Partners across the 57 prioritized jurisdictions implementing the Ending the HIV Epidemic in the U.S. (EHE) initiative are taking many innovative approaches to the initiative’s Treat pillar. These approaches focus on connecting people with HIV treatment as soon as possible after receiving a diagnosis, educating people about U=U, and tailoring campaigns to raise awareness about available HIV care and treatment services. 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 learning more about several jurisdictions’ efforts. Below are just a few of the innovative Treat pillar activities they learned about that may be useful models for other jurisdictions to consider.

Harris County Rapid ART Start Program Swiftly Links People to HIV Treatment

Harris Health System, an integrated healthcare system that cares for residents of Harris County, Texas, has taken multiple innovative approaches to support HIV treatment across their community. Since 2012, they have implemented the Routine Universal Screening for HIV (“RUSH”) program that requires HIV tests on all blood draws within their county hospital system unless the patient opts out. This enables early HIV identification and linkage to care. To support swift linkage to HIV care, as recommended under the EHE Treat pillar, Harris Health System’s Rapid Eligibility and ART (antiretroviral therapy) Dissemination Implementation (READI) program works to get patients who receive an HIV diagnosis in the system’s clinics or hospitals on ART within 72 hours of diagnosis and most often the same day. Through this program, a service linkage worker physically walks through the process with the patient to each station as they begin navigating care. All team members are aware of the new diagnosis and are "READI" for to provide compassionate service during the encounter. The following day, the service linkage worker checks on the patient to see how they’re doing on the meds and handling the diagnosis. The READI program has been the standard of care since 2019 at Harris Health, which provides HIV care and treatment to 60% of people with diagnosed HIV in the Houston area. The enhanced testing and treatment efforts within the Harris Health System has allowed them to achieve a viral load suppression rate of 88% for a client population of 5,700 people living with HIV. The RUSH and READI programs are supported in part through EHE resources from the Health Resources and Services Administration’s HIV/AIDS Bureau. View this presentation about the READI programExit Disclaimer from the 2022 Ryan White Conference.

South Carolina U=U Display Sparks Conversations

South Carolina’s Department of Health and Environmental Control (DHEC) proudly became one of the nation’s first state health departments to endorse U=U (undetectable = untransmittable) in 2019. The message means that people with HIV who have an undetectable level of virus in their blood as a result of adhering to HIV treatment are unable to transmit the virus to others. That same year, DHEC integrated U=U messaging into their EHE jurisdictional plan, which called for the creation of a U=U campaign as part of efforts to combat HIV-related stigma, promote awareness of U=U among people with HIV, and encourage people unaware of their status to get tested. The South Carolina DHEC collaborated with partners to create two portable, reusable U=U campaign displays that incorporate well-known state symbols of the palmetto tree and crescent, which have been deployed across the state at various events to raise awareness and spark conversations. Events have included the 2020 Ending the Epidemics South Carolina World AIDS Day event held at the State House in Columbia, SC, the state’s highest impacted area for HIV. The U=U display was utilized in South Carolina’s second highest impacted area, Charleston, where the U=U campaign was showcased at the 2021 Mayor’s Press Conference for National HIV Testing Day, the Intra-Jurisdictional EHE-Fast Track Cities Alignment Workshop in 2023, and the Charleston Area World AIDS Day observance. The displays have also been featured prominently at numerous additional outreach events such as health fairs, wellness expos, and conferences. South Carolina’s commitment to U=U messaging has inspired a growing number of South Carolinians living with HIV to share their lived experience, wisdom, and time to the community by advocating as U=U ambassadors.

Maricopa County Campaigns Highlight Available HIV Treatment Services and the Benefits of HIV Treatment

As part of its work under the EHE Treat pillar, the Maricopa County (Arizona) Department of Public Health launched two bilingual media campaigns promoting HIV treatment and how to access it in the county. Positively You!Exit Disclaimer is specifically designed to inform and empower young people with HIV between the ages of 18 and 30. The campaign's primary goal is to raise awareness of free and low-cost HIV services available through the Maricopa County Ryan White HIV/AIDS Program and its partners. Propelled by affirmative statements and a vibrant color palette, the campaign features local young adults who share their inspiring stories of why HIV treatment is essentialExit Disclaimer and how Ryan White services have helped them live healthily. Positively You! uses a multi-pronged approach, including digital and print ads, client-centric materials, and guides to available services, social media, and community outreach and engagement efforts. The secondary goal is to fight HIV-related stigma by sharing the powerful Undetectable=Untransmittable (U=U) message with the community at large.

The second campaign, Love Live,Exit Disclaimer is designed to educate people with HIV and the public about the significance of U=U. Love Live features local people with HIV celebrating the excitement and freedom of U=U, highlighted by bright graphics and simple messaging. Via a website and social media content, the campaign connects viewers with information about HIV prevention, care, and treatment and answers FAQs. Both campaigns are supported by EHE resources from the Health Resources and Services Administration’s HIV/AIDS Bureau.

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 the 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.