, vision, and commitment to strengthening programs to better meet the needs of people living with and at risk for HIV and hepatitis infection. Going forward, NASTAD will continue to collect and feature model programs and will provide peer-based technical assistance to support local adaptations of these innovative and successful programs. 

Click on the links below to jump to stories and resources from each state:


Alabama

Start Talking Alabama: Alabama’s Stigma Reduction and HIV Awareness Raising Social Media Campaign is a video series that seeks to increase HIV awareness and decrease stigma by sharing prevention, testing, and treatment information, and supporting messages aimed towards young men of color via social media. The “Start Talking Alabama” campaign was developed as an offshoot of the Centers for Disease Control and Prevention (CDC) "Start Talking Stop HIV" campaign. 

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Arizona

Arizona Department of Health Services’ Social Media Initiative “It’s Only Dangerous When You Don’t Know It’s There:" The campaign uses comical depictions of everyday life gone wrong, because the person encountered an unknown hazard. Ads end with the tagline, “Awareness is the Answer.” Using a combination of highly targeted digital and traditional ad placement, custom Snapchat filters, and volunteers posting on Facebook, visitors were directed to HIVAZ.org for comprehensive testing, prevention and care information and search functions.

In Arizona, a collaborative effort is underway to enroll Latinx and Ryan White HIV/AIDS Program (RWHAP) clients into health insurance. Agencies are undergoing activities such as identifying clients’ preferred language in RWHAP applications, hiring bilingual staff, and producing materials for clients in English and Spanish. These interagency coordination efforts help to build trust with Latinx clients, while insurance access allows Latinx clients to have more comprehensive care than the RWHAP programs alone can provide.

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Colorado

The Critical Events System in Colorado provides intensive case management and planning to clients newly diagnosed, lapsed in care, or medically vulnerable, who are also experiencing periods of instability (e.g., homelessness, unemployment, substance use, mental health concerns).  Through support and assistance in accessing care and re-engaging in treatment, along with help in stabilizing their personal lives, the program attempts to aid clients in reaching viral suppression, and thus becoming less likely to transmit HIV.

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Detroit

“Link-Up Detroit” is a Data to Care (D2C) program that uses Surveillance data to identify people who are living with HIV (PLWH) but are not in medical care (NIC) and connect them with medical providers and communitybased organizations (CBOs).

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District of Columbia

90/90/90/50 Plan: Ending the Epidemic in the District of Columbia by 2020 is a public-private partnership announced in Washington, DC on World AIDS Day with the following four goals:

  • 90 percent of DC residents with HIV will know their status.
  • 90 percent of DC residents diagnosed with HIV will be in treatment.
  • 90 percent of DC residents in treatment will achieve viral load suppression.
  • The District will see an overall 50 percent decrease in new HIV cases.

More information can be found at DC.gov.

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Global

Partner Services in Ethiopia: NASTAD recently began the implementation of a national Partner Services program to notify partners of people newly diagnosed with HIV and STIs to close the gap in identifying undiagnosed people living with HIV and facilitating their access to HIV services. NASTAD is working with the Ethiopia Ministry of Health to develop national guidelines, healthcare worker training, and program implementation support. 

Haiti’s Patient Linkage and Retention Program: NASTAD worked with the Haiti Ministry of Health (MoH) and CDC to design a Patient Linkage and Retention (PLR) toolkit which is being used to improve community-based patient follow-up in Haiti. The system uses encrypted handheld computer tablets to record key data from community outreach. An online dashboard tracks progress at the site, regional, and national levels.

Organizational Capacity Assessment (OCA) in Mozambique: NASTAD developed the OCA tool to provide technical assistance and capacity building support to CDC-Mozambique and the Mozambique Ministry of Health to improve the government and local partner’s ability to conduct essential public health management functions to control the HIV epidemic. The OCA tool allows governments to identify core competencies where technical assistance is needed, and develop concrete action plans for improvement. 

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Illinois

The Illinois Department of Public Health conducted a gap analysis of routine HIV testing delivered to identify areas in the state where Medicaid providers had not delivered HIV testing services in the previous six months. The gap analysis allowed the health department to then focus capacity-building activities on the areas of the state where they will have the greatest impact on the epidemic. 

