EHE Jurisdictions Innovate to Expand HIV Testing Opportunities

Partners across the 57 prioritized jurisdictions implementing the Ending the HIV Epidemic in the U.S. (EHE) initiative are taking many innovative approaches to activities under the initiative’s Diagnose pillar. These include providing HIV testing in a local jail system and bringing HIV and other syndemic-related services to communities via a mobile clinic. As the initiative’s fifth year continues, members of the HHS Office of Infectious Disease and HIV/AIDS Policy’s (OIDP) EHE and Engagement Teams have been hearing more about testing activities in several jurisdictions. Below are just a few of the innovative Diagnose pillar activities they have learned about that may be useful models for other jurisdictions to adapt.

Parkland Health Increases HIV Testing and Diagnoses in Dallas County’s Jail System

Parkland Health, a public hospital and clinic system and a partner in Dallas County’s (Texas) EHE plan, provides regular opt-out HIV testing for all individuals entering the Lew Sterrett Justice Center, Dallas County’s jail. This year, the jail is expected to conduct more than 12,000 tests. In addition, Parkland Health’s group sexual health classes and educational podcasts have contributed to increased HIV and STI testing during incarceration. In the jail, there have been 150 diagnoses per year for the past two years, a significant increase compared to the 60 per year in previous years. In addition to its work in the county jail, Parkland also facilitates swift linkage to HIV care for patients at the time of diagnosis regardless of how they enter the health system. A team of healthcare providers, case managers, peer navigators, financial counselors, and medication access specialists collaborates with patients to provide personalized care and ensure access to treatment and program retention. Currently, Parkland serves more than 6,300 people with HIV. 

Mobile Clinic Brings HIV Testing, Other Services to Tribal Communities in San Diego County

The Southern Indian Health Council (SIHC), a recipient of an Ending the HIV/HCV/STI Epidemic in Indian Country cooperative agreement, is a Federally Qualified Health Center in southeastern San Diego County, California. SIHC serves a Tribal Consortium comprised of seven American Indian tribes. With EHE funds provided by the Indian Health Service, SIHC has launched a mobile health clinic called Room 2 Roam (R2R), which offers syndemic-related care to roughly 2,000 people living within the rural SIHC reservation lands. The services provided include rapid testing for HIV, HCV, and syphilis, as well as COVID-19 and flu vaccines and blood pressure checks. Each visit takes roughly 20 minutes, and while individuals wait for their test results, a registered nurse provides education on harm reduction, HIV PrEP and PEP, and doxy PEP for sexually transmitted infections. Additionally, community health representatives at the mobile clinic help people check-in and provide education on the available services. The community health representatives have also expressed interest in learning how to provide rapid point-of-care HIV tests to expand capacity.

Incentives are used to drive testing efforts, and word about R2R has spread throughout the community. One community member receiving services remarked, “I haven’t been tested for HIV or syphilis in 21 years until today, but now I know my status.” Another observed, “It’s a lot easier to come here and get tested than at the clinic.” R2R soon will be adding penicillin injections for syphilis treatment, with the ability to treat individuals immediately following a rapid syphilis test, and multi-site gonorrhea and chlamydia testing with the addition of a portable restroom that will support self-sample collection.

The EHE Initiative

The activities discussed in this post are just three examples of the many innovative approaches being taken by partners working in each of the 57 prioritized jurisdictions to scale up four science-based strategies: diagnose, treat, prevent, and respond. The jurisdictions receive additional funding and technical assistance from CDC’s Division of HIV Prevention, HRSA’s Health Center Program and Ryan White HIV/AIDS Program to implement locally tailored plans to reduce new HIV transmissions by 90% by 2030. NIH and IHS also support complementary activities. OIDP supports these efforts through community engagement and information sharing by its EHE and Engagement Teams, as well as by sharing information on HIV.gov and managing the AHEAD Dashboard. To learn more about the EHE initiative, visit HIV.gov’s EHE section. Read more about OIDP’s Engagement Team.