The current national HIV Strategy in the United States calls for a 75% reduction in the number of new HIV cases by 2025 and a 90% reduction by 2030. However, in the most recent decade, the HIV infection rate in Michigan (MI) and across the U.S. has decreased at a much slower rate, despite the achievement of major innovations in HIV prevention and care strategies during that time, including the advent of pre-exposure prophylaxis (PrEP). In Michigan, the rate of new HIV infections only decreased by 13% from 2010-2019. CDC Grant PS22-2211, which will support enhanced surveillance and interviews of early and late HIV diagnoses, would provide the Michigan Department of Health and Human Services – Division of HIV/STI Programs (MDHHS DHSP) a unique opportunity to identify actionable missed opportunities to address barriers to the uptake of HIV prevention service and early HIV diagnosis. MDHHS is also uniquely suited to achieve the objectives of PS22-2211 due to its sizable annual number of stage 0 and stage 3 cases, complete HIV laboratory reporting, the large volume of reported HIV negative data, exemplary electronic laboratory reporting, strategic surveillance data quality assurance practices, long history as a Medical Monitoring Program (MMP) and National HIV Behavioral Surveillance (NHBS) site, and strong partnerships with external agencies who serve communities in MI most impacted by HIV incidence.
With the support of PS22-2211, MDHHS will hire an Enhanced Surveillance Recruiter who will attempt to contact and recruit all persons with a recent (i.e., within 12 months) HIV diagnosis at stage 0 or stage 3. Successfully recruited persons will be interviewed by a CDC contractor to collect data on barriers to uptake the HIV prevention tools and/or timely HIV diagnosis. The recruiter will be housed in the HIV/STI Surveillance and Epidemiology Section and will have ready access to surveillance tools, such as the enhanced HIV/AIDS Reporting System (eHARS) and the person search engine TransUnion TLO. The recruiter will collaborate with Medical Monitoring Project/National HIV Behavioral Surveillance staff, disease intervention specialists, local health departments, data to care, and other health providers. MDHHS will leverage MMP trainings and lessons learned through the active Community Advisory Board (CAB) and Provider Advisory Board (PAB) members to develop the recruitment protocol and ensure the appropriateness of recruitment strategies. The findings from this project will be shared internally with MDHHS’s HIV Prevention and Ending the HIV Epidemic units, as well as externally with numerous existing and new partners as needed (i.e., local health departments, CBO’s, medical providers, HIV planning councils, advisory boards, other grantees, and national audiences). MDHHS will hold brainstorming sessions with the above stakeholders to identify opportunities and strategies to address important barriers identified during the interviews. Expected outcomes for this project include increased knowledge among HIV prevention and care programs about individual and systems-level factors that contribute to testing and prevention barriers and the identification of evidence-based strategies to address these barriers. These strategies and activities will contribute to the development and implementation of effective efforts to improve uptake of HIV prevention and testing services and
ultimately reduce new HIV infections in Michigan and the United States.