Today is National HIV Testing Day, a day to encourage people to get tested for HIV, know their status, and get linked to care and treatment. In recognition of testing day and the administration’s Ending the HIV Epidemic: A Plan for America, HRSA encourages health centers to examine their HIV outreach, testing, prevention, and linkage to care efforts. According to the CDC, about 1.1 million people in the United States have HIV, and one in seven don’t know they have it.
Many health centers provide HIV testing and prevention services, including Pre-exposure Prophylaxis (or PrEP) for people at substantial risk of acquiring HIV. In 2017, the Health Center Program administered over 2 million HIV tests. Of the patients with a new HIV diagnosis, almost 85% were linked to HIV care within 90 days. This data is encouraging and with targeted efforts, health centers can reach the one in seven people who don’t know that they have HIV.
For additional information, including resources and promising practices to support your efforts in HIV outreach, testing, and prevention, please visit:
|
A team from HRSA visited Health Center Program grantee, Whitman-Walker Health (WWH) in Washington, D.C., to learn more about what health centers can do to prevent HIV and end the epidemic.
Keep scrolling to read about WWH’s promising work in integrating HIV care services into primary care.
Find video interviews with WWH staff and a PrEP patient at bottom of page.
For more information, contact: Megan Coleman, Family Nurse Practitioner, Director of Community Based Research, WWH.
|
HIV Prevention for D.C.’s Most Vulnerable Populations
In Washington, D.C., it’s estimated that one in every 20 adults is HIV positive. DC Health reports that 1.9% of the population is known to be living with HIV, and 5% of D.C. residents aged 50-59 are living with HIV. Furthermore, one in seven gay or bisexual men in DC has HIV, and one in three Black gay or bisexual men has HIV. Youth now represent 41% of new HIV diagnoses.
Approach
Whitman-Walker Health (WWH), a HRSA- funded health center, opened its doors 41 years ago to offer affirming, community-based health and wellness services to all with a special expertise in LGBTQ and HIV care. “Everyone should know about HIV, should know what their risk is for HIV, and should understand how they could come across HIV—and then also how HIV is treated,” said Megan, a WWH family nurse practitioner.
|
|
 |
 |
|
“And so I think the first step is just a universal HIV test. It’s not being prying; it’s not being questioning. It’s more just understanding where the person in front of you is and how to help them.” All staff are trained on HIV care, how to discuss sexual history with patients, and using culturally competent terminology like “vulnerable” instead of “at-risk.” |
Outreach
WWH utilizes an HIV testing and outreach mobile van to regularly visit sites in D.C., such as clubs, bars, stores, and youth hang outs. They also attend events such as DC Pride and HIV/AIDS walks. Palm cards about Pre-exposure Prophylaxis (PrEP) and non-occupational post-exposure prophylaxis (nPEP) help educate about HIV prevention.
“We also have partnerships with amazing CBOs or organizations in the field that day-to-day work with patients identifying their social barriers and their needs to achieve excellent health care,” continued Megan. “We’ve worked a long time on building those relationships, and they refer patients to us and are able to meet their social needs while we are able to help meet their health needs. It’s really a collaboration that makes it successful.”
|
Testing
WWH encourages quarterly screening for HIV and other sexually transmitted infections (STIs). The main health center clinics offer free walk-in testing daily. Self-test kits are given for patients concerned with privacy, and an evening clinic is anonymous. They also offer a free (no insurance is billed for privacy reasons) walk-in HIV and STI testing clinic twice a week. Primary care patients are routinely given a risk-based assessment to determine if they need testing.
“We have an amazing red carpet program for HIV linkage,” said Megan. “So anybody who does test HIV positive will have an appointment, a medical provider, and a benefits visit that day or the next day. They are able to get their medication same day as well at Whitman-Walker.”
|
|
PrEP
PrEP conversations begin during STI screening. PrEP navigators provide assistance with insurance, benefits, appointments, and medication adherence. “As a PrEP navigator, I usually end up having more time with the patients than providers do,” said WWH PrEP navigator Nicholas. “Sometimes I develop a relationship of trust, and sometimes they’re just more comfortable reaching out to me and discussing things that they feel they might also not have the time to discuss in a medical appointment.”
Candidates receive same-day labs and a prescription. Both sites have a 340B pharmacy, and medication assistance is available to those who do not have coverage. The PrEP clinic is used for follow-up visits, offering concierge-level service that includes quarterly visits, labs, and medication.
|
|
 |
During HRSA's visit to WWH, our team interviewed a PrEP patient, a clinician who prescribes PrEP, and a PrEP navigator. Hear more about WWH's HIV outreach, testing, and prevention program from those who know it personally.
 |
|
WWH PrEP patient David answers:
|
 |
|
WWH family nurse practitioner Megan answers:
|
 |
|
WWH PrEP navigator Nicholas answers:
|
|
Connect with HRSA
