DefiningtheEndofthe
AIDSEpidemicin
NewYorkState
December9,2013
KeyPoints
StatewideResponse
• Six‘DefiningtheEndoftheAIDSEpidemicinNewYork
State’meetingsheldacrossNewYorkState
• Over300participants
• NewYorkCity
• CapitalDistrict
• SyracuseRegion[includingBinghamton]
• UpdatesprovidedatStateadvisoryandplanningmeetings
• AIDSAdvisoryCouncil
• StatewideAIDSServiceDeliveryConsortium
• InteragencyTaskForceonHIV/AIDS
• Updatesprovidedatcommunitybasedmeetings
• UniversityatAlbany
MultipleSectors
• Keystakeholders
• Communitymembersandconsumers
• State,cityandlocalgovernments
• Academia
• Healthprofessionals
• Communitybasedproviders
• Publicandprivatesectors
Cascade of HIV Care
New York State, 2011
0
50,000
100,000
150,000
Estimated HIV Infected
Persons
154,000
Persons Living w/ Diagnosed
HIV Infection
131,000
85% of infected
Cases w/any HIV Care during
the year*
Cases w/continuous care
during the year**
Virally suppressed ( n.d. or
<200/ml) at test closest to
mid‐year
* Any VL or CD4 test during the year
** At least 2 tests, at least 3 months apart
85,000
55% of infected
65% of PLWDHI
74,000
48% of infected
57% of PLWDHI
60,000
39% of infected
46% of PLWDHI
71% of cases w/any care
PrioritiesDefiningtheEndofAIDS
Policy
• SimplifiedconsentforHIVTesting
• EnhanceddatasharingbetweentheStateHealth
Departmentandhealthcareproviders
• Removalof‘condomsasevidence’instatute
• Decriminalizationofsyringes
• Affordable,safeandstablehousingforlowincome
individuals;30%rentcapontotalincomespent
towardsrentforlow‐incomePLWHA;expandNYC
HASAeligibilityrequirements
• EnhancedDOHoversightofDOCCS(Departmentof
CorrectionsandCommunitySupervision)for
HepatitisCandHIVtreatmentandcare
PrioritiesDefiningtheEndofAIDS
Prevention
• SyringeAccessprograms
• ProposedMedicaidRedesignprograms
• HealthHomes
• PreventionandOutreachServices
• TreatmentAdherenceprogramstotargethighriskpopulations
[subpopulations]
• Increasedaccesstoculturallyandlinguisticallyappropriate
preventionandhealthcareservicesforundocumented
immigrantslivingwithHIV/AIDS,womenandwomen(ofcolor)
• Developapreventioncontinuumthatprioritizesinnovative
behavioralinterventions
• AdditionalHIVtestingsitesandenhancedintegrationof4th
generationtesting
• Increasetargetedtesting
PrioritiesDefiningtheEndofAIDS
Biomedical
interventions
• Promoteandensure
accesstonPEP and
PrEP inthe
communityandwithin
DOCCSfacilities
• ARVaccess
PrioritiesDefiningtheEndofAIDS
Surveillance
• EnhanceDataSharing
• Enhancedata
collectionpractices
[LGBT]
• Subpopulations
PrioritiesDefiningtheEndofAIDS
Accessto
Care
•SpecialNeedsPlans(Model)
•ADAP
•MedicaidManagedCare
•NYStateofHealthandinsurance
exchanges
• HealthandRecoveryPlans(HARPS)
•Medicare
PrioritiesDefiningtheEndofAIDS
Messaging
• Providerandconsumereducation
• TargetedmessagingtoHIVhigh
risknegativeandpositive
individuals
• Addressstigmaanddiscrimination
• Ensuremessagesarealigned
• Supportpreventionandclinical
practicesthatarepersoncentered
PrioritiesDefiningtheEndofAIDS
Resources
• EnsureARVaccessforall
• Fundtargetedpreventionandhealth
carepractices
• Specialtyservicessuchastransition
coveragefortransgendered
individuals
• Reviewofexistingfundingand
fundingallocations
KeyFramingQuestions
Whatisthecommunityperceptionof“EndofAIDS?”
• Thephrasing“EndofAIDS”promotesstigma.
• Insomecommunitiesthereisaperceptionthatthestatehasachievedthe“EndofAIDS”–
makingitnolongerapriority.
• Insomecommunitiesthe“EndofAIDS”isbeingconfusedwithhavinganavailablevaccine
orhavinganundetectableviralload.
• Toachievethe“EndofAIDS”,HIVcannotberegardedas“justanotherchronicdisease”.
• CommunitymembersareconcernedthattheEndofAIDSwillnotprotectoraddressthe
needsofindividualslivingwithHIV/AIDS.
• Toachievethe“EndofAIDS”policymakersmustidentifyandremoveNYSlawsthat
promotethecriminalizationofHIV/AIDS.
KeyFramingQuestions
Whatiseffectivecommunitymessagingandmedia?
•Communitymessagingmustbesensitiveandtargetedto
eachcommunity/population.
•Thinkofcommunitymessagingaslayersforeachtarget
population.
•DevelopmessagingforbothhighriskHIVnegativeand
positivepersons.
•Promotetheuseofphoneapplicationsandsocial
networkingtodelivercommunitymessaging.
•Utilizeempoweringcommunitymessages.
•Engageprintandsocialmediavenues.
KeyFramingQuestions
Whoelseneedstobeatthetable?
• Diverseconsumerrepresentationincludingmembersofthe
Latinocommunity
• Behavioralhealthproviders
• Unionrepresentatives
• YouthandSeniorrepresentatives
• Medicalproviders
• DOCCSrepresentatives
• LGBTrepresentation;Transwomenofcolor
• Sexworkers
• Membersofthefaithcommunity
• Publicandprivatesectorrepresentatives
KeyFramingQuestions
WhatistheroleofPreventioninthe
“EndofAIDS“movement?
• Developtargetedpreventionstrategiestoensureaccesstosafe,
stableandaffordablehousing/homelessnessasprimaryand
secondaryprevention
• Developtargetedpreventionstrategiestoaddresshomophobia
• Developeffectiveandinnovativebehavioralinterventions;utilizea
peermodel
• Targetpreventioninterventionstoyouthandseniors
• PromotesexualhealtheducationinNYSeducationsystems
• PrioritizepreventioninterventionswithinDOCCSfacilities
• Ensurepreventionmessagesalign‘acrosstheboard’
• Prioritizehumanrightsattheforefrontoftheconversation
StructuralBarriers
Housing
Stability
Food
Security
Transportation
Substance
Abuse
Social
Support
Vocational/
Educational
Mental
Health
Poverty
Cultural
Immigration
METRIX
Clinical
Prevention
Pharmacology
Community
Engagement
Costsandcost
savings
Transmission
rateof.5%
[730infections]
Progressionof
HIVtoAIDS
Stigmaand
Discrimination
DevelopingthePlan/StatewideInputand
nextsteps
• PrioritypointsofallcommunitymeetingsacrossNewYork
•
•
•
•
State.
InformtheStateoncommunityneedsandprioritiesto
achievetheEndofAIDSinNewYorkStateby2020.
PotentiallyinformaGovernorappointedTaskForcetowork
incooperationwithstate,city,localgovernmentsandthe
communitytoimplementastatewideplantoachievethe
EndofAIDSinNewYorkStateby2020.
Continuedcollaborationandpartnership.
Bimonthlycommunitycallstoprovideupdatesandseek
input.
Thankyou