Getting to Zero in Allegheny County
Allegheny County Pennsylvania has the second highest HIV prevalence in the state of Pennsylvania. In the county, racial and ethnic minorities are disproportionately impacted by HIV.
In response to HIV epidemic in the Allegheny County, AIDS Free Pittsburgh was created with the goals of reducing new HIV infections by 75% and declaring Allegheny County AIDS free (no new AIDS cases) by 2020.
AIDS Free Pittsburgh uses a collective impact framework in which partners pledge to collect and share data uniformly across health systems, to co-organize events for provider and community education, and to enhance access to quality healthcare by developing resources and referral networks.
Since its inception, there has been nearly a 43% decrease in new HIV cases, a 23% decrease in new AIDS cases, and other promising trends related to HIV testing, preexposure prophylaxis, linkage to care, and viral load suppression for people living with HIV in Allegheny County.
Through the initial implementation of a community collaborative, there have been several lessons learned:
- To measure progress for an initiative like AFP, there needs to be access to accurate and timely data. While HIV surveillance data at state and county levels was available, AFP had to come up with innovative solutions to collect data on other program metrics. An AFP subcommittee negotiated in-kind data use agreements rather than paying for data with its limited grant funding, resulting in successful multi-year data agreements with health plan and laboratory partners. Through advocacy of AFP and its member organizations, the Commonwealth of Pennsylvania recently changed the reporting guidelines for mandatory reporting of CD4 t-lymphocyte, viral load, and genotyping testing for HIV.
- To create more meaningful, long-term opportunities for community engagement, AFP distributed a community-wide survey and collaborated with community partners to host three virtual community engagement sessions to support strategic planning for the second phase of the initiative. AFP members also starting to pursue a variety of funding opportunities to recruit individuals from key communities with valuable knowledge, connections, and skills to serve on AFP subcommittees and compensate them for collaborating with AFP to translate their lived experiences into equitable actions to increase HIV awareness and access to HIV prevention and treatment services in their communities.
Information from: Whitfield DL, Chung A, Mangum L, et al. Getting to Zero in Allegheny County: Implementation of a Collective Impact Model to Achieve Ending the HIV Epidemic Objectives. Sex Transm Dis. 2023;50(6):381-385. doi:10.1097/OLQ.0000000000001791