1. 1 MMWR (60), 2011. Of all with HIV infection, ~850,000 individuals do not have suppressed HIV RNA (72%) 100 % 75% 50% 25% 80 % 77 % 66 % 77 % 89 % Gaps that Limit Test and Treat for HIV Prevention in US

2. 2 TO IDENTIFY 95% OF HIV+ RESIDENTS OF THE SECOND DISTRICT WHO ARE NOT IN CARE Goal

3. 3 1. DETERMINE TOTAL HIV+ POPULATION OF SECOND DISTRICT 2. DETERMINE NUMBER NOT AWARE OF STATUS A. HOW DO WE FIND THEM? 1) PHYSICIANS TESTING THEIR PATIENTS 2) FOCUSED INTERVENTION 3) ZIP-CODE COMMUNITY TESTING 4) CHURCHES AND OTHER SUPPORT B. OTHER 3. HIV+ BUT NOT IN CARE A. INCENTIVES B. CHURCHES AND OTHER COMMUNITY SUPPORT 4. IMPROVE ADHERENCE A. MCC ( MEDICAL CASE COORDINATION) B. DOT ( DIRECT OBSERVATION OF THERAPY) Objectives

5. Awareness of HIV Serostatus: Estimates of Transmission People Living With HIV (1,039,000-1,185,000) New Sexual infections/Year (~32,000) Percent ~25% Unaware of Infection ~54% of New Infections ~46% of New Infections ~75% Aware of Infection Marks G. AIDS. 2006;20:1447-1450.

6. 6 Young Men’s Survey (1994-2000): Perceived Risk and Unrecognized HIV Infection MacKellar DA, et al. JAIDS. 2005;38:603-614. HIV Positive (%) White Hispanic Black 10% of 5649 Young MSM Tested Were HIV Positive 77% Were Unaware They Were HIV Infected Unaware of HIV Infection Aware of HIV Infection 75% Conducted in Baltimore, Dallas, Los Angeles, Miami, New York, and Seattle. White Hispanic Black 75% 91% 56% 64% 91% 15 to 22 Years of Age 23 to 29 Years of Age

7. 7 1. OASIS DATA : 46% OF ADOLESCENT CLIENTS ARE INFECTED AFTER BEING “KICKED OUT” OF HOME…. MOMS CAN’T HANDLE THEIR SEXUALITY Keeping the HIV Neg MSM HIV neg

8. 8 1. CHURCHES /SORORITIES 2. LOCAL MSM GROUPS 3. WE CAN’T FORGET THE “CLOSETED MEN” 4. IF BLACK MOTHERS CAN LOVE THEIR SONS WHO ARE IMPRISONED FOR MURDERING SOMEONE….THEY SHOULD BE ENCOURGAGED TO LOVE THEIR KIDS WHO LIKE SOMEONE OF THE SAME SEX Programs

9. 9

10. 10 Current Treatment Cascade