Ending the HIV Epidemic | Regional Champions 2023-2024
As we set out to achieve our Ending the HIV Epidemic (EHE) mission of less than 3,000 new HIV infections per year in the U.S. by 2030, we want to acknowledge some of the clinical care teams involved. The following “Star” clinics have collaborated with their regional AETC and have achieved successful HIV-related patient care outcomes as a result.
“ Regional ‘23 Champions ‘24 Building on Principles of Ending the HIV Epidemic
Regional Building on Principles of ‘23 Ending the HIV Epidemic Champions ‘24 Ending the HIV Epidemic in the United States (EHE) scales up foEnding the HIV Epidemic in the United States (EHE) scales up four science-based strategiesur science-based strategies that can end the HIV epidemic. The four strategies, called “pilthat can end the HIV epidemic. The four strategies, called “pillars,” are Diagnose, Treat,lars,” are Diagnose, Treat, Prevent, and Respond. The eight Regional AETC organizations prPrevent, and Respond. The eight Regional AETC organizations provide targeted training,ovide targeted training, technical assistance, and capacity building support totechnical assistance, and capacity building support to assist clinics acro assist clinics across the Unitedss the United States with implementing the four EHE strategies and as a resulStates with implementing the four EHE strategies and as a result have helped these clinicst have helped these clinics make notable progress wmake notable progress with their efforts to diagnose, treat, prevent, and respond to Hith their efforts to diagnose, treat, prevent, and respond to HIV.IV. These clinics are Health Resources and SerThese clinics are Health Resources and Services Administration’s Federally Qualified vices Administration’s Federally Qualified CoCommunity Health Centers and Ryan White HIVmmunity Health Centers and Ryan White HIV/AIDS Program (RWHAP) funded Part A and /AIDS Program (RWHAP) funded Part A and Part BPart B clinics that the regional AETCs collaborate w clinics that the regional AETCs collaborate with to integrate HIV status-neutral care ith to integrate HIV status-neutral care in a continuous, patient-centered process.in a continuous, patient-centered process. To highlight the progress made in 2023 – 2024To highlight the progress made in 2023 – 2024, each AETC region designated a "Regional, each AETC region designated a "Regional Champion"Champion" clinic that they have w clinic that they have worked closely worked closely with to successfully implement the EHE ith to successfully implement the EHE strategies that resulted in the clinic’s expanded capacity to pstrategies that resulted in the clinic’s expanded capacity to provide HIV treatment and rovide HIV treatment and care.care. This brochure w This brochure was developed to spotlight the innovative partnerships and efforas developed to spotlight the innovative partnerships and efforts ots of f the AETCs and these “Regional Champiothe AETCs and these “Regional Champion” clinics. n” clinics. We wWe want to thank the regioant to thank the regional AETC teams and their partnering clinical care teams in makinal AETC teams and their partnering clinical care teams in makingng great strides, one clinic at a time, in their wgreat strides, one clinic at a time, in their work to integrate HIV care into primarork to integrate HIV care into primary care.y care.
