The Hawai’i State Department of Health (DOH) is requesting federal financial assistance to maintain, strengthen, and implement a comprehensive HIV surveillance and prevention program to prevent new HIV infections and to support improving health outcomes for Hawai‘i persons living with HIV (PLWH) through achieving and sustaining viral suppression, and reducing health-related disparities. This will be done by using high quality, timely, and complete surveillance and program data to guide HIV prevention efforts. The HIV surveillance program is responsible for managing reported HIV cases statewide, monitoring disease trends, and providing data as a guide for allocating HIV/AIDS prevention and care resources. The prevention program is responsible for testing people who are at risk for HIV, offering partner services for those who test HIV positive, linking and retaining in care, and offering PrEP to HIV negative persons who are at risk for HIV.
Hawai‘i has a population of approximately 1.4 million people living in four island counties: The City and County of Honolulu (on Oahu), Maui County, Kauai County, and Hawai‘i County (the Big Island). Hawai‘i has reported 4,676 cumulative HIV infection cases, including 3,494 cumulative AIDS cases, and 2,519 individuals living with HIV infection by the end of 2015. In 2015, there were 124 new HIV diagnoses, 86.3% of whom linked to care within one month. Among living persons aged 13 years or older at year-end 2014 with HIV infections diagnosed by year-end 2014 and residing in Hawai‘i at year-end 2015, 51.2% were retained in care and 69.4% achieved viral suppression. In addition, there were 370 PLWH and unaware of their infection in 2014 (CDC estimate for Hawai‘i).
In the coming years, the HIV surveillance and prevention programs in the Hawai‘i DOH, Harm Reduction Services Branch (HRSB) will focus on reducing new infections in high risk populations through targeted testing, increasing access to care, improving health outcomes for people living with HIV (PLWH), and promoting health equity. Emphasis will be placed on increasing testing, linking PLWH to medical and other services, retaining and re-engaging PLWH in HIV medical care, referring persons at risk for PrEP, and increasing monitoring, evaluation, and quality assurance. To achieve these outcomes, surveillance will systematically collect, analyze, interpret, and disseminate HIV data to characterize trends in HIV infection, detect active HIV transmission, implement public health interventions, and evaluate public health response through various activities; surveillance and prevention programs will collaborate to provide direct services, contract and partner with community based organizations, and collaborate with health care providers throughout the state; and HRSB will implement HIV strategies that are appropriate, effective, and scalable.