DATA TO CARE: A CRITICAL TOOL FOR ENDING AIDS IN NEW YORK STATE

October 31, 2016 • By Rachel Hart-Malloy, PhD, MPH, Senior Program Coordinator, Division of HIV/STD Epidemiology Evaluation and Partner Services, AIDS Institute, New York State Department of Healthand James Tesoriero, PhD, Director, Division of HIV/STD Epidemiology Evaluation and Partner Services, AIDS Institute, New York State Department of Health

In 2014, the Governor of New York State announced a three-point plan to end the AIDS epidemic in New York State by the end of 2020. The plan states intention to:

Identify persons living with HIV who are undiagnosed and link them to care,
Link and retain persons with diagnosed HIV in health care, and
Facilitate access to pre-exposure prophylaxis (PrEP) for persons at risk of HIV.

To reach the State’s goal of Ending the AIDS Epidemic, innovative strategies must be employed to go beyond the successes already reached in New York and nationwide.

Data to Care is Transforming Partner Services in New York State

Part of the CDC’s High Impact HIV Prevention Initiative, “Data to Care” represents a new public health strategy that aims to use health department HIV surveillance data to identify HIV-diagnosed individuals who are not in care, link them to care, and support them in progressing along the HIV Care Continuum.

The New York State Department of Health AIDS Institute began Partner Service-based Data to Care programming in 2013, the year marking the launch of our successful Data to Care Expanded Partner Services pilot. This pilot focused efforts in four counties in New York State and demonstrated the feasibility of using HIV surveillance data to identify, locate, and re-link persons living with HIV back into medical care.

In 2014, our Data to Care programming expanded with funding from the Secretary’s Minority AIDS Initiative Fund under Partnerships For Care (P4C) [PDF 308 KB], an initiative to build sustainable partnerships between CDC-funded state health departments and HRSA-funded health centers to support expanded HIV service delivery in communities highly affected by HIV, especially among racial/ethnic minorities.

As a result of P4C, New York State has successfully implemented expanded Data to Care programming in areas served by our partnering health centers (corresponding to 12 counties: Monroe, Wayne, Ontario, Niagara, Erie, Columbia, Orange, Dutchess, Ulster, Kings, New York, and Queens Counties). This work is considered Partner Service-based Data to Care programming since health department-based Partner Services staff conduct all outreach activities, differing from other Data to Care programming whereby provider-based staff and/or community based organizations [PDF 774 KB] are conducting outreach.

Partner Services Data to Care: Going Beyond Disease Notification

Through a patient-centered approach to meet individuals where they are, our specially trained[PDF 2.54 MB] Partner Services field staff have continued to show great success in effectively re-linking individuals back into care. From arranging sustainable transportation options for an individual to make it to their appointment, to securing stable housing, our field staff work with the individual to overcome whatever barriers

[PDF 1.4 KB] might have been a factor in their falling out of care. Field staff must foster partnerships with providers and community based organizations to ensure patients get the best care for their individual needs.

This type of programming goes beyond the more traditional role of Partner Services staff whose focus is typically on disease notification, linkage to care and treatment, and partner elicitation (gathering partner names and contact information from individuals who test positive). While partner elicitation is still a factor, the intention of this work is to ensure sustainable re-linkage to care, which will impact viral load suppression and potentially decrease further transmission.

Successes along the HIV Care Continuum: Impact of Partner Services Data to Care

Although results are preliminary, Partner Services-delivered Data to Care in New York State shows promise in improving outcomes along the HIV care continuum. Since 2015, in the 12 counties served by our partnering health centers, roughly 75% of individuals determined to be out of care have been re-linked to HIV care. Looking statewide, preliminary evidence suggests that not only are individuals re-engaging in consistent care with a provider, but they also are reaching viral load suppression following re-engagement. With continued implementation, Partner Services-delivered Data to Care in New York State will aid in reaching the State’s 2020 goal of Ending the AIDS Epidemic.

Megan Johnson, MPH, CHES, Prevention Services Coordinator in the Division of HIV/STD Prevention at the New York State Department of Health’s AIDS Institute, contributed to this post.