10 Ways to Maximize High-Impact HIV Prevention

December 15, 2015

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Integrate Health Systems

6. Next we must better integrate our health systems. The ACA has expanded insurance coverage to millions of Americans and transformed our health care system. Now more than ever, we must identify new and different public health partners, including public and private payers and ensure that our partners interact seamlessly. Our goals have shifted to include ending the HIV epidemic, but we can't do that with categorical funding and siloed programming. We must engage every part of our health care system to work in partnership with public health programs and providers to leverage new resources, scale up access to PrEP and HIV treatment, and monitor quality. And finally we MUST ENSURE that the Ryan White Program remains strong and fills gaps in services.

Focus on the Right People, Right Places and Right Practices

7. Seventh, As the National HIV/AIDS Strategy (NHAS) so eloquently points out, we must focus on the right people, the right places with the right practices. I've already mentioned the right people and the right practices, but we need to ensure that our entire country has the tools necessary to end the epidemic. This is especially true in the South and in our rural communities. We can't focus only on cities, as evidenced by the recent and unfortunate 184 new HIV infections (which also included many hepatitis C infections) in rural Indiana. And while approximately 75% of our citizens live in cities, 100% of our cities are within states. States are constitutionally responsible for protecting the health of its citizens. States and cities together must coordinate in bold new ways, like New York City and the State of New York and like Denver and Colorado to create change and move toward ending new HIV infections.

Cultivate Meaningful Community Engagement

8. We must strengthen the way communities work with government and cultivate meaningful community engagement. People living with HIV, sex workers, transgender individuals, gay men, people who use drugs and many other groups of people must be at the table in our collective work to shape our new paradigm of working together. We all must be bold, courageous and take risks to work differently together and be a part of ending the epidemic. And our plans must be integrated. The fourth goal of the National Strategy emphasizes a coordinated response. I applaud CDC and HRSA for their work to develop an integrated plan and we must continue to move toward better coordination to incorporate community into our collective planning.

Reform Broken Policies

9. We must reform broken policies. Public health professionals must be at the table to create more equitable policies around employment, housing and mental health and substance use services, which must be central to our programs. All states must have electronic lab reporting to feed into data systems to help us determine where to focus our resources and our work. And we must end the criminalization of people living with HIV as well as END the Congressional ban on the use of federal funds for syringe access programs. Decisions and policies need to be based on science and what works and NOT on political ideologies.

Engage in Social Action

10. And finally, we must reinvigorate social action as we have done so many times before in our movement. In the early days of the epidemic when there was no action from our government and people rallied tirelessly to Act Up and create change, we must institute our generation's social action. As Dr. Fauci reminds, WE are who will end this epidemic and WE must end HIV. And as Thomas Jefferson said ""If you want something you have never had, you must be willing to do something you have never done." The time to act is now.

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This article was provided by National Alliance of State and Territorial AIDS Directors. Visit NASTAD's website to find out more about their activities and publications.

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