Illinois’ Summits of Hope program connects justice-involved individuals to health services within their community. Participants are offered voluntary services, such as HIV and HCV testing and health insurance enrollment. Drug screenings are also offered, but are not punitive. Instead, if a participant tests positive they are linked to an appropriate community-based treatment center. Since its founding in 2010, the Summits of Hope program has engaged more than 30,000 individuals, and has helped to destigmatize particpants and reintegrate them into their community by connecting them to local services.

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Indiana

Creative Collaborations: Indiana’s Program on Linkage and Retention in Care for Priority Populations - The Damien Center, Indiana's largest provider of HIV services, teamed up with Brothers United, an organization with an African-American focused HIV mission, to ensure better access to care for the African-American population. Through this strategic collaboration, the organizations created memorandums of understanding (MOUs) that allowed for The Damien Center to operate a satellite location within Brothers United's office, paving the way for the provision of new services that clients had previously struggled to access. These services, critical to maintaining engagement in care, include linkage to care, non-medical case management (NMCM), and mental health, in addition to pre-exposure prophylaxsis (PrEP) services. The program fills the gap between available medical and supportive services by providing individualized, long-term, one-on-one support for clients.

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Iowa

The Iowa Department of Public Health (IDPH) has made striven to reframe HIV prevention and care services to reflect the disproportionately high burden of developmental trauma (i.e., adverse childhood experiences (ACEs) among PLWH. These efforts include: the establishment of the Trauma Informed Leadership Workgroup, a collective of health department staff across programs; hiring a Trauma Informed Prevention and Care Coordinator to lead, assess, and expand on trauma informed capacity-building statewide; and sponsoring Trauma Informed Excellence (TIE) trainings among clinical and non-clinical providers. 

Iowa's Trauma Leadership Workgroup is an interdepartmental team dedicated to breaking down silos and promoting trauma informed care across disciplines. As stated by an Iowa services
provider: “A trauma informed approach to my work helps me see my clients as humans who are in need of compassion and assistance when it can be so easy to instead be overwhelmed by the volume of what needs to be done.”

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Louisiana

In Louisiana, data linkages with HIV surveillance and the use of viral load suppression incentives enables Medicaid managed care organizations to better monitor HIV-related outcomes among their enrollees. HIV viral suppression data can be used by MCOs to improve their outreach and services for persons living with HIV who are not virally suppressed or not in HIV-related medical care.

Leveraging Health Systems Transformation to Cure Hepatitis C Among People Living with HIV - The Louisiana Curing Co-Infection project launched in May 2017 with the goal of increasing provider knowledge about screening, diagnosis, and treatment of HCV among co-infected individuals. The Department of Health partnered with three clinic sites in high-prevalence areas to increase HCV screening, retention, and cure among co-infected people of color through provider education and practice transformation.

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Maryland 

The HCV Testing and Linkage to Care Program is a Maryland Department of Health initiative, piloted in February 2017, to increase the number of Marylanders that are made aware of their hepatitis C (HCV) status  and successfully linked to care in the community. This program was developed to expand HCV testing services, infrastructure, and coordination in local jurisdictions lacking this much-needed support. The long-term goal of the program is to ensure that targeted testing services are available in all counties in Maryland, paying special attention to high burden jurisdictions and reaching people most at risk for HCV.

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Mississippi

The Mississippi Department of Health’s "Test to Treat Family and Self" program provides culturally competent education in the coastal Vietnamese communities of Hancock, Harrison, and Jackson counties about the risk factors for Hepatitis B virus (HBV) and the importance of getting screened and vaccinated. The program also provides evidence based-interventions to empower community members to manage their chronic illnesses and links individuals living with Hepatitis B who are unable to pay for treatment to insurance coverage.

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Nevada

The Southern Nevada Harm Reduction Program Trac-B Exchange is a storefront SSP designed to provide easier access to safe injection supplies and to allow participants to enroll in access to one of three SSP vending machines. The program supports linkage to medical and social services, thereby improving outcomes for PLWH and/or viral hepatitis.

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New Hampshire

New Hampshire’s RWHAP Part B program developed a plan to utilize insurance services to improve the health of clients aged 50 years and older, including payment for supplementary premiums and coverage of co-payments and deductibles for Medicare beneficiaries enrolled in the RWHAP Part B program.  These efforts were implemented following a focus group discussion led during the development of the New Hampshire Integrated HIV/AIDS Plan for 2017-2021.  Participants expressed concerns about coordinating the logistics of accessing HIV-related care for aging PLWH through insurance and programs like the New Hampshire RWHAP.

