HJNO Sep/Oct 2019

Q&A 22 SEP / OCT 2019 I  Healthcare Journal of new orleans   and indicating we have much more to do here. The most recent HIV national rankings can be found in the HIV Surveillance Report, 2017; Vol 29 released by the CDC on Novem- ber 15, 2018. Overall, are you optimistic the rates of HIV can continue to decline? We believe we are at a turning point with this epidemic, but wemust continue aggres- sive elimination programming and identify- ing outbreaks in order to adequately allo- cate resources to intervene, educate, and link persons to testing and treatment providers. RapidARV Start programs are expanding to clinics across the state, and we already see great results due to this enhanced model in New Orleans and Baton Rouge. PrEP is another critical tool to prevent new infec- tions, but for many who need it the most, access to PrEP is still cost prohibitive. We are hopeful that the newly assignedAgrade by the USPSTF will improve PrEP financ- ing under the ACA and increase access and acceptance for many communities. What else do healthcare providers and patients need to know about HIV and coordination of care? Unfortunately, HIV stigma continues to be a real barrier to effective prevention and treatment of HIV. Efforts to normalize HIV screening as a routine part of regular medi- cal care for all adults is one of themost effec- tivemethods providers can employ to elimi- nate stigma. In addition, ensuring healthcare providers and patients know about new highly effective prevention and treatment tools is another key strategy to reduce HIV stigma. The message is fairly simple: PrEP will keep persons negative and U=U empow- ers persons living with HIV to live a healthy life and to eliminate the possibility of trans- mitting the virus to anyone else. There are resources to support HIV and other STI screening and access to health care and medications across all payer sources and income levels. Navigators and case managers are located throughout the state to assist patients in learning about and effectively navigating these systems of care to maximize their options and health outcomes. Eventually, can this disease be eradicated? Absolutely, but it will require steadfast commitment and continued local and fed- eral funding. Expert modeling suggests we need at least 90 percent of people living with HIV to be diagnosed, at least 90 percent of them to be linked and engaged in HIV treat- ment, and at least 90 percent to be virally suppressed to bring HIVunder epidemic lev- els, or to end the HIV epidemic. Nationally, we are aiming for elimination by 2030, and we are making steady progress toward that goal in Louisiana. n