Scaling Up an HIV Viral Load Suppression Model in New York City
Special Projects Fund
November 5, 2015
WebsiteSEE GRANT OUTCOMES
Despite advances in medicine, the AIDS epidemic continues to be a major public health concern—especially in New York City, which remains an epicenter of the disease.
During 2013, New York City recorded 2,832 new HIV diagnoses and 1,784 new AIDS diagnoses. Currently, more than 117,000 people are living with diagnosed HIV infection in New York City, many of whom come from vulnerable populations. Federal guidelines recommend antiretroviral (ARV) medication for all people living with HIV. ARV treatment suppresses the level of HIV in the blood to an undetectable level, which enables HIV-positive people to live healthy lives while making it virtually impossible to transmit the virus to others. Although ARV is highly effective and the established standard of care, only 43% of HIV-positive New York City residents have achieved viral suppression. In 2015, NYHealth awarded Housing Works, Inc., a grant to scale up a highly successful viral load suppression model to help those living with HIV manage the disease and prevent its further transmission.
Under this grant, Housing Works expanded its evidence-based Undetectables program—an innovative viral load suppression model that overcomes barriers to ARV access and adherence for underserved New Yorkers with HIV infection. Preliminary results for this cost-effective model show a high level of success, with 82% of participants becoming virally suppressed. Housing Works, the New York City Department of Health and Mental Hygiene, and Amida Care formed a consortium to collectively adopt, refine, and scale up the model. The consortium developed and published an implementation toolkit and modules for educational forums. Additionally, the consortium focused on how early adopters can secure funding to continue sustainability for the model, including through the Delivery System Reform Incentive Payment (DSRIP) program and other sources. The consortium provided technical assistance and training to Performing Provider Systems (PPSs) throughout New York City, educating them on the Undetectables model and offering scale-up resources for PPSs to adopt it. The model was promoted to Amida Care’s wide network of hospitals, community health centers and private provider groups. A citywide social marketing campaign was conducted to build awareness of and increase participation in the model.