Pillar Two:

Treat

This strategy aims to treat HIV rapidly to achieve viral suppression. Assessing rapid ART, flexible clinic times, appointment schedules, and utility of surveillance and other data sources informed this pillar. In Shelby County in 2018, 70% of newly diagnosed individuals were linked to care within 1 month and 90% by 1 year. That same year, 62% of persons with diagnosed HIV were virally suppressed. The epidemiologic profile indicates that these rates are below the National HIV/ AIDS strategy goals.

Connect newly diagnosed individuals living with HIV with the HIV Care and Antiretroviral Therapy (ART) Program

Help individuals living with HIV who are newly diagnosed be informed of and initiate the ART Program on the same day or within 72 hours of diagnosis. (added June 2024)

Increase linkage to care for persons who have experienced incarceration

Develop a flow process with the criminal justice system to improve linkage-to-care process upon release. Consult with Ryan White to find agencies that provide linkage-to-care services, including for people returning from incarceration.

Improve access to mental health services

Create small group sessions led by mental health professionals, possibly available online. Build a network of mental health providers, including those who can provide free care.

Expand case management services to support and address patients’ needs related to HIV care

Collaborate with private practices and insurance companies about HIV and HIV services for their patients and secure an agreement for them to pay toward a case management position instead of using Ryan White. Make case management a “billable service” for the insurance companies.

Improve access to treatment and care related to substance abuse and injection drug usage

Partner with providers of substance abuse treatment to increase testing, linkage to care, and other HIV-related needs. Host condom drives and HIV education events at substance abuse treatment centers.

Use telehealth to expand access to health services for PWH

Identify an existing mobile app already approved by Ryan White that can be used for telehealth appointments. Identify and recruit local doctors and nurses/clinics who can participate in telehealth.

Create an alternative pathway to HIV care through holistic approaches and health practices in addition to HIV medications

Utilize partnerships with dieticians, naturalists, other alternatives/mental health providers as access points for treatment and care. Create a series of classes and resources (for example—meditation, spiritual guidance, nutrition, yoga) on the benefits of using the holistic approach to help boost the immune system.

Increase the percentage of persons with diagnosed HIV infection who are virally suppressed to at least 90%

Create “Fast Track” Viral Load (VL) blood draw program. PWH will come to their appointments 1-2 days before their adherence appointment. On the day of their appointment, they will receive the results for their viral load. Patients who come to their first appointment will receive a gift card for participation and viral suppression. A running log will be created to show their viral load status and will be used as a motivation log.

Increase the effectiveness of the community health worker workforce in Shelby County to support clients with anti-retroviral therapy (ART) adherence to become virally suppress

Conduct two annual trainings for community health workers and supervisors (focusing on a variety of subjects, including specific populations—e.g., women, seniors, Latinx), using an evidence-based curriculum, open to all Ryan White grantees in Shelby County. Assign mentors to community health workers.

Increase to 75% the number of trans women who reach and maintain viral suppression by 2025

Train transwomen to be advocates for HIV care/prevention navigation and to act as connectors for younger/new transwomen seeking care resources. Supply transwomen with “healthcare kits” (hygiene products, HIV tests, contraceptives, lubrication) via trans advocates, clinics, and trans-friendly and accessible organizations.

Treat

Diagnose

Prevent