142nd APHA Annual Meeting and Exposition

Annual Meeting Recordings are now available for purchase

Who's Really Missing from the HIV Treatment Cascade and How Do We Engage Them?

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Monday, November 17, 2014 : 10:30 AM - 10:50 AM

Victoria Cargill, M.D., M.S.C.E. , Office of AIDS Research, National Institutes of Health, Bethesda, MD
Florence Momplaisir, M.D., M.S.H.P. , Drexel University Hospital, Drexel University Hospital, Philadelphia, PA
William Short, MD , Division of Infectious Diseases, Jefferson Medical College of Thomas Jefferson University, Philadelphia, PA
Risha Irvin, M.D., MPH , Division of Infectious Diseases, Johns Hopkins Medical Institutions, Baltimore, MD
Anita Jackson, B.S., CACI , Treatment Adherence Department, Family Medical and Counseling Service, Inc., Washington, DC
The HIV Treatment Cascade is an effective framework for identifying opportunities to improve the health of, and services for, people living with HIV infection (PLWH).  It has become a model used by federal, state and local health agencies to identify opportunities for intervention.  However, marginalized and vulnerable populations are underrepresented at every stage of the continuum, and thus continue to experience poorer treatment outcomes and increased morbidity and mortality.  This panel presents research observations and grassroots derived interventions to address these differential outcomes in specific populations. Utilizing the data from the Medical Monitoring Project (MMP) we report an evaluation of the treatment cascade in 10,000 adult PLWH in Philadelphia to estimate the proportion with mental illness and retained in care, as well as achieving viral suppression, and to determine if this differs for adults without mental illness. We also provide data on female PLWH (N=1139) in 23 health jurisdictions from the MMP across the U.S. identifying the gaps in care provision, notably HIV prevention counseling and safer behaviors. The HIV prevention and care needs of Black MSM are presented based on the HIV risk, prevention and needs data from 1,553 Black MSM enrolled in HPTN 061, and the relevance of this data to the expanding need for PrEP in this population. The panel discussion will close with a summary of several grassroots derived approaches to increasing HIV treatment engagement including treatment readiness groups utilized by a case manager and a physician in an densely populated urban area with a mature expanding HIV epidemic.

Learning Areas:

Conduct evaluation related to programs, research, and other areas of practice
Implementation of health education strategies, interventions and programs

Learning Objectives:
Describe the populations who may not be well captured or described by the HIV Treatment Cascade. Identify those challenges to care engagement for marginalized and vulnerable subpopulations with HIV infection. Formulate strategies to provide more HIV risk reduction information for those poplations when they encounter medical care. Discuss grassroots formulated strategies for reaching these populations.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I was a co-investigator on HPTN 061 and will be reviewing the data learned from HPTN 061.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.