HJNO Sep/Oct 2019

Q&A 20 SEP / OCT 2019 I  Healthcare Journal of new orleans   Why are the numbers of HIV cases declining in Louisiana? In late June, 2019, the Louisiana Depart- ment of HealthOffice of Public Health, STD/ HIV/Hepatitis Program reported that 989 persons in Louisiana were newly diagnosed with HIV in 2018. The number of persons newly diagnosed with HIV in Louisiana has declined over 12 percent in the past three years from 1,124 newly diagnosed persons in 2016 to 989 newly diagnosed persons in 2018. Fewer than 1,000 persons newly infected with HIV has not been reported in Louisiana since 2005–2006, and it is assumed that low numbers in those years were significantly impacted by the effects of Hurricanes Katrina and Rita on health services and the population of Louisiana. Prior to 2005 and 2006, Louisiana had not diagnosed fewer than 1,000 persons with HIV since 1988. This decline is attributed to a number of factors, including efforts to implement comprehensive interventions and services throughout the state, including: Increased testing and earlier diagnosis (decreased late testing); LDH nearly dou- bled the number of HIV tests conducted statewide in 2008/2009 (increased from approximately 55,000 tests to approxi- mately 100,000 tests annually), and has maintained the increased testing each year since then. Increased PrEP availability and utiliza- tion (e.g. launching robust PrEPeducational/ marketing campaigns, funding PrEPnaviga- tors at community health clinics, provider detailing/education=many more providers prescribing PrEP now than when first FDA approved in 2012, implementing a statewide TelePrEP program) Improved linkage to care (reduction in the time from diagnosis to starting ARVs, most recently expanding rapid ARV start programs and re-engaging clients back to care with innovative data-to-care pro- grams that also address barriers and chal- lenges patients experience with maintain- ing regular care) Increased rates of viral suppression “The number of persons newly diagnosed with HIV in Louisiana has declined over 12 percent in the past three years from 1,124 newly diagnosed persons in 2016 to 989 newly diagnosed persons in 2018.” D eAnnGruber,PhD,LCSW,is thedirector of theBureauof InfectiousDiseases for the Louisiana Department of Health, Office of Public Health. The STD/ HIV Program, immunizations, TB control, infectious disease epidemiology, and environmental epidemiology and toxicology programs are under her direction in this bureau. Dr. Gruber’s experience includes more than 30 years in the HIV/ AIDS field, where she started at the pediatric AIDS program of Children’s Hospital, and remained there for ten years, serving the last three years as the program director. In 2004, she joined the faculty of LSUHSC’s School of Public Health and served as the evaluation manager for the LDH OPH HIV/AIDS program for six years before moving into the director position of the STD/HIV program (SHP) from 2010–2016. SHP is the state’s integrated program that includes STD/HIV/ hepatitis surveillance, prevention, care and services/treatment, capacity building and community engagement, regional/field operations, data management/ analysis, and program evaluation. Dr. Gruber earned a PhD from Tulane University (2003) and a master’s in social work from Southern University at New Orleans (1991). Dr. Gruber is an adjunct associate professor with LSU Health Sciences Center’s School of Public Health, where she continues to teach program monitoring and evaluation in the Behavioral and Community Health Sciences program.