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New Jersey

The New Jersey Department of Health Division of HIV, STD and TB Services (DHSTS) developed a supportive transitional housing project, funded through Ryan White Part B rebates, to co-locate needed medical case management, psychosocial support services, independent living readiness, and more in a transitional housing program in partnership with the AIDS Resource Foundation for Children. From 2015 to present, 54 residents have been inducted into the program. Of those 54, 30 have stayed longer than three months with 90% achieving viral suppression, 100% with access to treatment, and no missed HIV medical visits in the last six months.

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New Mexico

New Mexico’s U-30 Enhanced Hepatitis C (HCV) Surveillance Project aims to collect accurate information on individuals under 30 years old who are living with HCV and to provide them with health education, prevention messages, and referrals. The U-30 Project was developed in 2013 in response to the sharp increase in the HCV rate among young adults in New Mexico.  It is designed to conduct basic surveillance activities such as identifying new cases, monitoring disease trends, and obtaining accurate risk factors.

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New York

Ending the Epidemic Dashboard is a resource developed by New York State to track progress toward meeting the goals of the state’s 2015 Blueprint to end the epidemic by:

  • Identifying persons with HIV who remain undiagnosed and linking them to health care.
  • Linking and retaining persons diagnosed with HIV in health care to maximize virus suppression so they remain healthy and prevent further transmission.
  • Facilitating access to Pre-Exposure Prophylaxis (PrEP) for persons who engage in high-risk behaviors to keep them HIV negative.

Click here to learn more at the New York Department of Health website and download the 2015-2016 Ending the Epidemic Activity Report here.

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North Carolina

 North Carolina's Engagement in Care Database for HIV Outreach (NC ECHO)  is a database that collects standardized data on people living with HIV (PLWH) from five NC DHHS data sources.

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Oklahoma

The Oklahoma Department of Health developed a culturally appropriate and effective HCV awareness campaign for baby boomers (i.e., persons born between 1945 and 1965) who seek medical care within the Cherokee Nation. This awareness campaign focused on reducing new infections, was one component of a multi-party collaborative effort to eliminate HCV and improve the health of Native Americans in the Cherokee Nation Health Service (CHNS) by developing a community based program to test, treat, and cure HCV.

Oklahoma’s AIDS Drug Assistance Program (ADAP) has been particularly successful in providing HIV/HCV co-infected clients with access to directly-acting antiviral (DAA) HCV treatment medications, primarily through their ADAP-funded insurance program.  Oklahoma has also leveraged existing relationships with two Ryan White Part C clinics to track and monitor the health outcomes (i.e., sustained virologic response (SVR)) among those clients that receive DAA HCV treatment.

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Oregon

End HIV Oregon is a health department and community-developed initiative and five-year plan to end new HIV infections by expanding access to testing, prevention, and treatment. The plan calls for the following:

  • Expanding patient navigation and case management services so all people living with HIV benefit from treatment.
  • Implementing early intervention services statewide to link newly diagnosed people to care quickly and make sure people at risk get tested.
  • Expanding use of PrEP, a daily pill that dramatically reduces risk of HIV infection.
  • Focusing on disparities, health equity and stigma.
  • Working with community members statewide to implement this shared vision.

Download the following PDFs for more information:

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Philadelphia

The Philadelphia Department of Public Health (PDPH) launched a Perinatal Hepatitis C Program in January 2016 in response to the increasing incidence of HCV infection among pregnant women, driven by the opioid epidemic. 

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Rhode Island 

The Rhode Island STD Clinic’s PrEP implementation program is the only dedicated clinic providing PrEP services in the state.  With the support and collaboration of the Rhode Island Department of Health, the program raises PrEP awareness among the community by providing brief educational sessions and supporting materials to all MSM that present at the clinic.  The program then links individuals interested in receiving PrEP to available medical providers.  

In 2017-2018, Rhode Island Department of Health (RIDOH) has embarked on an initiative to evaluate social media usage among at-risk groups (adolescents, young adults, and MSM) and subsequent roll-out of a state-wide HIV/STD prevention and testing campaign targeting popular social media platforms.

