health department implementation and opportunities · •nastad one of the first national...
TRANSCRIPT
U=UHealth Department Implementation and Opportunities
June 12, 2019Webinar
Agenda
•Introductions
•Welcome by NASTAD Board Chair Johanne Morne, New York State
•Opening Remarks by Tim Horn, NASTAD
•Presentations:
○ Michael Kharfen, Washington DC
○ Mariah Wilberg, Minnesota •Discussion
Housekeeping
•Please mute your computer microphone or telephone during presentations
•Feel free to use the chat feature to ask questions; we’ll address these during
the Q&A periods
•If you would like to ask your question, please click the raise hand button. We
will open up the chat feature during the Q&A periods
•A recording of the webinar and slides will be made available
•For more information, contact Tim Horn ([email protected]) or Andrew
Zapfel ([email protected])
Welcoming Remarks Speakers
Johanne Morne
Director, New York State Department
of Health AIDS Institute
NASTAD 2019-2020 Board Chair
Tim Horn
Director, Medication Access and
Pricing
NASTAD
Welcome
Johanne Morne
Opening Remarks
Tim Horn
HTPN 052: 93% risk reduction; no linked transmissions when VL
was undetectable
PARTNER: 58,000 condomless sex acts; no linked transmissions
PARTNER 2: 77,000 condomless sex acts; no linked
transmissions
Opposites Attract: 17,000 condomless sex acts; no linked
transmissions
Zero transmissions
between people living with HIV with undetectable viral
loads while on ART and their HIV-negative partners
U=U Jurisdictions
11
U.S. state health
departments
1. Arizona
2. California
3. Connecticut
4. Hawaii
5. Illinois
6. Iowa
7. Louisiana
8. Michigan
9. Minnesota
10. New Jersey
11. New York
12. Rhode Island
13. Washington
City & county health departments
1. Baltimore (Maryland)
2. Baton Rouge (Louisiana)
3. Champaign-Urbana (Illinois)
4. Chicago (Illinois)
5. Cleveland (Ohio)
6. Columbus (Ohio)
7. Cuyahoga County (Ohio)
8. Denver (Colorado)
9. Hennepin County (Minnesota)
10.Houston (Texas)
11.Jefferson County (Alabama)
12. Kitsap (Washington)
13. LMAS District (Michifan)
14. Long Beach (California)
15. Los Angeles County (California)
16. Nashville Metro (Tennessee)
17. New Orleans (Louisiana)
18. New York City (New York)
19. San Diego (California
20. San Francisco (California)
21. Scott County (Indiana)
22. Washington, D.C.
23. Whatcom County (Washington)
12
Prevention Access Campaign
Undetectable = Untransmittable
www.uequalsu.org
As of June 5, 2019
872 organizations (including HDs and health ministries)
from 98 countries have signed on to share the U=U
message in ways that work for their communities
NASTAD Here to Help
13
• NASTAD one of the first national organizations to endorse U=U
• Engaged in all levels of federal policy to ensure U=U remains cornerstone of efforts to end the HIV epidemic
• Catalogs state, city, and county member U=U activities and messaging
• Provides TA to jurisdictions: presentations, site visits, webinars, peer-to-peer and peer-to-partner linkage, public health source documents and messaging assistance
Panel Speakers
Michael Kharfen
Senior Deputy Director HIV/AIDS,
Hepatitis, STDs and TB, Washington
DC Department of Health
NASTAD 2019-2020 Secretary and
Treasurer
Mariah Wilberg
Communications Specialist,
Minnesota Department of Health
U=U: Washington, DCMichael Kharfen
Senior Deputy DirectorHIV/AIDS, Hepatitis, STD, and TB Administration
DC Department of Health
DC Endorsement of U=U
• DC Ending the Epidemic Plan – December 2016• Treatment as Prevention
• NASTAD Endorsement
• Meeting Bruce Richman
• Internal Health Department Deliberation
• Proposal to Mayor
• Annual Report Event Planning
• Endorsement Announcement – July 2017
• Second U.S. health department
Mayor Bowser U=U Announcement
Washington DC Joins U=U
https://www.youtube.com/watch?v=JycP9sN4-KQ
U=U Message Development
• Treatment as Prevention• Focus Groups
• Trial Messages
• U=U• Focus Groups
• HIV Negative Persons
• HIV Positive Persons
• Reduce Stigma
• Treatment Adherence
• Connection to Ending the Epidemic
U=U Social Marketing
U=U Social Marketing
• Public Advertising• Metro Bus
• Bus Stop Shelters
• Social Media• Twitter
• Internet• Google AdWords
• Web sites
U=U Social Marketing• New Sex Positive Framework