Regional Champions Building on Principles of Ending the HIV Epidemic New England Mountain West Northeast/ Caribbean Pacific Midwest MidAtlantic South Central Southeast
a MidAtlantic (MAAETC) MidAtlantic Spectrum Health Services, Inc. Philadelphia, PA Outstanding Attributes & Contributions: • Myra Rutland, DNP, FNP-BC article, “Implementing Status Neutral Care in Primary Care Settings” in the Spring 2023 issue of HIV Specialist Magazine • Dr. Rutland, Spectrum Health Center Director of Infectious Disease and Community Outreach, “The MAATEC program has been extremely helpful in being another voice collaborating in what I believe is the job of primary care to be the foot soldiers in ending the HIV epidemic. More of our primary care providers have become eager participants in prescribing PrEP.” • Health Center colleagues meet the 4th Friday of each month to discuss PrEP cases. Having the regular updates and education from MAAETC allows the team to stay informed about clinical updates Identified Need: • Clinical care team education and support on status neutral care • HIV testing and PrEP implementation Implementation: • HIV status neutral care • Rapid HIV testing for everyone 13 years and older at least annually • PrEP initiation and maintenance • Monthly case conferences among clinical case team members to discuss PrEP client care 4
a Outcomes: • The number of patients on PrEP increased by more than 526% from 38 in 2020 to 200+ in 2023 • 2,000+ condoms and PEP/PrEP information packets distributed each month • Ongoing education for clinical care team members on creating a positive sexual health experience for patients at the clinic Regional Champions 5
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a Midwest (MATEC) Corktown Health Detroit, MI | Wayne County Outstanding Attributes & Contributions: • Taking HIV care to the next level by developing an LGBTQ+ community focused care and retention to care model • Corktown Health has participated in HIV care for the past 30 years Identified Need: • A lack of primary care and health disparities for the LGBTQ+ community in the Detroit Metro area Implementation: • Developed internal processes, policies, electronic medical record (EMR) updates. • Revised Human Resource policies for inclusivity • Initiated CDC text messaging program (TXTXT) for antiretroviral therapy (ART) adherence of young adults • Established an HIV-specialized dental clinic • Created centralized management system for HIV Care & Management • Formed partnerships with local CBOs for legal assistance 6
a Outcomes: • Strengthened Corktown’s ability to use the EMR to gather relevant data to more actively respond to patient needs • Increased community testing and referrals for PrEP • Strengthened clinical HIV skills for providers through tailored trainings, continuously making aware of guidance changes • Strengthened awareness of implicit bias resources and tools through tailored training • Supported HIV and hepatitis C virus (HCV) community testing efforts with seamless linkage to care at Corktown • Successful completion and submission of the Human Rights Campaign Health Equity Index (HEI) survey Corktown Health - LGBTQ+ Affirming Health Care Blue Cross Blue Shield of Michigan Regional Champions 7
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a Mountain West (MWAETC) Sea Mar Salmon Creek, WA Outstanding Attributes & Contributions: • Successfully transitioned from a practice transformation project (PTP) clinic to a Ryan White HIV/AIDS Program Part B & Part C funded clinic • Initiation of the Rapid ART Program ensured 100% of newly diagnosed patients received their first dose of medication within 7 days of diagnosis and achieved viral suppression within two months • After identifying unmet need, clinic champions built capacity for onsite high resolution anoscopy (HRA) for patients with HIV. Twenty- three patients were screened in 8 months, identifying 9 patients with abnormal anal cancer screening results, one of whom had HSIL and received treatment onsite Identified Need: • Improvements in HIV screening rates and rapid initiation of ART to address treatment barriers for newly HIV diagnosed patients Implementation: • Leveraged Oregon AETC support for capacity building and training on EMR system integration to increase HIV screening rates • Implemented the Rapid ART Program for newly diagnosed patients, supported by peer navigator program for patient engagement • Utilized on-site 340B pharmacy to increase access to HIV medication, with guidance from Oregon AETC • Launched pilot project for HRA for anal cancer screening to enhance preventive care measures 8
a Outcomes: • Sea Mar Salmon Creek nearly tripled the number of • Successful re-engagement of 60% of HIV patients patients with HIV receiving care, from 34 patients in lost to follow-up through the Rapid ART Program and 2019 to 91 patients in early 2024 integration of peers • 92% of patients with HIV were virally suppressed • Successful replication of routine HIV screening as of January 2024 and 100% of newly diagnosed prompts at all Sea Mar primary care clinics, resulting patients were virally suppressed within 2 months of in a significant increase in HIV screening across the engagement system, 7% in 2018 as compared with 23% in 2022 Regional Champions 9
