vision — national hiv/aids strategy

“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”

Vision — National HIV/AIDS Strategy

Reducing New HIV infections

Goals – By 2015:• Lower the annual number of new

infections by 25%. • Reduce the HIV transmission rate by 30%. • 90% of the people living with HIV know

their serostatus.

Action Steps • Intensify HIV prevention efforts in the

communities where HIV is most heavily concentrated.

• Educate all Americans about the threat of HIV and how to prevent it.

Increasing Access to Care and Improving Health Outcomes for

People Living with HIVGoals – By 2015:• Increase the proportion of newly

diagnosed patients linked to clinical care within three months of their HIV diagnosis from 65% to 85%.

Action Steps• Establish a seamless system to

immediately link people to continuous and coordinated quality care when they learn they are infected with HIV.

Reducing HIV-Related Health Disparities

GoalsImprove access to prevention and care services for all Americans.

Action Steps • Reduce HIV-related mortality in

communities at high risk for HIV infection

• Adopt community-level approaches to reduce HIV infection in high-risk communities

• Reduce stigma and discrimination against people living with HIV

But how?

• Identify the best mix of interventions and strategies to:– Address gaps in current HIV prevention

efforts – Improve coordination in your

community of HIV prevention, treatment and care services

DSHS Expanded Testing Strategy

• Support routine HIV testing in medical settings in areas of the state with the highest prevalence.

• Support projects in counties with highest rate* and/or number of cases.

• Jefferson County – 2009 TX HIV Surveillance Report:

• No. 4 in Texas 328.2 cases /100,000 population

• No. 9 in Texas 799 PLWH

Routine Testing June 2008 – April 2011

Type of Testing Site Tests Positives Positivity rate

Community Health Centers 22,349 337 1.5%

Correctional Health Facilities 81,446 539 0.7%

Emergency Departments 283,056 4,438 1.6%

Family Planning Clinics 7,618 20 0.3%

STD Clinics 54,140 745 1.4%

Total 448,609 6,079 1.4%

Vision to Eliminate AIDSEarly detection means a better prognosis

“It’s critical to understand that routine screening could potentially eliminate AIDS diagnoses. People in care should never have an AIDS diagnosis. It is within our power to eliminate AIDS among people who are in care, any care. How’s that for a vision?” Lisa Fitzpatrick, MD, MPH

Ref: Routine HIV Testing in the ED: The Experience in the Nation’s Capitol. Annals of Emergency Medicine, Vol. 57, NO. 4: April 2011.

A physician’s duty to promote patient welfare and to improve the public’s health are fostered by routinely testing their adult patients for HIV.

www.ama-assn.org/go/cdjareports

The AMA ETHICS POLICY

Resources

Test Texas HIV Coalition

http://testtexashiv.org/

Community of peers sharing routine HIV implementation experiences, including a group site for discussion

Meetings and networking opportunities to support champions, address stigma and AIDS exceptionalism, ethics and 3rd party reimbursement

Access to technical and training resources, continuing education credits

Resources• DSHS HIV STD/Unit: www.dshs.state.tx.us/hivstd • Centers for Disease Control & Prevention

www.cdc.gov/hiv/• Texas/Oklahoma AIDS Education

Training Center (AETC) www.aidseducation.org

• Medscape – free continuing education • SGIM (Society of General Internal Medicine)

www.sgim.org/go/hiv

Routine HIV Testing Team• Jenny McFarlane, BA, Routine Testing Coordinator;

(512) 533-3094: jenny.mcfarlane@dshs.state.tx.us

• Isabel Clark, MA, RD, Routine Testing Consultant; (512) 533-3060: isabel.clark@dshs.state.tx.us

• Brian Rosemond, BBA, BSN, RN, Routine Testing Consultant; (512) 533-3071: brian.rosemond@dshs.state.tx.us

• Mary McIntosh, MEd. Test Texas Coordinator; (512) 533-3017: mary.mcintosh@dshs.state.tx.us

• Karalee Poschman, MPH, Data Coordinator; (512) 533- 3107: karalee.poschman@dshs.state.tx.us

Test Texas HIV Coalition

http://testtexashiv.org/

Please join us in our efforts to eliminate HIV/AIDS