1. East Bay HIV Update Conference
Getting
to ZER
in the East Bay
PrEP
Linkage & retention
HIV testing
A strategic planning workshop to reduce new infections and HIV-related deaths as a community
June 2, 2017
East Bay HIV Update Conference

2. objectives
where we’re at
where we want to go
vote on metrics

3. East Bay has: HIV testing PrEP Linkage & retention
HIV testing programs: universal testing in 3 EDs, 6 FQHCs, Planned Parenthood, Roots, jail; high-risk testing programs in CBOs
PrEP network, CHRP and navigator projects
Linkage and retention, HIV provider and nurses networks

4. Drivers of HIV Transmission among MSM
Casual (50%) or main (40%) partner
Chronic infection
Partners not retained in care
Chapin-Bardales Abstract CROI 2017 #1024

5. Where are new infections coming from overall?
diagnosed & not retained
2015 JAMA, Skarbinski et. al.

8. ZERO new infections
ZERO AIDS-related deaths
ZERO discrimination

9. HIV ACCESS data through March 2017
60% tested
96% with ART Rx
87% virally suppressed
HIV ACCESS data through March 2017

10. HIV ACCESS data through March 2017
60% tested
76% retained
87% virally suppressed
HIV ACCESS data through March 2017

11. How’s it going for youth ages 13-19?
100% with ART Rx
91% virally suppressed
Children’s Hospital Oakland 2017 data

12. How’s it going for youth ages 13-19?
95% retained
91% virally suppressed
Children’s Hospital Oakland 2017 data

13. How’s it going in Zambia?
83% diagnosed
74% on ART
Zambia PopART Trial, published May 2017

14. HIV ACCESS data through March 2017
60% tested
76% retained
87% virally suppressed
HIV ACCESS data through March 2017

15. National data are from "NHAS Update to 2020," published Dec 2016.
HIV ACCESS data definitions:
% diagnosed is based on national estimates since we don't have local NHBS data
% linked within 90 days from date of diagnosis to date of first HIV medical visit (CHCs only; 90%)
% retained with at least one HIV medical visit in the first 6 month and last 6 month period of the last 12 months (78%)
% virally suppressed with a <200 copies/mL viral load result within the last 12 months (86%)
National data are from "NHAS Update to 2020," published Dec 2016.
HIV ACCESS data is updated with 2017 Quarter 1 HIV ACCESS data, distributed May 2017.

16. National data are from "NHAS Update to 2020," published Dec 2016.
Alameda County data are from "HIV Surveillance Report, ," published Feb 2017.
Contra Costa County data are from "HIV Surveillance Brief," data to 2014, published Aug 2016.

19. to be diagnosed with HIV
African Americans
are 4.5x more likely
to be diagnosed with HIV

21. to be diagnosed with HIV
20-29-year-olds
are 2.3x more likely
to be diagnosed with HIV

23. to be diagnosed with HIV
African Americans
are 5.7x more likely
to be diagnosed with HIV

25. to be diagnosed with HIV
20-29-year-olds
are 2.8x more likely
to be diagnosed with HIV

26. The Collective Impact model
shared metrics
enforcing strengths & activities
common agenda
continuous communi-cation
backbone support
Develop a common agenda: everyone on the same page
Shared measurement: metrics we all collect and share
Mutually enforcing activities: we use our existing strengths to contribute to the collective goals and agenda. Leverage existing linkage & retention network, HIV provider network… develop PrEP navigator network?
Continuous communication: regular (quarterly?) meetings and contact
Backbone support: we need a core leadership team to coordinate efforts

27. The Collective Impact model
shared metrics
enforcing strengths & activities
common agenda
continuous communi-cation
backbone support
Develop a common agenda: everyone on the same page
Shared measurement: metrics we all collect and share
Mutually enforcing activities: we use our existing strengths to contribute to the collective goals and agenda. Leverage existing linkage & retention network, HIV provider network… develop PrEP navigator network?
Continuous communication: regular (quarterly?) meetings and contact
Backbone support: we need a core leadership team to coordinate efforts

28. Which prevention metric should we focus on? (this will be a live poll)
By 2021…
Reduce the # of new HIV diagnoses by ≥25%
Increase the % of MSM and TG persons tested by ≥20% (publicly-funded)
Increase the # people on PrEP by ≥100%
Reduce the % of late testers among new HIV diagnoses by ≥50%

29. Which retention metric should we focus on? (this will be a live poll)
By 2021…
Increase the % of PLWHA linked to care within 30 days of dx to ≥90%
Increase the % of PLWHA retained with 1 medical visit/year to ≥90%
Increase the % of PLWHA who are virally suppressed to ≥80%
Increase the % of Ryan White clients stably housed to ≥90%