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