EHE Jurisdictions Innovate to Respond Quickly to Communities Affected by Rapid HIV Transmissions

Enhancing efforts to respond quickly to potential HIV outbreaks to get prevention and treatment services to people who need them is one of the key strategies of the Ending the HIV Epidemic in the U.S. (EHE) initiative. Partners across the 57 prioritized jurisdictions are using many innovative approaches to the initiative’s Respond pillar, tailored to community needs. These include leveraging navigators and syringe services programs to support people newly diagnosed with HIV, facilitating peer distribution of HIV self-test kits within affected networks, and engaging community partners with deep connections to specific populations. As EHE’s fifth year continues, members of the HHS Office of Infectious Disease and HIV/AIDS Policy’s (OIDP) EHE and Engagement Teams have been hearing more about Respond pillar activities in several jurisdictions. Below are just a few of the innovative activities they have learned about that may be useful to other jurisdictions.

SSP Team and Navigators Support Response to Rapid HIV Transmissions in Baltimore

Through its EHE-supported Getting to Zero Program and Syringe Services Program (SSP), the Baltimore City Health Department (BCHD) responds to people affected by rapid HIV transmission detected in the city. Both the health department and community partners are engaged in identifying and responding to the communities affected. Together they deploy services to swiftly connect affected individuals to the HIV testing, prevention, care and treatment, and other services they need, and ongoing transmission can be halted. For example, one recently detected cluster that was first identified by a healthcare provider included a client of the SSP. The BCHD’s SSP team and Getting to Zero program engaged and recruited clients for HIV testing and services near the provider’s location to reduce the incidence of new cases and provide other assistance. In this and other efforts, navigators connect individuals with HIV to resources that assist in removing barriers to their HIV treatment and care, offering housing, health insurance, food, driver’s education classes, and childcare.

Los Angeles County Strategies Support EHE Respond Pillar

As part of their work under the Respond Pillar, the Los Angeles County Department of Public Health has implemented a number of strategies and programs related to data to care (i.e., using data to inform action), including (1) creating an internal public health department cluster detection and response work group to better track communities affected by rapid HIV transmissions to quickly deploy HIV testing resources and link people to prevention or treatment services, (2) developing a statewide community advisory board to inform cluster detection practices, (3) leveraging their Community Health Ambassador Program which trains ambassadors from HIV clusters to distribute HIV self-test kits to their social and sexual networks, and (4) launching the DARE2Care (Data for Adherence, Retention, and Engagement to Care) Program, which increases HIV clinic capacity to identify patients who are not engaged in care and deploy HIV engagement specialists to locate these individuals and help re-engage them in care.

Baton Rouge’s Capitol Area Reentry Program Engages in Responses to HIV Clusters

The Capitol Area Reentry ProgramExit Disclaimer (CARP) is one of the several community partners that mobilize to respond to people newly affected by rapid HIV transmissions in East Baton Rouge Parish, Louisiana. CARP works to redefine reentry in Baton Rouge through a holistic approach to routine health screenings, compassionate engagement, and harm reduction services aimed to reduce health disparities among people who inject drugs and LGBTQ+ individuals. During their outbreak responses, CARP leverages its SSP to distribute clean syringes to people who inject drugs. Local data indicate that this mode of HIV transmission has increased, especially among populations with recent justice involvement transitioning to their community. In addition, CARP’s certified peer advocates provide HIV testing in high incidence areas, respond to clients’ needs such as housing and job placement, and monitor and manage harm reduction vending machines, which provide Narcan, wound care kits, and HIV self-test kits. CARP attributes some of its effectiveness to the work of their peer advocates, trained by the organization to engage in outreach to priority populations that identify themselves with their peer’s lived experience. The agency collaborates with and shares referrals with the health department, detention facilities, law enforcement, mental health and social services providers, and medical providers who offer rapid start HIV treatment, PrEP and on-demand PEP services.

The EHE Initiative

These are just three examples of the many innovative approaches being taken by partners working in each of the 57 prioritized jurisdictions to scale up four science-based strategies: diagnose, treat, prevent, and respond. The jurisdictions receive additional funding and technical assistance from CDC’s Division of HIV Prevention, HRSA’s Health Center Program and Ryan White HIV/AIDS Program to implement locally tailored plans to reduce new HIV transmissions by 90% by 2030. NIH and IHS also support complementary activities. OIDP supports these efforts through community engagement and information sharing by its EHE and Engagement Teams, as well as by sharing information on HIV.gov and managing the AHEAD Dashboard. To learn more about the EHE initiative, visit HIV.gov’s EHE section. Read more about OIDP’s Engagement Team.