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EIIHA Pilot Projects
PROVIDING GUIDANCE FOR EARLY IDENTIFICATION,
ENHANCE TESTING, AND FAST TRACKING TO CARE
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Early Identification Scale Up TestingFast TrackingImproved AccessRetention
EIIHA PILOT PROJECTS
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Identify opportunities to collaborate and enhance EIIHA efforts
Develop EIIHA outreach and targeted testing
Establish fast track linkage to careDefine goals for EIIHA
Improve individual health outcomesReduce community viral load
LEARNING OBJECTIVES
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New strategies around "early identification of individuals living with HIV/AIDS"
Implement scale up and routine HIV testing.
The resources available for these objectives.
Coordinate a public health clinical services plan to find individuals unaware of their HIV status and connect them to care.
Ways to support/enhance existing efforts.
PROJECT OBJECTIVES
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Unaware into Care
Goal 1: Increase opportunities for testing and diagnosis of HIV among the following populations: 1) Individuals testing for STDs; 2) Men who have sex with men (MSM); 3) Disproportionately aff ected communities of color, primarily African Americans, African-born and Latino; 4) Partners and social networks of: a) Newly diagnosed PLWH; b) Individuals diagnosed with AIDS within one year of testing; c) Populations with high co-infection rates (i.e., those with syphilis or Hepatitis C); d) High-risk and comorbid populations (e.g., substance abusers, incarcerated, homeless and those with mental health issues).
BACKGROUND
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Unaware into Care
Goal 2: Increase testing among partners and social networks of PLWH who receive Ryan White funded services.
Goal 3: Develop and implement updated standards for all RW outreach services to include formal and functional relationships with testing sites and early intervention programs.
BACKGROUND
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Unaware into Care
Goal 4: Ensure that all publicly funded testing sites and early intervention programs have formal and functional relationships with Points of Entry outside the RW system as well as with primary care and MCM programs to create a seamless system where unaware individuals can flow from testing to diagnosis to care with minimal steps and barriers.
BACKGROUND
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State HIV Surveillance Report, 2011 - Estimated Number of Persons Living with HIV/AIDS in Minnesota
As of December 31, 2011, 7,136* persons are assumed alive and living in Minnesota with HIV/AIDS
3,775 living with HIV infection (non-AIDS)3,361 living with AIDS
BACKGROUND
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STATE HIV SURVEILLANCE REPORT, 2011
Race/Ethnicity Cases % RateWhite, non-Hispanic 143 49% 3.2
Black, African-American 64 22% 32.6
Black, African-born 44 15% 60.3
Hispanic 24 8% 9.6
American Indian 4 1% 7.2
Asian/Pacific Islander 8 3% 3.7
Other^ 5 2% x
Total 292 100%
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STATE HIV SURVEILLANCE REPORT, 2011
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Engaging Stakeholders
Research & Education
Examining Outreach, EIS, and Services Outside the Ryan White System of Care.
MULTI-PRONGED APPROACH
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Unaware into Care Workgroup
Public Health ClinicsRed Door
Healthcare for the Homeless
Refugee Health
ENGAGING STAKE-HOLDERS
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Literature Review
EMA/TGA Network
Technical Assistance and Training (Scale Up Testing)
RESEARCH AND EDUCATION
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EIS, Outreach, and other opportunities to reach unaware.
EIS Service Area Definition
Program Standards
SERVICE AREAS REVIEWS
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StakeholdersProject ObjectivesProgram Standards
BRIDGING THE PRONGS
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Clear goals and objectives
Identify the problem and proposed solution
Flexibility for improvement
Measure and evaluate
TESTING UNAWARE- PILOT PROJECTS
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CTR Training
Routine Testing Procedure
Op-Out
HEALTH CARE FOR THE HOMELESS
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Scale Up Routine Testing
HEALTH CARE FOR THE HOMELESS
2010 2011 Jan-Jun, 2012
258
582
294
0 2 2
Scale Up Testing
Tests Cases found
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Outreach & Testing
Fast Track
Peer Network
PUBLIC HEALTH CLINIC
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OUTREACH & TESTING STANDARDS
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FAST TRACK
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RW El-igible88%
Non-RW Eligible12%
100% Accepted Fast Track (n=83)
FAST TRACK
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59%
39%
0% 2%
83 Cases
InternalExternalOut of CarePending
PUBLIC HEALTH CLINICFAST TRACK
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FT Linkage
79%
Pending21%
Fast Track and Linkage to Care
RED DOOR – PUBLIC HEALTH CLINIC
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17 Recruiters
20 Associates
Training
Incentives
Setting Goals
Managing Recruiters’ Expectations
OUTREACH & TESTINGPEER NETWORK
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Early Identification
Scale Up Testing
Fast Tracking
Improved Access
Retention
SUCCESSES
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Moderate Incidence & Reaching Unaware
Manage Expectations of Peers
CHALLENGES
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Engage Stakeholders
Beyond Ryan White System of Care
Targeted Scale Up Testing
Set Realistic Expectations Flexibility is Key
LESSONS LEARNED AND MODIFICATIONS
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EvaluateImproveRepeat
NEXT STEPS