The Illinois Department of Public Health has a well-integrated HIV surveillance and prevention program. The Department’s Data Security and Confidentiality Guidelines permit the exchange of HIV testing, HIV surveillance, Direct Services and ADAP data between these programs: to confirm if a reactive HIV test result is a new or prior diagnosis; to forward labs from testing to surveillance; to assess whether HIV medical care was accessed prior to or subsequent to a test; to refer testing clients to Ryan White Case Management and to confirm their enrollment to the test provider; to confirm their medical care retention and viral suppression; and to refer surveillance-reported patients who are newly diagnosed, not in care, recently STI-diagnosed, virally unsuppressed, or molecular cluster-connected to prevention providers for individually tailored services. HIV surveillance data will drive prioritized population definitions and rankings; regional prevention funding allocations; service objectives reflecting regional incidence by risk, race and ethnicity; zip codes selected for clinic routine HIV screening development or for prioritized population outreach; and Continuum of Care outcome report cards to both funded and unfunded healthcare facilities.
Through the five-year PS24-0047 project, Illinois will use quality, timely, and complete surveillance data to guide the implementation of all required strategies to reduce population risk; to prevent new HIV and syndemic infections; to diagnose the undiagnosed; to improve PLWH health outcomes to sustained viral suppression; and to reduce service and health disparities. National prevention goals, CDC’s High-Impact HIV Prevention (HIP) approach and the HIV Care Continuum will guide these efforts.
Illinois’ approach to addressing PS24-0047 priorities may be briefly summarized as follows.
• Individual knowledge of HIV status will be increased through risk-focused non-clinical outreach and self-administered HIV testing, expanded clinical routine HIV screening, perinatal first and third trimester HIV screening and Partner Services. Risk-based HIV testing equitably serves prioritized risk/race/ethnicity groups in proportion to regional HIV incidence. This strategy finds undiagnosed PLWH at high rates in the most HIV-impacted networks.
• New HIV infections among HIV-negative persons will be prevented by reducing transmissions from HIV-positive persons and by reducing exposures and infections among HIV-negative persons. Reducing exposures to HIV and syndemic infections will be achieved through cost-effective behavioral interventions and community-level risk reduction activities which reduce sexual and injection exposures. Preventing HIV infections resulting from HIV exposures will be achieved through pre- and post-exposure prophylaxis. Risk-focused prevention will serve HIV-negative prioritized risk/race/ethnicity groups in proportion to their regional incidence to avoid service disparities and to reduce incidence disparities within the networks statistically most likely to become HIV-infected.
• HIV Transmission from PLWH will be reduced by identification through HIV testing or surveillance with needs assessment and navigation as individually needed to rapid HIV treatment engagement, effective medication adherence interventions and cost-effective effective sexual risk or injection harm reduction interventions. Interventional surveillance will be strengthened to support life-long care engagement, sustained viral suppression, STI or viral hepatitis treatment, partner counseling and testing, prompt time-space increase investigations, and effective cluster and outbreak investigations and responses.
Illinois’ activities will conform to the Surveillance’s Security and Confidentiality Policy as required by the Data Security and Confidentiality Guidelines for HIV, Viral Hepatitis, Sexually Transmitted Disease, and Tuberculosis Programs.
