The San Francisco HIV Prevention Strategy, : An Integrated, Citywide Approach HIV Prevention Planning Council November 8, 2012

HPPC Work Group  Richard Bargetto  Chadwick Campbell  David Gonzalez  Paul Harkin  Aja Monet (co-chair)  Jessie Murphy  Kyriell Noon  Frank Strona  Laura Thomas  Channing Wayne (co-chair) SFDPH Staff  Laurel Bristow, HPS  Dara Geckeler, HPS  Emalie Huriaux, HPS  Kevin Hutchcroft, HHS  Eileen Loughran, HPS  Oscar Macias, HPS  Jenna Rapues, HPS

Timeline for Engagement & Review  August 9 th HPPC Meeting: HPS provided overview of Jurisdictional Plan, identified need for work group, and timeline. HPPC executive committee established the Work Group (WG).  August 20 th HHSPC Meeting: HPS provided overview of the process for developing the Strategy and invited participation of HHSPC members on the WG.  August 27 th Meeting with Marin & San Mateo Counties: HPS met with the counties to provide an overview and determine how the counties will include their strategies.  September 4 th HPPC WG Meeting: The WG provided feedback about what should be included in the Strategy.  September 14 th HIV Testing Coordinators Meeting: HPS provided an overview of the process.  September 20 th Joint HPS & HHS Meeting: HPS provided an overview of the process and garnered feedback about how to include care & treatment info.  October 1 st HPPC WG Meeting: The WG provided feedback on the initial draft  October 5 th HIV/AIDS Providers Network Meeting: HPS provided an overview of the process.  October 10 th HPPC WG Meeting: The WG provided feedback on the draft.  October 16 th Transgender Advisory Group Meeting: HPS provided an overview of the process.  October 22 nd HPPC WG Meeting: The WG voted to approve the draft.  October 25 th HPPC Executive Committee Meeting: The Committee reviewed the draft and approved the presentation.  November 8 th HPPC Meeting: HPPC votes on concurrence

 5-year plan ( ) required by CDC  The Strategy outlines “the vision”  Due December 30, 2012  Will update annually, as needed The SF HIV Prevention Strategy

Steps in the planning process Stakeholder identification Results-oriented engagement process SF HIV Prevention Strategy development, implementation, and monitoring

Shared Roles/Responsibilities of SFDPH & HPPC  Ensure collaboration and coordination of HIV prevention, care, and treatment services.  Ensure that the SF Strategy aligns with the goals of the National HIV/AIDS Strategy.  Ensure services and resources are directed and disseminated to the areas with the greatest HIV burden.

Roles/Responsibilities SFDPH  Submit the SF Strategy to CDC. HPPC  Inform the development of the SF Strategy.

Five components of “high-impact prevention”: 1.Effectiveness and cost; 2.Feasibility of full-scale implementation; 3.Coverage in the target population; 4.Interaction and targeting of interventions; and 5.Emphasis on interventions that will have the greatest overall potential to reduce HIV infections. The SF Strategy is guided by…

Letter to CDC from HPPC, including:  Documentation that HPPC was informed regarding the development of the Strategy;  Description of the process used to review it;  Concurrence, concurrence w/ reservations, or non-concurrence. “The Letter”

Programmatic activities and resources are being allocated to the most disproportionately affected populations and geographical areas that bear the greatest burden of HIV disease, including populations at greatest risk of HIV transmission and acquisition. (definition from CDC’s community planning guidance) or The Strategy matches the information (e.g., epidemiology, community knowledge/experience). Concurrence

Information (epidemiology, community knowledge/ experience) Resources

Review of Strategy Narrative

 Local Epidemiology  The San Francisco HIV Prevention Strategy  Goals and Objectives  Underlying Principles  Summary Introduction (pp )

The HIV Prevention, Care & Treatment Cascade (pp ) Viral suppression, achieved through secondary and tertiary prevention efforts, is ultimately a primary prevention strategy for HIV-negative individuals. Thus, secondary and tertiary prevention activities for PLWHA are primary prevention for HIV-negative people, even those HIV negative individuals who never come into direct contact with any HIV prevention effort. Viral suppression, achieved through secondary and tertiary prevention efforts, is ultimately a primary prevention strategy for HIV-negative individuals. Thus, secondary and tertiary prevention activities for PLWHA are primary prevention for HIV-negative people, even those HIV negative individuals who never come into direct contact with any HIV prevention effort.

 Gaps Along the Cascade: A Quantitative Perspective  Community Needs: A Qualitative Perspective  Populations with Significant Barriers to HIV Testing, Care, and Treatment  Structural Change Needs Gaps and Needs in HIV Prevention, Care & Treatment (pp )

 HIV Prevention Allocation  Consolidating & Coordinating Resources  Health Care Reform  Leveraging Private Resources to Support the Strategy Resources for HIV Prevention, Care & Treatment Services (pp )

*Data from 2011 HIV/AIDS Epidemiology Annual Report

 Background  Core Activities  Syringe Access & Disposal  HIV Testing & Other Status Awareness Efforts  Comprehensive Prevention with HIV-Positive Individuals  Condom Distribution  Evidence-based Interventions for HIV-negative People at Highest Risk of Acquiring HIV (i.e., HERR)  Programs to Address HIV-Related Health Disparities  PrEP & PEP  Addressing Stigma, Discrimination & Criminalization Strategies to Address HIV Prevention, Care & Treatment (pp )

 The HIV Prevention Planning Council  The HIV Health Services Planning Council  Integrated Prevention and Health Services Planning Community Planning for HIV Prevention, Care & Treatment (pp )

 Research Conducted by the HIV Prevention Section  Research Conducted by Bridge HIV  Research Conducted by the HIV Epidemiology Section HIV-Related Research within SFDPH (pp )

 Major implementation milestones for the Strategy have already been achieved.  We are looking forward to measuring outcomes and understanding the successes and challenges created by our approach.  The Comprehensive HIV Prevention Plan outlines in detail the objectives of the Strategy and how we will measure the outcomes. Timeline for Implementation & Conclusion (p. 67)

 Part 1: SF HIV Strategy  Part 2: Jurisdictional Strategy for Marin  Part 3: Jurisdictional Strategy for San Mateo  Appendices  HPS RFP  CDC Required & Recommended Activities Table  Summary of Funded Programs  HIV Testing Policy Additional Sections & Appendices

Resources allocated to most disproportionately affected populations  Special projects to reach MSM, Latino MSM, African American MSM, TFSM

 HIV prevention programmatic activities and resources are being allocated to the most disproportionately affected populations that bear the greatest burden of HIV, including populations at greatest risk of HIV transmission and acquisition, in San Francisco. “The resources match the information (e.g., epidemiology, community knowledge/experience).” Concurrence

Q & A