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Michael KharfenBureau Chief, Partnerships, Capacity Building, Community OutreachDC Department of HealthHIV/AIDS, Hepatitis, STD and TB Administration
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Michael Kharfen
Communications & Community Outreach Bureau Chief
District of Columbia Department of Health
SYNChronicityDC HIV Public-Private Partnerships“Offer the Test”
Michael KharfenBureau Chief, Partnerships, Capacity Building, Community OutreachDC Department of HealthHIV/AIDS, Hepatitis, STD and TB Administration
Partnership Portfolio• Corporate
▫HIV Testing and Gilead Department of Motor Vehicles Social Service Center
• Foundation▫DC Female Condom Project and MAC AIDS Fund
Education/Distribution• Government/Academic
▫DC Partnership for HIV/AIDS Progress and NIH Research Clinical Services
HIV/AIDS in DC
0.4%
1.9%
2.7% 3.0%
2.3%3.0%
3.1%
2.7%
Percentage
0-1.4%
1.5%-2.4%2.5%-3.4%
Prevalence of HIV/AIDS in the District of Columbia, 2009
• 16,721 reported living with HIV/AIDS in the District at the end of 2009• 5,505 new HIV cases reported between 2005 and 2009• 3.2% of the District’s population diagnosed with HIV/AIDS• One-third to one-half of people (locally) may be unaware of their HIV status. (Source: DC NHBS data)
DC Resident Living with HIV/AIDS as of 2009, by Gender and Race/Ethnicity
Black Hispanic White Other Total
Male 8,325 756 2,620 350 12,051
Female 4,256 156 141 117 4,670
Total 12,581 912 2,761 467 16,721
DC% 75.2% 5.5% 16.5% 2.8% 100.0%
US% (2008) 49.3% 20.0% 27.8% 2.9% 100.0%
HIV/AIDS in DC
Blac
k Males
All Bl
acks
Hispa
nic Males
Whi
te M
ales
Blac
k Fe
males
All His
pani
cs
All W
hite
s
0.0%
1.0%
2.0%
3.0%
4.0%
5.0%
6.0%
7.0%
8.0%
7.1%
4.7%
3.4%
2.9% 2.8%
2.1%1.8%
Overall DC HIV/AIDS prevalence Among Adults and Adoles-cents
1.0%
3.2%
HIV Prevalence by Race/Ethnicity (diagnosed cases)
HIV/AIDS in DC
Public Health Imperative• Generalized Epidemic
▫Missed Opportunities• DC Policy Recommendation
▫Routine annual testing for all adults and adolescents (ages 13 to 84)
• DC Routine HIV Testing Program▫Hospitals (EDs)▫Primary care clinics▫Outreach testing
• Success▫More than 40 partners▫43,000 in 2007 to 122,000 in 2011
Private Sector Approach
•Pharma inspired components▫Consumer Driven “Ask for the Test”▫Provider Driven “Offer the Test”
•Gap▫Private Practitioners
•New Partnership▫GBC Health▫Pfizer
•Private Sector Core Competency▫Detailing
“Offer the Test”
•Department of Health Materials▫Handbook▫Poster▫Patient Information Cards▫Button
•Sales representative training•~200 primary care practices
Provider Survey
•Details▫Period: 12/1/10 – 2/11/11 (3 months)▫Method: Internet / Phone▫Respondents: 106
•Focus▫Provider & Patient Demographics▫Provider Understanding of HIV/AIDS in DC▫Provider Testing Practices▫Provider Knowledge of Testing Guidelines
Provider Survey
SE NE SW NW I don't know
None0%
20%
40%
60%
80%
Which DC quadrant(s) meet the UN threshold for a “generalized and se-vere” HIV epidemic? (Select all that
apply).
30 – 3
9
20 –
29
40 – 4
9
50 – 5
960
+
13 – 1
9
Don
't ...
Non
e0%
20%
40%
60%
80%
Which age groups would you say have an HIV/AIDS prevalence of above 1% in Washington, D.C.? (Select all that
apply).
51 – 75%
26 – 50%
0 – 25% I don’t know
76 – 100%
0%
10%
20%
30%
40%
50%
What percent of heterosexual HIV+ DC residents do not know their HIV
status?
51 – 75%
26 – 50%
I don’t know
0 – 25% 76 – 100%
0%
10%
20%
30%
40%
50%
What percent of HIV+ DC residents test “late” for HIV/AIDS?
Provider Survey
Strongly agree69%
Agree23%
Neither6%
Dis-agree
2%
Strongly disagree
1%
It is important to incorporate rou-tine HIV screening in the medical
care of all my adult patients/clients:
0-10%
11-20%
21-30%
31-40%
41-50%
51-60%
61-70%
71-80%
81-90%
91-100%
0
5
10
15
20
25
What % of your patient population would you estimate you offered an HIV
test?
Provider Survey
•DC Testing Recommendation▫Aware: 69%▫Implementing: 49%
•Barriers▫Limited time to perform HIV counseling▫None▫Cost or reimbursement concerns▫Limited time to perform HIV testing▫HIV is not an issue for my patient
population
Lessons Learned
•Partnerships work▫Shared health missions▫Shared health goals
•Data/Evaluation▫National model significance▫Challenges
•Sustainability▫Communication▫Refresh design, training, materials
Questions