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June 2006

Challenges

• When the Advancing HIV Prevention (AHP) Initiative was first introduced—under a tight timeline—it was important to clearly communicate its goals and strategies to a variety of constituents and partners.
• Guidances and other materials were needed to effectively convey the requirements and program impacts of this new initiative to organizations applying for AHP-related funds.
• AHP’s emphasis on early diagnosis of HIV infection—as well as improved access to medical care, treatment, and ongoing prevention services for HIV-positive individuals—needed to be communicated to a variety of different target audiences.
• As programs and activities of the four AHP strategies begin to produce results, effective communications are needed to convey successes and challenges associated with the initiative.

Accomplishments

To address the challenges outlined above, the Centers for Disease Control and Prevention’s (CDC’s) Division of HIV/AIDS Prevention (DHAP) and its partner organizations:

• Conducted consultations to gather feedback and recommendations from communities of color, experts on stigma, professional medical associations, provider groups, and people living with HIV.
• Developed the AHP Interim Technical Guidance.
• Developed Questions and Answers on the Science Behind the New Initiative.
• Developed Procedural Guidance for Selected Strategies and Interventions for Community-Based Organizations
• Created an AHP Internet site to help communicate the details of the initiative.
• Completed formative research and materials testing to prepare for the launch of social marketing campaigns on (1) HIV testing with a focus on African American women, (2) prevention in care for people living with HIV, and (3) perinatal HIV testing.
• Planned and moderated a symposium at the 2005 meeting of the Infectious Diseases Society of America (IDSA) as a pre-launch activity for the Prevention in Care campaign. This symposium covered the rationale for implementation of the Prevention in Care recommendations; effective screening for HIV behavioral risk factors; cross-cultural and gender barriers to effective HIV prevention messaging; and principles for engaging patients in prevention in care. The symposium was audiotaped to help develop materials that can be distributed to health care providers as part of the planned campaign.
• Held 4 Web conferences with health departments to discuss the initiative.
• Convened meetings with the Congressional Minority Caucuses, Federal AIDS Policy Partners, Presidential Advisory Council on HIV and AIDS, and CDC/Health Resources and Services Administration’s Advisory Committee on HIV and STD Prevention and Treatment to provide briefings and gather feedback on AHP strategies.
• Developed messages and materials to support key AHP strategies with target audiences, including health care providers, pregnant women, and people at high risk for HIV.
• Completed 6 AHP-related satellite broadcasts:
  • Update on Rapid Testing for HIV (April 2003)
  • Incorporating HIV Prevention into the Medical Care of Persons Living with HIV (Nov 2003)
  • Prevention with Positives: HIV Risk Reduction Strategies for Health Care Providers (April 2004)
  • Rapid Testing: Advances for HIV Prevention (November 2004)
  • Partner Counseling and Referral Services for HIV Prevention (April 2005)
  • Social Networks: A Recruitment Strategy for HIV Counseling, Testing, and Referral Services (April 2006)

A total of 6,500–10,000 viewers at about 500 viewing sites participated in each broadcast. The programs were delivered via Internet by live Web cast and are available for 3 years after air date via archived Web cast. These programs are also available on videotape and CD-ROM.

• Worked with a grantee—Hollywood, Health, and Society—to provide subject matter materials. Also provided expert consultations on AHP-related topics to writers of adult medical dramas such as ER, House, Judging Amy, Bones, and Law and Order: SVU.
• Created the AHP Speakers Bureau, which has fulfilled AHP presentation requests from local, state, and national organizations. CDC staff members have given numerous talks relating to each of the four strategies of AHP.
• Created publications, including:
  • Procedural Guidance for Community-Based Organizations: at a Glance.
  • CDC. Advancing HIV Prevention: new strategies for a changing epidemic. MMWR 2003;52:329–332.
  • CDC. Partner counseling and referral services to identify persons with undiagnosed HIV—North Carolina, 2001. MMWR 2003; 52(48):1181–1184.
  • CDC. Rapid point-of-care testing for HIV-1 during labor and delivery—Chicago, Illinois, 2002. MMWR 2003; 52(36):866–868.
  • CDC. Incorporating HIV prevention into the medical care of persons living with HIV: recommendations of CDC, the Health Resources and Services Administration, the National Institutes of Health, and the HIV Medicine Association of the Infectious Disease Society of America. MMWR 2003; 52(RR12):1–24.
  • CDC. Notice to readers: Protocols for confirmation of reactive rapid HIV tests. MMWR 2004; 53(10):221–222.
  • CDC. Using the Internet for partner notification of sexually transmitted diseases—Los Angeles County, California, 2003, MMWR 2004; 53(06):125–131.
  • CDC. Assessment of increase in perinatal exposure to HIV among Hispanics—20 Counties, Georgia, 1994-2002. MMWR 2004; 53(40):944–946.
  • CDC. Use of social networks to identify persons with undiagnosed HIV infection—seven US cities, October 2003–September 2004. MMWR 2005; 54(24):601–605.
  • CDC. Rapid HIV antibody testing during labor and delivery for women of unknown HIV status: a practical guide and model protocol; CDC;2004:1–44.
  • Cohen MH, Olszewski Y, Branson B, et al. Using point-of-care testing to make rapid HIV-1 tests in labor really rapid. AIDS 2003; 17(14):2121–2124.
• Created subject-specific Web sites to provide further information:
  • AHP Internet site provides up-to-date guidelines, program news and announcements, questions and answers, slide presentations, and journal articles.
  • Perinatal HIV Prevention Program site provides background, guidelines/recommendations, and program details.
  • Rapid HIV Testing site includes information on the rapid HIV tests approved by the FDA, how the tests can be implemented in different settings, and research on the effectiveness and possible uses of the tests.