An end to HIV/AIDS epidemic in U.S.?

Too often, I hear AIDS referred to as the “forgotten epidemic”. But this is no time for forgetting, particularly in a country where nearly 640,000 people living with HIV/AIDS don’t have access to the care they need.

How can we as a country be making an impact on an epidemic when such a significant number can’t even access the care they need? Treatment is prevention when it comes to ending HIV/ AIDS in America, and community programs have an incredible ability to give treatment where it is needed most.

As the largest infusion of cash into the HIV/AIDS fight since the Ryan White Care Act, these Social Innovation Fund dollars deliver a renewed sense of urgency to support innovative, community-driven interventions to change how we invest in improving the health outcomes of people living with HIV/AIDS in the U.S.

The awards are well deserved. Not only because these community-based programs are doing innovative work, but their approach to healthcare – engaging first at the local level – is already having positive outcomes on communities hardest hit by the HIV/AIDS epidemic.

Based on their early successes, the end of this epidemic is truly within our reach.

Over the next year, these ten programs will develop and implement ways to improve access to quality care for low-income, communities of color, in ways that have not been tried before. The goal is to meet the direct needs of each person living with HIV/AIDS, in a tangible and measurable way.

This is about rethinking the public health model. I know from years of experience developing and evaluating HIV/AIDS programs that communities disproportionately affected by HIV/AIDS are rooted in other systemic and structural inequalities. HIV/AIDS is only a part of the story, and so addressing other disparities in addition to HIV will tell us the rest. By collaborating with partners from intersecting public health arenas such as mental health, diabetes, cardiovascular wellness, and poverty alleviation groups, we will help build an integrated approach to the AIDS
epidemic beyond the traditional methods of prevention and treatment.

New and innovative approaches rolling out in communities across the U.S. include:

• Mobile Engagement Teams: These teams will reach the most complex, chronically-ill HIV-positive people through street-based outreach and a full spectrum of supportive services, including psychiatric and housing support.

• Handheld technology: For outreach workers who need to record client data and contact information, the use of cutting edge handheld technology will result in quicker service delivery, more immediate contact information, and better tracking of outcome data. Several steps related to data entry will be eliminated, creating a leaner system of service delivery.

• Center of Excellence in HIV-positive Women’s Care: Clinical care for women living with HIV will be integrated to address behavioral health needs, bilingual information and care, and childcare services. The Center of Excellence will be linked to clinical research, addressing a gap in existing research specific to women living with HIV/AIDS.

• Telemedicine: A ground-breaking approach to serving people who have a severe shortage of nearby HIV medical providers, one program will use video technology to allow local nurses to communicate and collaborate with medical providers at
permanent HIV treatment sites.

Make no mistake, the answer to end the HIV/AIDS epidemic, or any healthcare epidemic for that matter, does not lie in a series of innovative public health programs alone. It is equally important to have the support of private sector investors who can match our grants in each community to further advance change locally. With those additional dollars, we can remove more of the barriers that have been plaguing the HIV/AIDS community for so long; barriers such as the struggle to coordinate care for people with multiple conditions like diabetes and HIV and the struggle to address enormous disparities in care from one region of the country to the next.

It’s simply not enough that one organization is committed to change, that ten organizations are implementing change, or that our national governing body mandated a strategy for change. It’s that we are working together – public and private – to roll out innovations that improve health outcomes for those who need it most.

Dr. Vignetta Charles is Vice President of Programs and Evaluation for AIDS United, where she leads efforts to measure and document program outcomes in the fight to eradicate HIV/AIDS in the U.S. She is an alumna of the Harvard School of Public Health and the Johns Hopkins Bloomberg School of Public Health.