East Bay HIV Update Conference Getting to ZER in the East Bay PrEP Linkage & retention HIV testing A strategic planning workshop to reduce new infections and HIV-related deaths as a community June 2, 2017 East Bay HIV Update Conference

objectives where we’re at where we want to go vote on metrics

East Bay has: HIV testing PrEP Linkage & retention HIV testing programs: universal testing in 3 EDs, 6 FQHCs, Planned Parenthood, Roots, jail; high-risk testing programs in CBOs PrEP network, CHRP and navigator projects Linkage and retention, HIV provider and nurses networks

Drivers of HIV Transmission among MSM Casual (50%) or main (40%) partner Chronic infection Partners not retained in care Chapin-Bardales Abstract CROI 2017 #1024

Where are new infections coming from overall?  diagnosed & not retained 2015 JAMA, Skarbinski et. al.

ZERO new infections ZERO AIDS-related deaths ZERO discrimination

HIV ACCESS data through March 2017 60% tested 96% with ART Rx 87% virally suppressed HIV ACCESS data through March 2017

HIV ACCESS data through March 2017 60% tested 76% retained 87% virally suppressed HIV ACCESS data through March 2017

How’s it going for youth ages 13-19? 100% with ART Rx 91% virally suppressed Children’s Hospital Oakland 2017 data

How’s it going for youth ages 13-19? 95% retained 91% virally suppressed Children’s Hospital Oakland 2017 data

How’s it going in Zambia? 83% diagnosed 74% on ART Zambia PopART Trial, published May 2017

HIV ACCESS data through March 2017 60% tested 76% retained 87% virally suppressed HIV ACCESS data through March 2017

National data are from "NHAS Update to 2020," published Dec 2016. HIV ACCESS data definitions: % diagnosed is based on national estimates since we don't have local NHBS data % linked within 90 days from date of diagnosis to date of first HIV medical visit (CHCs only; 90%) % retained with at least one HIV medical visit in the first 6 month and last 6 month period of the last 12 months (78%) % virally suppressed with a <200 copies/mL viral load result within the last 12 months (86%) National data are from "NHAS Update to 2020," published Dec 2016. HIV ACCESS data is updated with 2017 Quarter 1 HIV ACCESS data, distributed May 2017.

National data are from "NHAS Update to 2020," published Dec 2016. Alameda County data are from "HIV Surveillance Report, 2013-2015," published Feb 2017. Contra Costa County data are from "HIV Surveillance Brief," data to 2014, published Aug 2016.

to be diagnosed with HIV African Americans are 4.5x more likely to be diagnosed with HIV

to be diagnosed with HIV 20-29-year-olds are 2.3x more likely to be diagnosed with HIV

to be diagnosed with HIV African Americans are 5.7x more likely to be diagnosed with HIV

to be diagnosed with HIV 20-29-year-olds are 2.8x more likely to be diagnosed with HIV

The Collective Impact model shared metrics enforcing strengths & activities common agenda continuous communi-cation backbone support Develop a common agenda: everyone on the same page Shared measurement: metrics we all collect and share Mutually enforcing activities: we use our existing strengths to contribute to the collective goals and agenda. Leverage existing linkage & retention network, HIV provider network… develop PrEP navigator network? Continuous communication: regular (quarterly?) meetings and contact Backbone support: we need a core leadership team to coordinate efforts

The Collective Impact model shared metrics enforcing strengths & activities common agenda continuous communi-cation backbone support Develop a common agenda: everyone on the same page Shared measurement: metrics we all collect and share Mutually enforcing activities: we use our existing strengths to contribute to the collective goals and agenda. Leverage existing linkage & retention network, HIV provider network… develop PrEP navigator network? Continuous communication: regular (quarterly?) meetings and contact Backbone support: we need a core leadership team to coordinate efforts

Which prevention metric should we focus on? (this will be a live poll) By 2021… Reduce the # of new HIV diagnoses by ≥25% Increase the % of MSM and TG persons tested by ≥20% (publicly-funded) Increase the # people on PrEP by ≥100% Reduce the % of late testers among new HIV diagnoses by ≥50%

Which retention metric should we focus on? (this will be a live poll) By 2021… Increase the % of PLWHA linked to care within 30 days of dx to ≥90% Increase the % of PLWHA retained with 1 medical visit/year to ≥90% Increase the % of PLWHA who are virally suppressed to ≥80% Increase the % of Ryan White clients stably housed to ≥90%