• Sexual Being
• Web site• https://sexualbeing.org/get-treated/uequalsu/
U=U Website
U=U Program Integration
• Regional Early Intervention Services RFA• Status Neutral Approach• “Hi-V”(high-five) pillars that promote
equity, eliminate barriers, and improve whole-person health• Find• Teach• Test• Link• Keep
• All proposed programs must integrate U=U into their clinical and non- clinical services and communication with individuals
U=U Program Integration
• Washington, DC Regional Planning Commission on Health and HIV• U=U White Paper
• Add U=U to all Ryan White service standards
• Provider Education• Biomedical Work Group
• Provider Handbook (in development)
• Academic Detailing (in development)
• 90/90/90/50 Plan Update (December 2019)• U=U Work Group
• Community Consultation
Thank YouAcknowledgementsClover BarnesLena LagoAvemaria SmithAdam ViscontiKa’leef Stanton MorsePeter DeMartinoMaryland Dept. of HealthDiana JordanVirginia Dept. of HealthKenneth PettigrewOctane LLCEverett HamiltonNicole Morant
P R O T E C T I N G , M A I N T A I N I N G A N D I M P R O V I N G T H E H E A L T H O F A L L M I N N E S O T A N S
Mariah Wilberg | Communications Specialist
U=U in Action: Lessons from Minnesota
2 7P R O T E C T I N G , M A I N T A I N I N G A N D I M P R O V I N G T H E H E A L T H O F A L L M I N N E S O T A N S
Minnesota 3rd State to Join October 23, 2017
1. New York
2. Michigan
3. Minnesota
4. California
5. Illinois
6. Washington
7. Arizona
8. Iowa
9. New Jersey
10.Louisiana
11.Hawaii
12.Rhode Island
2 8P H O T O S F R O M E N D H I V M N P R E S S E V E N T , M A Y 2 0 1 9
ProvidersCommunityPartnersHealth Department
Different Audiences
Health Department
3 0P R O T E C T I N G , M A I N T A I N I N G A N D I M P R O V I N G T H E H E A L T H O F A L L M I N N E S O T A N S
Internal MDH U=U Trainings
▪ Refugee & International Health▪ Hepatitis▪ STD/HIV/TB Epidemiology & Surveillance▪ STD/HIV/TB Planning & Improvement Unit▪ Partner and Care Link Services▪ Prevention Unit▪ Health Equity Unit▪ District Epidemiologists▪ Infectious Disease, Epidemiology, Prevention
and Control Division
3 1P R O T E C T I N G , M A I N T A I N I N G A N D I M P R O V I N G T H E H E A L T H O F A L L M I N N E S O T A N S
Internal U=U Resources
▪ U=U SharePoint site▪ Key messages and talking points
▪ Graphics
▪ U=U Slides
▪ Links to the relevant studies
▪ Links to more resources
▪ Language guide
▪ Summary of U=U campaign for partners
3 2P R O T E C T I N G , M A I N T A I N I N G A N D I M P R O V I N G T H E H E A L T H O F A L L M I N N E S O T A N S
▪ Added to progress reports
▪ Added U=U section HIV testing (CTR) training
▪ Added U=U section to new grantee onboarding
▪ Added U=U language to our Care Continuum Messaging
Integrating U=U into our work
3 3P R O T E C T I N G , M A I N T A I N I N G A N D I M P R O V I N G T H E H E A L T H O F A L L M I N N E S O T A N S
▪ Currently revising/creating:▪ Health threat guidance/duty to warn
▪ U=U protocol for partner services
▪ Disclosure guidance for health care provider
Partner and Care Link Services
3 4P R O T E C T I N G , M A I N T A I N I N G A N D I M P R O V I N G T H E H E A L T H O F A L L M I N N E S O T A N S
▪ Webpages
▪ Print materials
▪ Presentations
▪ Trainings
Educational Materials
3 5P R O T E C T I N G , M A I N T A I N I N G A N D I M P R O V I N G T H E H E A L T H O F A L L M I N N E S O T A N S
Factors to consider when choosing a method for sexual HIV prevention
Example of CTR Training Integration
Condoms PrEP TasP/U=U
Reduces risk for other STDs X
Reduces risk for pregnancy X
Prevents HIV with a partner living with HIV who is undetectable X X X
Prevents HIV with a partner living with HIV with unknown treatment status X X
Prevents HIV with a partner of unknown HIV status X X
Free or low cost X
Requires insurance & possible copays X X
Requires taking medications daily X X
Can be used immediately X
Requires weeks or months of daily adherence before effective X X
Partners
3 7H T T P S : / / W W W . H E A L T H . S T A T E . M N . U S / N E W S / P R E S S R E L / 2 0 1 7 / H I V 1 0 2 3 1 7 . H T M L
Alerting Our Partners
▪ U=U Summary ▪ HIV Prevention Grantees
▪ Eliminating Health Disparities Grantees
