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Hiv Prevention Plan DISTRICT OF COLUMBIA HIV PREVENTION PLAN 2011-2012 Developed by the HIV/AIDS, Hepatitis, STD, and TB Administration DC Department of Health and the DC HIV Prevention Community Planning Group June 9, 2011 Page | 0 Table of Contents Introduction ............................................... Page 1 Community Services Assessment ..................... Page 3 June 2011 HIV Prevention Interventions ......................... Page 74 July 2008 Prioritization of Populations ........................... Page 162 August 2009 Recommended Interventions .......................... Page 168 July 2008 Introduction The primary purpose of the District of Columbia HIV Prevention Plan is to identify the HIV prevention needs of District residents, to help the DC HIV Prevention Community Planning Group (HPCPG) identify and prioritize the populations most in need of HIV prevention services and the most effective HIV prevention strategies and interventions for those populations. The plan is developed by the DC Department of Health‘s HIV/AIDS, Hepatitis, STD, and TB Administration (HAHSTA) in conjunction with the District‘s HIV Prevention Community Planning Group (HPCPG), following the requirements of the ―2003-2008 HIV Prevention Community Planning Guidance” of the Centers for Disease Control and Prevention (CDC). HIV prevention community planning is a collaborative process by which HAHSTA works in partnership with the community to develop a comprehensive HIV prevention plan that best represents the needs of populations infected with or at risk for HIV.1 Together, representatives of affected populations, epidemiologists, behavioral and social scientists, HIV/AIDS prevention service providers, health department staff and others analyze the course of the epidemic in the District, assess and prioritize HIV prevention needs, identify HIV prevention interventions to meet those needs, and develop an HIV prevention plan that is directly responsive to the epidemic. HAHSTA uses the information on prioritized populations and recommended interventions to guide its annual application for federal HIV prevention funds from the Centers for Disease Control and Prevention (CDC), as well as the use of District- appropriated funds for HIV prevention. The District of Columbia HIV Prevention Plan for 2011-2012 is divided into the following sections: Community Services Assessment: This section, approved by the HPCPG in June 2011, describes the HIV prevention needs of the populations that were prioritized by the planning group in 2009. Information was obtained from behavioral surveillance studies conducted in DC among men who have sex with men (MSM), heterosexuals and injecting drug users (IDUs); focus groups with several populations, including transgender women, and literature reviews. HIV Prevention Interventions: This section describes interventions and strategies that can be used to prevent new HIV infections, and identifies which interventions have been shown to reduce HIV risk behavior in different populations. Prioritization of Populations: This section describes the process used by the HPCPG to prioritize the prevention needs of at-risk populations using information from the District of Columbia HIV/AIDS Epidemiology Annual Report 2007. Recommended Interventions: This section identifies the interventions that the HPCPG determined were most appropriate for each of the prioritized populations. 1 HIV Prevention Community Planning Guidance, Centers for Disease Control and Prevention, 2003 DC HIV Prevention Plan 2011-2012 1 Acknowledgements Dr. Gregory Pappas, MD, PhD Senior Deputy Director DC Department of Health, HIV/AIDS, Hepatitis, STD, and TB Administration HIV Prevention Community Planning Group Melina Afzal, Community Co-Chair Paola Barahona, Community Co-Chair, 2008-2010 Néstor Rocha, Government Co-Chair Terrence Young, Community Co-Chair-Elect Members Patty Alleman Calvin Gerald Tyler Spencer Natalia Averett Leandrea Gilliam Ron Swanda Susan M. Blake Daniel O’Neill Rev. Dana Tolliver Mark Baker Ken Pettigrew Mamie Washington Chris Bryant Richard Rice Brian Watson Cyndee Clay Hazel V. Smith Pernell Williams Margaux Delotte-Bennett Andrew Kerkhoff Meredith Zoltick Manuel Díaz-Ramírez Alternates Abby Charles David Mariner Laureen Lynch-Ryan Kehinde Hall José Ramírez DC Department of Health, HIV/AIDS, Hepatitis, STD, and TB Administration Prevention and Intervention Services Bureau Strategic Information Bureau Néstor Rocha, Chief Tiffany West-Ojo, Chief Jenevieve Opoku Partnerships, Capacity Building & Community Outreach Bureau Donald Babb, HIV Prevention Community Planning Coordinator George Washington University School of Public Health and Health Services Dr. James Peterson; Michelle Folkers, MPH; Whitney Montgomery, MPH; Dr. Amanda Castel