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San Francisco

End Hep C SF is a multi-sector collective impact approach working to eliminate HCV and HCV-related stigma in San Francisco. This initiative released a 2017-2019 strategic plan highlighting five major priorities for elimination which include strengthening the overall End Hep C SF framework, making better use of data to guide programs and policies, improving education and prevention strategies, increasing community-based testing and linkage, and expanding access to HCV treatment. This is a city-wide initiative and the bulk of the efforts focus on communities that are most impacted by HCV.

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Tennessee 

Tennessee’s Social Network Strategy (SNS) HIV Testing Program is a non-clinical testing program in which three contracted community-based organizations (CBOs) targeted testing among young Black MSM while also identifying “recruiters” to conduct further outreach within their social networks.  The SNS HIV Testing Program was implemented in the two cities of Tennessee with the highest rates of HIV over a period of three years and is an innovative and non-traditional approach to reaching Black MSM.

Tennessee’s Statewide HIV/HCV Vulnerability Assessment was conducted as an ecological study using a dimension reduction statistical methodology across various local data sources (e.g., United States Census; surveillance data from multiple Tennessee Department of Health (TDH) programs, and the Tennessee Bureau of Investigation) to score each county’s risk for an HIV/HCV outbreak.  TDH used the ecological study to determine if more granular data improved insights into county-level HIV/HCV outbreak vulnerability as compared to the Centers for Disease Control & Prevention’s vulnerability assessment study.  This more detailed understanding will be used to inform public health practice and response. 

 

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Virginia

Virginia Department of Health’s Pharmacy-based HIV Testing Initiative: Retail pharmacy-based HIV testing is a program designed to expand access to HIV testing in areas of limited resources or high stigma. Pharmacies are known to offer a variety of products for daily use, and some have recently expanded to provide select point of-care health screening tests. This program helps normalize the act of seeking an HIV test by offering it in a familiar environment alongside non-stigmatized screening tests.

The Comprehensive HIV/AIDS Resources and Linkages for Inmates (CHARLI) Program provides linkage to medical providers, medication access, transportation assistance, and assistance in applications for social services for PLWH who are transitioning out of correctional settings and back into community in Virginia. In addition to lower rates of recidivism among participants, retention in care and viral suppression rates at follow up for CHARLI clients were 97% and 75%, respectively.

Virginia’s In-Home HIV Testing program was developed to meet the needs of residents whose living circumstances or place of residence make it difficult to access HIV testing from another venue due to stigma, time constraints, or other factors. Clients to receive in-home testing kits (i.e., MSM and transwomen with a Virginia address and not currently using PrEP) were identified based on the results of an online eligibility survey.

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Washington

The Point Defiance AIDS Project Care Coordination Initiative in Washington State provides care coordination services to address housing and treatment access needs for participants of SSPs. The program works to reduce stigma and impact social determinants of health through a harm reduction approach, ultimately increasing participants’ ability to meet their own HIV/HCV care goals.

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Washington, D.C.

DC Health launched its social marketing campaign, Sexual Being, in July 2018. The health department conducted formative research to launch this multi-faceted campaign with components including a website, social media, and traditional media outlets. While the campaign includes goals to increase testing, prevention options (PrEP, PEP, condoms), U=U messaging, and treatment, it is also intended to start a movement that makes sexual health a strength for people, to inform and activate persons to understand their rights, promote equity, and foster healthier attitudes and relationships.

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Wisconsin

Wisconsin Department of Health Services’ program to Increase Leadership Diversity in the HIV Workforce: Rates of HIV are unacceptably high and increasing among young Black gay and bisexual men and transgender women. Increasing workforce diversity, particularly at the leadership level, is crucial to addressing the disparate impact of the epidemic on these populations. The Wisconsin Health Leaders Fellowship is a one year leadership development program designed to increase the number of leadership positions held by people of color, particularly men who have sex with men (MSM) of color, in organizations providing HIV services in Milwaukee, Wisconsin. Fellows come from five local agencies which have committed to the program and to supporting staff to participate as fellows. The fellowship is coordinated and supported by the Wisconsin AIDS/HIV Program at the Wisconsin Division of Public Health.

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Please contact Amanda Bowes if you have any questions or if you’d like more information on how to contribute a success story from your jurisdiction.