The U.S. Health Resources and Services Administration (HRSA) has funded the UCSF Center for AIDS Prevention Studies to provide leadership and support to seven states implementing interventions to enhance HIV testing and diagnosis, linkage to and retention in high quality HIV care among populations who do not yet know their status or who have been previously diagnosed, but are not currently engaged in care.
The grant from the HRSA Special Projects of National Significance Program will total $1.5 million per year for four years and will aggressively tackle two of the three primary goals of the National AIDS Strategy: the second, increasing access to care and optimizing health outcomes and the third, reducing HIV-related health disparities.
“Recent studies point to gaps in testing, linkages to care and treatment success,” said Janet J. Myers, PhD, MPH, associate professor of medicine at the UCSF Center for AIDS Prevention Studies (CAPS) and principal investigator of the project.
“Of the 1.1 million people living with HIV in the U.S., about 20 percent are unaware that they are infected. Further, while about 75 percent of those diagnosed with HIV are linked to care within a year, only approximately 50 to 60 percent of people living with HIV are successfully retained in care over time. Consequently, barely a third of all people living with HIV in the U.S. maintain undetectable levels of virus in their blood, the gold standard for treatment success.”
This initiative seeks to close these gaps by engaging people with HIV in high quality health care. A key goal of the program, Myers said, “is to bring about system wide structural changes to facilitate patients’ success in care in these seven states.”
UCSF CAPS will serve as the Evaluation and Technical Assistance Center for the seven demonstration states – Massachusetts, New York, Pennsylvania, Virginia, North Carolina, Wisconsin and Louisiana – in the program, known as the Systems Linkages and Access to Care for Populations at High Risk of HIV Infection Initiative.
“We will work with the states to pilot linkage and retention interventions,” said Wayne T. Steward, PhD, MPH, assistant professor of medicine at UCSF CAPS and co-principal investigator of the project. “After figuring out which programs work best, the demonstration projects will roll out their interventions on a statewide level. Our UCSF evaluation center will then help states assess how well the programming actually works in achieving desired linkage and retention goals.”
As a result, he said, “the initiative will promote the development of innovative strategies that successfully integrate different components of the public health system to better engage hard-to-reach populations in high quality HIV care.”
Core team members of the Evaluation and Technical Assistance Center include Steve Morin, the senior scientist on the project, Edwin Charlebois, Kim Koester, Andre Maiorana, Deepalika Chakravarty, and Bill Woods, all of UCSF CAPS. UCSF faculty experts assisting the ETAC team include, James G. Kahn from the Institute for Health Policy Studies at UCSF, Katerina Christopoulos from the UCSF Division of HIV/AIDS at San Francisco General Hospital, and Marguerita Lightfoot, also of UCSF CAPS. Collaborators with expertise in innovative surveillance methods (Moupali Das), quality programs (Kathleen Clanon, Lori DeLorenzo), and evaluation of innovative outreach programs (Jane Fox, Carol Tobias) will also provide technical assistance for states.
Established in 1986, CAPS conducts research to prevent new HIV infections, improve health outcomes among those infected, and reduce disparities. CAPS and the UCSF Division of HIV/AIDS at San Francisco General Hospital are affiliated with the AIDS Research Institute (ARI) at UCSF. UCSF ARI houses hundreds of scientists and dozens of programs throughout UCSF and affiliated labs and institutions, making ARI one of the largest AIDS research entities in the world.
UCSF is a leading university dedicated to defining health worldwide through advanced biomedical research, graduate level education in the life sciences and health professions and excellence in patient care.