For additional information on the HIV Prevention Community Planning Group please contact [email protected] or 202-671-4900, or visit www.doh.dc.gov/HPCPG For additional information on HAHSTA and HIV/AIDS in the District of Columbia visit http://doh.dc.gov/hiv 2 DC HIV Prevention Plan 2011-2012 Community Services Assessment June 2011 The purpose of the Community Services Assessment is to demonstrate the HIV prevention needs of different populations in the District of Columbia and factors related to HIV risk behaviors. This chapter brings together epidemiologic data, behavioral data, and ethnographic data to provide a comprehensive description of communities at risk for HIV in the District. Behavioral and qualitative data show broad behavioral risk factors across all populations. These behaviors affect different populations in their own unique ways with varying levels of impact, yet they are all present in each population. Addressing prevention activities that exist across all populations as well as those designed for specific populations provides a more in-depth portfolio for HIV prevention within the District. Prioritized Populations In 2003, the Centers for Disease Control and Prevention launched an initiative to reduce HIV transmission using strategies that focused on people living with HIV (PLWH), including reducing barriers to early diagnosis of HIV infection and increasing access to quality medical care, treatment, and prevention services for those living with HIV. The initiative consists of four key strategies: Making HIV testing a routine part of medical care; implementing new models for diagnosing HIV infections outside medical settings; preventing new infections by working with persons diagnosed with HIV and their partners; and further decreasing perinatal HIV transmission. The strategies included increasing emphasis on services targeted at prevention for PLWH by requiring that PLWH be the number one priority for prevention services in all jurisdictions. In July 2009, the HPCPG prioritized populations by risk group based on the data on newly diagnosed HIV cases in 2001-2006. People living with HIV – Black Heterosexuals of all ages; Black men who have sex with men (MSM) of all ages; Latino MSM, 20-39; White MSM, 20-49; Black injecting drug users (IDUs), 20-59; Latino IDUs, 40-49; and White IDUs, 30-49 – were ranked as Priority 1. High-risk, HIV-negative individuals from the same risk groups were ranked as Priority 2. All populations within each of these two groups have the same priority. The HPCPG also prioritized 10 Special Populations: High-Risk Youth; Transgender Individuals; Individuals Involved in the Sex Trade; the Deaf and Hard of Hearing; individuals who are 50 or older; Latino heterosexuals between 20 and 49 years old; recent immigrants that may face challenges in accessing health services; incarcerated and recently released individuals; individuals with physical, mental or developmental disabilities; and homeless individuals. DC HIV Prevention Plan 2011-2012 3 Contents Priority One: People Living with HIV PLWH .............................................................. Page 6 Black Heterosexuals of all ages; Black men who have sex with men (MSM) of all ages; Latino MSM, 20-39; and White MSM, 20-49; Black injecting drug users (IDUs), 20-59; Latino IDUs, 40-49; and White IDUs, 30-49 Priority Two: HIV-Negative Individuals Black Heterosexuals ................................... Page 18 MSM: Black, White and Latino ........................ Page 27 Injecting Drug Users: Black, Latino and White .... Page 32 Special Populations High-Risk Youth ......................................... Page 37 Transgendered Individuals ............................ Page 39 Individuals Involved in the Sex Trade .............. Page 46 Incarcerated and Recently Released ............... Page 49 Homeless Individuals .................................. Page 51 Individuals 50 and older .............................. Page 54 Latino Heterosexuals .................................. Page 55 Recent Immigrants .................................... Page 59 The Deaf and Hard of Hearing ....................... Page 61 Individuals with Disabilities .......................... Page 63 Other Populations Non-Injection Drug Users ............................. Page 64 4 DC HIV Prevention Plan 2011-2012 Methodology / Organization In order to determine the specific prevention needs of the target populations, a literature review was done for all prioritized and special populations, and focus groups and key informant interviews were conducted with MSM, Black and Latino heterosexuals, transgender women and current and former substance users. The specific questions that guided the CSA were: What are the HIV-related risk behaviors of the target populations?
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