Philadelphia EMA Integrated HIV Prevention and Care Plan Prepared for: Philadelphia Ryan White Part A Planning Council and HIV Prevention Planning Group OFFICE OF HIV PLANNING | 2017-2021 0 Acknowledgements Thanks to all the stakeholders and community members who provided data, insight, and knowledge that made this integrated plan possible. Special thanks to: Philadelphia EMA Part A Ryan White Planning Council Philadelphia HIV Prevention Planning Group Philadelphia Department of Public Health, AIDS Activities Coordinating Office Pennsylvania Department of Health New Jersey Department of Public Health Matthew McClain Document written and edited by: Mari Ross Russell, Briana Morgan, and Nicole Johns of the Office of HIV Planning Copy editing by: Jennifer Hayes Document layout and formatting by: Mari Ross Russell 1 Table of Contents Introduction .................................................................................................................................................. 6 Section I: Statewide Coordinated Statement of Need/Needs Assessment……………………………………………….8 A. Epidemiologic Overview ........................................................................................................................... 8 a. Geographical region of the EMA ....................................................................................................... 9 b. Socio-demographic characteristics ................................................................................................... 9 Race and Ethnicity ............................................................................................................................... 10 Poverty and Income ............................................................................................................................ 10 Education ............................................................................................................................................ 11 Employment ........................................................................................................................................ 12 Insurance ............................................................................................................................................. 12 c. HIV/AIDS .......................................................................................................................................... 13 Deaths ..................................................................................................................................................... 16 Emerging Populations: New HIV Cases versus Prevalence ..................................................................... 17 Special Populations ................................................................................................................................. 17 Gay, Bisexual, and Other Men Who Have Sex with Men of All Races and Ethnicities ........................ 18 Black Women and Men ....................................................................................................................... 18 Latino Men and Women ..................................................................................................................... 18 People Who Inject Drugs .................................................................................................................... 18 Youth Aged 13 – 24 ............................................................................................................................. 19 Transgender Women .......................................................................................................................... 19 Pregnant Women ................................................................................................................................ 20 d. Indicators of HIV Risk....................................................................................................................... 20 Mental Health ..................................................................................................................................... 20 Substance Use ..................................................................................................................................... 20 Sexual Behaviors ................................................................................................................................. 22 Teen Pregnancies ................................................................................................................................ 22 Prenatal Care ....................................................................................................................................... 22 Sexually Transmitted Infections .......................................................................................................... 23 Incarceration ....................................................................................................................................... 23 Housing ............................................................................................................................................... 24 2 B. HIV Care Continuum ............................................................................................................................... 26 a. HIV Care Continuum ....................................................................................................................... 26 HIV Care Continuum Definitions ......................................................................................................... 26 Engagement in Care Comparison ............................................................................................................ 27 b. Disparities along the Continuum .................................................................................................... 28 HIV Diagnosis ...................................................................................................................................... 28 Concurrent Diagnosis of HIV/AIDS ...................................................................................................... 28 Living with HIV/AIDS ........................................................................................................................... 29 In Care ................................................................................................................................................. 29 Retained in Care .................................................................................................................................. 30 On ART ................................................................................................................................................ 30 Viral Suppression ................................................................................................................................ 30 c. Continuum Use in Planning ............................................................................................................. 31 C. Financial and Human Resources Inventory ............................................................................................. 32 a. Funding Sources and Services, Actual for 2015 and Anticipated for 2016 ..................................... 33 b. Work Force Capacity ....................................................................................................................... 36 c. Coordination of HIV Prevention, Care and Treatment Services and Funding Sources ................... 38 d. Efforts to identify and secure needed services ............................................................................... 38 Housing ............................................................................................................................................... 38 Health Insurance Cost-Sharing ............................................................................................................ 39 D. Assessing Needs, Gaps, and Barriers ...................................................................................................... 40 a. Needs Assessment Process ............................................................................................................. 40 OHP Needs Assessment Activities ....................................................................................................... 40 PDPH and National Data Sources ........................................................................................................ 42 b. Identified Service Needs of PLWH and Those at Most Risk ............................................................ 42 High Quality HIV and Primary Care ..................................................................................................... 43 Medical and Non-Medical Case Management .................................................................................... 44 Transportation .................................................................................................................................... 44 Dental Care ......................................................................................................................................... 45 Mental Health ..................................................................................................................................... 45 Substance Use ....................................................................................................................................