Program strives to connect people living with HIV/AIDS with care
According to the CDC, as of November 2011, less than 30% of all HIV-infected individuals in the U.S. were virally suppressed. Not only can care and treatment extend lives, but an HIV-positive person who is on treatment and virally suppressed is much less likely to transmit the virus. If an individual is among our nation’s marginalized communities they are even less likely to seek and receive life-saving treatment and care. The success of the global community’s strides in ending the HIV/AIDS epidemic will largely depend upon programs that can effectively link and ensure that HIV-positive individuals remain in care.
AIDS United’s Access to Care (A2C) program connects people living with HIV/AIDS (PLWHA) to direct service organizations in their communities that can provide them with the care and support that they need. AIDS United’s Social Innovation Fund (SIF) grant supports 12 innovative partnerships that are improving individual health outcomes and strengthening local services systems.
Resources from the SIF not only enable AIDS United to continue to provide grants and technical support to more than 250 direct service organizations, but also helps them connect at least 3,500 low-income and marginalized individuals with HIV to high-quality health care and the supportive services they need. Through the SIF grant and targeted special initiatives, AIDS United is able to reach the people most in need of support.
AIDS United’s A2C program is making inroads in bridging the gap between HIV-infected individuals and support systems within their communities. While many of HIV/AIDS programs work in the general American population, the A2C program specifically works within the most marginalized populations, including communities of color and people living in the deep south, who often suffer some of the worst health outcomes.
Through rigorously evaluated program models and expansive networks of care, the A2C program serves as an innovation hub for communities to strategically tackle barriers to care and is an inspiring example of a public-private partnership that is effectively advancing the goals of our country’s national HIV/AIDS strategy.
AIDS United has partnered with researchers at Johns Hopkins’ Bloomberg School of Public Health to conduct rigorous evaluations of the A2C initiative. Through this sub-grantee evaluation process, AIDS United is able to determine if their health outcomes and access and retention in care are better than the outcomes and retention of people who seek health care and support services through other outlets. An innovative network analysis and return on investment assessment completes the evaluation to measure how much stronger and better prepared the local AIDS-serving networks are as a result of their grant.
Their SIF Evaluation Plan (SEP) consists of a multi-part evaluation that includes an impact evaluation, an outcomes evaluation, and an implementation evaluation. The impact evaluation targets a moderate evidence level, while the outcome evaluation will likely produce preliminary level evidence.
The impact evaluation will use a randomized control trial design in the UAB sub-grantee site to assess the impact of intensive case management and motivational interviewing on viral loads among PLWHA. The outcome evaluation, which encompasses all sub-grantee sites, includes three aspects: (1) a pre/post examination of patient-level health indicators, (2) a cost analysis to determine savings related to program participation, and (3) a network analysis to examine if A2C participation leads to greater program network density.
The A2C programs were initially implemented in five geographically diverse sites. AIDS United’s work was significantly expanded when it received funding from the SIF, allowing notable expansion in the deep South through Montgomery AIDS Outreach, Inc.; Birmingham AIDS Outreach; and Louisiana Public Health Institute. The grants called for geographically and culturally diverse organizations to combine their expertise in the development of community-driven solutions to help enable greater access to HIV care and treatment.
In alignment with the National HIV/AIDS strategy, A2C is also hoping to scale this approach further using the outcome of their evaluation and lessons learned to drive adoption beyond their grant portfolio.
Transforming Lives. Strengthening Communities.
The Washington Post highlighted the critical need for accessible support services for individuals living with HIV/AIDS through Johneisha Jones’ personal story.
Despite being a woman living with AIDS, Jones’ sought to seek assistance instead of committing suicide. Christie’s Place, a community based HIV organization dedicated to building the health and resilience of women, children and families impacted by HIV/AIDS, proved to be the salvation for Jones in her times of crisis.
Instead of jumping off a bridge, she thought about her 16-year-old son who would be left without any parents since his father had died years before. She walked to the nearest emergency room and after initial treatment she was referred to Christie’s Place. The staff helped her get food, transportation, counseling, health care navigation, and provided other support services that enabled Ms. Jones to feel like her life was salvageable.
Christie’s Place is supported by the Social Innovation Fund (SIF) through AIDS United and partner funders. With SIF funding, Christie’s Place is expanding the capacity of their network to serve at new clinic sites and through a mobile home-based model, substantially increasing access to care for women by coordinating efforts across multiple service providers to establish a “network of care,” providing assistance to ameliorate barriers to care such as transportation, food and childcare, and more.