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a New England (NEAETC) DotHouse Health Center Dorchester, MA Outstanding Attributes & Contributions: • Multidisciplinary approach to improving HIV prevention services across departments, including urgent care and behavioral health Identified Need: • Standardized assessment tools, workflows and protocols needed for sexually transmitted infection (STI) screening and PrEP prescribing in urgent care • Expanded training across departments Implementation: • Standardized STI/HIV risk form implemented in urgent care department; with sexual health RN triaging asymptomatic STI visits • PrEP standing order and visit protocol approved by the Chief Medical Officer (CMO) • Sexual Health RN workflow for positive STI results notification and PrEP education 10
a Outcomes: • STI/HIV prevention team has successfully been embedded in urgent care • Enabled enhanced counseling, promoted same-day PrEP initiation and increased awareness of PrEP/PEP among the primary care nursing team • 84 new patient referrals received in 2023 with new protocols and workflows Regional Champions 11
a Northeast/Caribbean (NECA) HealthPro Med (HPM) San Juan, PR (HPM Health Center sites in San Juan, Carolina, Guaynabo) Outstanding Attributes & Contributions: • The clinic’s one-stop shop model integrates HIV services & primary care, emphasizing prevention, screening, and addressing social determinants of health Identified Need: • Integrated HIV services and primary care, focusing on prevention, screening, and addressing social determinants of health • Workforce capacity building in HIV testing, PrEP programming, treatment adherence, and community outreach Implementation: • Implemented one-stop shop model for integrated HIV services and primary care • Certified workers conduct outreach and provide rapid testing in high-risk areas • Participated in “Twinning Project” with NECA+HPM, sharing expertise in HIV services and workforce capacity building • Presented successful strategies for expanding PrEP access and implementation at major conferences 12
a Outcomes: • 400% increase in PrEP patients through participation in the “Twinning Project” with NECA+HPM • Presented at major conferences, showcasing successful strategies • Demonstrated twinning as a viable training modality for workforce capacity building Regional Champions 13
a Pacific (PAETC) Huntridge Family Clinic Las Vegas, NV Outstanding Attributes & Contributions: • LGBTQI+ focused clinic, HIV testing, HIV treatment, PEP/ PrEP, STI testing and treatment, harm reduction services, transgender care Identified Need: • Address retention in care among patients with HIV • Decrease the monthly percentage of missed visits among patients with HIV Implementation: • Adaptation of the ANSWER Outreach Protocol with a specific focus on outreach to all patients with HIV who missed a scheduled medical visit, recording barriers to care • Utilized Plan-Do-Study-Act (PDSA) cycles for implementation 14
a Outcomes: • Although recently implemented, “no shows” have decreased from 30% to 26% in one month • Development of a tailored protocol led by Case Manager Project Champion • Routine review of project indicators and documentation of patient-reported barriers to care • Services and strategies are offered to overcome identified barriers Regional Champions 15
a South Central (SCAETC) South Texas Rural Health Services Carrizo Springs, TX SCAETC Regional Partner: University of Texas (UT) Health San Antonio, TX Outstanding Attributes & Contributions: • Institutionalized clinical guidelines for opt-out HIV screening • Developing a PrEP program with support from UT Health San Antonio Identified Need: • Improve HIV screening rates and linkage to care services in the rural Texas community • Technical assistance and consultation to establish clinical guidelines and develop a PrEP program Implementation: • Institutionalized clinical guidelines for opt-out HIV screening • Actively developing a PrEP program with support from regional partners • Continues to receive consultation to increase clinic capacity 16
a Outcomes: • Increased HIV screening rate from 1% in 2021 to 43.4% in 2024 • Identification of two positive HIV cases with successful linkage to long-term HIV care services • Institutionalization of clinical guidelines for opt-out HIV screening within the clinic setting • Ongoing development of a PrEP program with support from the regional partner, contributing to improved HIV prevention efforts in the community Regional Champions 17
a Southeast (SEAETC) Rural Health Services, Inc. Aiken, SC Outstanding Attributes & Contributions: • The leadership’s HIV expertise and inclusion of a sexual health program in new provider orientation further demonstrate their commitment Identified Need: • Increase HIV screening rates and expand services. • Peer support, outreach, and long-acting injectable (LAI) PrEP and ART enhancements Implementation: • Began tracking HIV services closely and introduced peer support • Implemented robust HIV testing outreach • Initiating LAI PrEP and prepared to offer LAI ART upon patient request • Utilized experienced leadership in HIV and incorporated a sexual health program into new provider orientation 18
a Outcomes: • Implemented robust HIV testing outreach with greater than 500 rapid tests done so far • Initiated LAI PrEP and prepared for LAI ART provision • Enhanced provider orientation with the inclusion of a sexual health program • Increased HIV screening rates significantly from 19.6% in 2020 to 38.94% in 2022 Regional Champions 19
“ Regional ‘23 Champions ‘24 Building on Principles of Ending the HIV Epidemic Contact any of the regional AETCs: www.aidsetc.org/directory