PHILADELPHIA — Today on World AIDS Day, the Health Department released an innovative new plan to effectively end the decades-long HIV epidemic in Philadelphia.
Its primary goal is to reduce new HIV infections by 75 percent within five years, putting HIV on par with other rare, but treatable, chronic conditions.
Taking its title from its function and federal government counterpart, “Ending the HIV Epidemic in Philadelphia” (EHE) is unique in that it combines extensive lived experience and community engagement alongside epidemiological data to form a specific, concrete strategic plan. Philadelphia’s EHE plan also puts an equity lens over all publicly-funded HIV programs in the city.
The U.S. Department of Health and Human Services funds the nationwide EHE initiative.
“Philadelphia is a city of neighborhoods, so it’s fitting that this plan is the culmination of thousands of different voices of Philadelphians, especially those living with HIV, from across the entire city,” said Dr. Thomas Farley, commissioner of the Health Department. “We should be proud that we’re combining this lived experience together with data and scientific knowledge to create a plan that isn’t just talk but is instead focused on action that is measurable and, most important, achievable.”
“The extensive community engagement that went into this plan has made it all that much stronger,” said Coleman Terrell, director of the Health Department’s AIDS Activities Coordinating Office. “The plan itself lays bare the system failures fueling the modern HIV epidemic, be they related to healthcare or housing, but it also provides solutions by way of measurable, achievable goals. To do this, though, we’re going to be flipping the script on public health.”
Some of the major changes taking place entail standard strategic planning actions, like redirecting funding toward higher impact programs, but others are more revolutionary. For instance, the plan rethinks barriers, viewing them not as unchangeable realities to navigate around but, instead, systemic failures that can be and must be fixed.
“One example includes provider hours of operation,” said Javontae Williams, lead coordinator for the EHE community engagement and planning process. “Yesterday, if you could not make your HIV doctor appointment because you couldn’t get off work or make it from picking your kid up from school in time, we said it was a time management issue or a barrier as a result of your income or marital status. Today, we argue that that this is not a barrier the consumer must overcome but instead a provider problem in that they’ve not adequately served their population in terms of when they’re open. These kinds of insights are backed up by data but we also found them in interviews, small group discussions, and town hall meetings.”
Through rethinking systems and redirecting resources, the plan will make HIV rare using existing resources — like modern HIV treatment for people living with HIV and pre-exposure prophylaxis (PrEP) which can include a single pill taken once a day by HIV-negative people that prevents HIV — making the plan immediately achievable.
“We estimate that about 1,700 Philadelphians living with HIV are unaware they live with the disease. Under the EHE plan, we’d diagnose around 1,650 of them,” explained Dr. Kathleen A. Brady, chief medical officer and head of AACO’s epidemiological team. “Our goal of a 75 percent reduction sounds impressive, but it’s realistic if we work together. It’s the difference between 439 people being diagnosed with HIV, as they were last year, and only about 110 people being diagnosed by 2025.”
“While we cannot end HIV entirely with the current tools,” Williams observed, “we can indeed end the HIV epidemic as we know it. We can also build systems to ensure that your chances of acquiring HIV don’t increase or decrease based upon the color of your skin. “
A blog summarizing the plan as well as the full plan itself are both available online at phila.gov.