Overview of Ending the Epidemic Initiatives:

Objectives, Organizing, Outcomes

About Treatment Action Group

Treatment Action Group is an independent research and policy think tank focused on activism to accelerate research, treatment,

access, and community information to prevent, treat, and cure HIV and its most common coinfections, hepatitis C virus (HCV) and

tuberculosis (TB).

www.treatmentactiongroup.org

Introductions

Name

Organization (if any)

Where you’re from

In one or two words: what would ending the epidemic mean to you?

TAG’s Southern EtE Work

TAG has been funded by the Elton John AIDS Foundation, MAC AIDS Fund, Ford, Gilead, and ViiV to assist EtE development in Southern jurisdictions

In May 2017, TAG, the Southern AIDS Coalition, the Southern AIDS Strategic Initiative, NASTAD, Sisterlove, and AIDS Alabama convened 45 advocates and public health officials from the Deep South for a discussion in Atlanta.

Looked at key opportunities and challenges and identified jurisdictions that are ready to move forward with an EtE plan.

TAG has been working closely with advocates in Nashville, TN; Alabama, and Louisiana to

begin EtE planning.

What does it mean to “end” the epidemic?

For the first time ever, we have evidence-based tools in HIV treatment and prevention that are so effective that they could conceivably end epidemics.

“Bending the curve” and bringing new infections below epidemic levels

Implementing policies and programs to address structural and social drivers.

Ending the epidemic while continuing to demand a cure and vaccine for HIV/AIDS

Improving outcomes for people

living with HIV

Comparison to Other Targets

Getting to Zero

Gives us an ambitious target on our way to this ultimate vision

90-90-90

Frequently part of EtE targets, but misses out on HIV negative individuals

National HIV/AIDS Strategy Targets

Still very useful, but we want to be even more ambitious

Key EtE Advantages

CBO and Community Driven/Led

Statewide/Citywide

Can work synergistically with existing plans

Focus on vulnerable HIV negative individuals

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Where are EtE Initiatives Happening?

Cities/Counties States

HoustonPittsburgh

Washington D.C.Fulton County, GA (Atlanta

Metro Region)Miami-Dade County

San Francisco Hennepin County, MN

ArizonaColorado

MassachusettsNew York

Washington Oregon

In 2014 New York became the first jurisdiction in the world to announce an EtE plan. Now, several other cities, counties, and states around the US have made similar announcements.

What Does an EtE Initiative Look Like?

No “one-size-fits-all” approach

Successful planning usually involves partnership and shared leadership between community leaders, activists, service providers, representatives from academic institutions, and public health officials

Key steps: community mobilization, action planning, developing a written EtE plan, implementation, monitoring/evaluation

Bottom up and top down document: not another integrated care, treatment, and prevention plan

EtE Plans

Most plans contain some common elements. Defined, quantifiable targets for Ending the Epidemic in your

city/county/state. Specific recommendations/objectives for:

HIV Prevention Access to Care and Treatment Surveillance and Data Addressing Structural and Social Barriers

Strategies for implementing the plan Cost savings/cost modeling

The plan serves as a “blueprint” or “roadmap” for achieving drastic cuts in newinfections in your jurisdiction.

A community proposal: Five pillars for a plan to end AIDS in NYS

① Use 21st century surveillance strategies to “know the epidemic”and guide responses

② Ramp up evidence-based combination prevention (biometrical, behavioral & structural) for both HIV+ and HIV- persons

③ Fill gaps in the continuum of care to maximize the number of people able to rapidly suppress viral load after HIV diagnosis

④ Ensure access to housing and supportive services needed to support health, prevention and retention in care for all

⑤ Garner the commitment of political leaders and all communities to leadership and ownership of the plan to end AIDS

Supported with smart, strategic & sustained public investments

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Health Disparities

Social and Structural Barriers

Culturally competent providers

Stigma and Discrimination

Adapting to A Changing Landscape

Medicaid Expansion

Timeline and Steps for a Plan: Houston

November 2015: Legacy Community Health received a $50,000 Southern REACH grant from AIDS United for EtE work.

March 29-30, 2016: Community leaders attended an invitation-only kickoff meeting and divided up into work groups focused on five broad subject areas related to the plan.

April - July 2016: Co-chairs for the working groups convened monthly meetings to develop recommendations for ending the epidemic.

September 2016: A second community meeting was held to review and provide feedback on a draft plan.

December 1, 2016: Officially launched the final plan. The plan reflects the input of over 150 community members.

Who Do We Need at the Table?

Diverse community representation

Pharmaceutical companies

Academia

Public health officials

Ryan White Planning councils

Elected officials

Non-traditional partners

Service providers and

healthcare administrators

Sororities/Fraternities

Police Departments

Faith-based institutions

Key Opportunities in the South

Trailblazers: existing EtEinitiatives in Fulton County, GA and Houston

Political allies in key jurisdictions

Passionate, experienced advocates

Increased attention to funding disparities

Innovative use of HIV surveillance

Budget savings: every new HIV infection costs almost $444,000 in health spending

Small Group Discussions (20 minutes)

Is your jurisdiction already participating in EtEwork? If yes, how did that work start and what benefits/challenges do you see? If no, would EtEplanning help further your work? How so?

How do we best include Latino communities in planning and implementation?

Why is it important for healthcare workers and social workers to be engaged in these discussions?

EtE Resources

TAG EtE Website

NASTAD EtE Tools

TAG Prevention Advocacy Modules

Act Now End AIDS Coalition

Jeremiah.johnson@treatmentactiongroup.org