Commonwealth of Massachusetts High-Impact HIV Prevention and Surveillance Program - The Commonwealth of Massachusetts is well-positioned to implement the strategies described in PS24-0047 because of its coordinated team of staff and community partners responsible for carrying out highly effective prevention, surveillance, and EHE expansion activities. DPH procures and administers State and federal HIV prevention, treatment, and drug assistance programs; collects, analyzes, and effectively communicates all required data to federal partners, funded providers, and the public; and collects, analyzes, interprets, and disseminates case data. Despite a reduction in the number of new HIV diagnoses in recent years, health inequities persist. DPH is committed to partnering with communities, examining the root causes of inequities, co-creating solutions, and creating structures and policies that address health equity. The purpose of the interventions proposed in the Commonwealth’s application is to increase individuals’ knowledge of their HIV status, link HIV+ individuals to treatment and care, prevent new HIV infections, respond to public health emergencies, act on surveillance trends, tailor prevention and care strategies to the needs of the community, and improve health equity. Approach and Outcomes: Strategy 1 – Diagnose. DPH employs a network of funded integrated HIV, STI, hepatitis C, and TB testing providers. The State Public Health Laboratory co-tests all specimens for HIV, HCV, and syphilis. DPH will strive to ensure that 95% of people receive a diagnosis as early as possible. Strategy 2 – Treat. DPH and its funded agencies will provide linkage to care, partner services, rapid antiretroviral therapy, and health navigation. DPH has set a goal to increase linkage to care within 30 days from 92% to 95% and to increase viral suppression from 81% to 95%. Strategy 3 – Prevent. DPH will support comprehensive PrEP linkage, distribution of condoms, 65 (and growing) State-funded syringe service programs, and support services. DPH plans to expand its social marketing campaign promoting testing and PrEP. DPH will strive to meet the CDC goal of increasing PrEP coverage to 50% of those with indications for PrEP. Strategy 4 – Respond. DPH will track incidence trends by region and demographics to identify clusters and transmission chains. Field Epidemiologists will respond to clusters by contacting every Massachusetts resident newly diagnosed with HIV and/or infectious syphilis to conduct follow up and provide partner services. Strategy 5 – Surveillance. DPH will conduct passive and active surveillance activities, data collection, and data analysis to identify people diagnosed with HIV, STDs, TB, and viral hepatitis. DPH will leverage electronic health records, geocoding, and MAVEN, the DPH-supported integrated data system. Strategy 6 – Community Engagement and Planning. DPH has an advisory group structure in place to review data, monitor progress on PS24-0047 goals, assess service needs, provide feedback and guidance, and address gaps and barriers to prevention and care. These groups also plan and update the HIV Integrated Prevention and Care Plan. Developing the public health workforce through support for recruitment, hiring, retention, and capacity-building is a pillar of DPH’s Strategy Map. DPH employs multiple approaches to support a strong and prepared workforce with the knowledge, skills, and abilities necessary to effectively recruit and serve diverse populations. Massachusetts welcomes the integrated nature of this funding opportunity. Since the earliest years of the epidemic, DPH has coordinated a highly effective system of care for people newly diagnosed, living with, or at risk for HIV. This new opportunity will challenge DPH to improve prevention and surveillance activities, address persistent health inequities, and improve the quality of life for people living with HIV.