▪ Child & Teen Check-up Grantees
▪ Two versions1. Basic for those without HIV experience
2. Advanced, including talking points/key messages, for those with HIV experience
3 8P R O T E C T I N G , M A I N T A I N I N G A N D I M P R O V I N G T H E H E A L T H O F A L L M I N N E S O T A N S
Partner U=U Trainings
▪ All Provider Meeting (Prevention & Care grantees)▪ Sexuality and Family Life Educators▪ Minnesota Council for HIV/AIDS Care & Prevention▪ South West/South Central Local Public Health▪ Midwest AIDS Training + Education Center▪ Local Epidemiology Network of Minnesota▪ New HIV Prevention Grantees Introduction Webinar▪ Infectious Disease Doctors Quarterly Review▪ Metro Immigrant and Refugee Health Task Force▪ Network Nite▪ Ramsey County Public Health▪ White Earth Harm Reduction Summit
3 9P R O T E C T I N G , M A I N T A I N I N G A N D I M P R O V I N G T H E H E A L T H O F A L L M I N N E S O T A N S
Partner U=U Spotlight
4 0P R O T E C T I N G , M A I N T A I N I N G A N D I M P R O V I N G T H E H E A L T H O F A L L M I N N E S O T A N S
U=U Summit Dec. 10, 2019
▪ Local public health
▪ HIV care providers
▪ Prevention workers
▪ Case managers
▪ Government
▪ Clinic staff
▪ Health educators
Community
4 2P R O T E C T I N G , M A I N T A I N I N G A N D I M P R O V I N G T H E H E A L T H O F A L L M I N N E S O T A N S
Public Rollout – World AIDS Day 2017
▪ Created email list during partner trainings
▪ Created social media toolkit
▪ Promoted U=U on social media
▪ Promoted U=U at several World AIDS Day Events
4 3P O S I T I V E S E R I E S . O R G
Over 40,000 reached:▪ 614 reactions
▪ 126 share/retweet
▪ 65 comments
▪ 180 link clicks
▪ 292 video clicks
Social Media: 2017 – 2018
4 4P R O T E C T I N G , M A I N T A I N I N G A N D I M P R O V I N G T H E H E A L T H O F A L L M I N N E S O T A N S
Metro Transit Ad Campaign
Total Impressions as of 5/17/18: 5,129,099
4 5P R O T E C T I N G , M A I N T A I N I N G A N D I M P R O V I N G T H E H E A L T H O F A L L M I N N E S O T A N S
Combined U=U and PrEP Campaign
▪ Tribal health
▪ Local public health
▪ Health care providers
▪ University students
▪ Researchers
▪ ASOs
▪ Greater MN
▪ Clinic staff
▪ Community members
▪ Youth-based organizations
▪ Advisory board
Providers
4 7P R O T E C T I N G , M A I N T A I N I N G A N D I M P R O V I N G T H E H E A L T H O F A L L M I N N E S O T A N S
Provider Education - Magazines
4 8W W W . H E A L T H . S T A T E . M N . U S / D I S E A S E S / H I V / P R E V E N T I O N / U U / S U R V E Y . H T M L
▪ Partnership with Midwest AIDS Training and Education Center
▪ 10-State Midwest Region
▪ Contents:▪ Provider knowledge & beliefs▪ Patient characteristics▪ Message testing▪ Argument rating▪ Qualitative section
U=U Provider Survey: Over 400 Responses
4 9P R O T E C T I N G , M A I N T A I N I N G A N D I M P R O V I N G T H E H E A L T H O F A L L M I N N E S O T A N S
Provider Survey Sneak Peek n=360
Strongly Disagree, 23,
6%
Disagree, 67, 19%
Neutral, 64, 18%
Agree, 128, 35%
Strongly Agree, 78,
22%
I feel comfortable counseling a client with a durably
undetectable viral load about viral suppression being sufficient for sexual HIV
prevention in the absence of condoms or PrEP.
5 0H T T P : / / 2 0 1 9 U S C A . O R G /
U=U in Practice: Results from a Midwest HIV Provider Survey
September 7, 2019 from 9-11 a.m.
Coming to USCA 2019
5 1P R O T E C T I N G , M A I N T A I N I N G A N D I M P R O V I N G T H E H E A L T H O F A L L M I N N E S O T A N S
Opportunities & Recommendations
▪ Add U=U slide(s) as standard part of presentations
▪ Discuss U=U when doing 1:1 work
▪ Use U=U to promote adherence, staying in care
▪ Consistent messaging ‘HIV Prevention Toolbox’
▪ Provider education
▪ More community education
▪ Training for partners & grantees
▪ Peer navigation programs
5 2P R O T E C T I N G , M A I N T A I N I N G A N D I M P R O V I N G T H E H E A L T H O F A L L M I N N E S O T A N S
▪ Money
▪ Coordination/integration
▪ Additional training/capacity building needed
▪ Providers not consistent
▪ Time/staff time
▪ Language
Barriers
Discussion
Thank you!For more information, feel free to reach out to NASTAD staff Tim Horn
([email protected]) or Andrew Zapfel ([email protected])