Preventing HIV in DeKalb County, Georgia
One Conversation at a Time
Ending the HIV Epidemic: A Plan for America (EHE) is a bold new federal initiative that aims to reduce new HIV infections in the United States by 90 percent by 2030. The initiative is beginning with a targeted infusion of new resources, technology, and expertise to fight HIV in the communities that are now hardest hit by the HIV epidemic.
In July 2019, the U.S. Department of Health and Human Services awarded $6 million from the Minority HIV/AIDS Fund to support innovative efforts to expand HIV diagnosis, treatment, prevention, and response in four U.S. jurisdictions with high concentrations of new HIV diagnoses, including DeKalb County, Georgia. Lessons learned from these jumpstart areas are providing important insights for the 57 EHE jurisdictions that will begin this year to scale up efforts to end local HIV transmission.
To jumpstart national efforts to end the HIV epidemic, Georgia’s DeKalb County is connecting more people to vital HIV prevention options and empowering them to lead longer, healthier lives. They are doing this by:
Using nursing protocols to overcome challenges to accessing pre-exposure prophylaxis (PrEP), a daily pill that’s up to 99% effective in preventing sexual HIV transmission
Creating a safe, trusted, and respectful environment to talk about PrEP, sexual health, and HIV and STI prevention
Delivering critical education, support, and follow-up care after a PrEP prescription, so that people taking PrEP understand how to use it, have support to adhere to it and navigate financial barriers, and receive critical follow-up care
Spreading the word about PrEP throughout the community, through marketing and social media campaigns, partnerships with community-based organizations, and efforts to expand PrEP access across DeKalb County and beyond
T.O. Vinson is one of five public health centers operated by the DeKalb County Board of Health in the metro Atlanta, Georgia, area. The majority (70%) of T.O. Vinson’s clients are African American and the clinic operates on a sliding scale model for medical services, allowing the clinic to serve people of all ages and incomes in DeKalb County, regardless of their ability to pay for care or their health insurance status. In the past few years, the nursing staff at T.O. Vinson were troubled to hear clients say they were reluctant to try game-changing HIV prevention options like pre-exposure prophylaxis, or PrEP. The nurses knew many of their clients could benefit from PrEP if they understood more about what it is and its effectiveness in preventing HIV, how to get it — and, in many cases, if they had someone they could speak with openly about their sexual practices and prevention options. With support from the Ending the HIV Epidemic: A Plan for America (EHE) initiative, T.O. Vinson Health Center has launched a new PrEP program, enabling registered nurses (RNs) to connect more people in DeKalb County to vital HIV prevention options and empowering them to lead longer, healthier lives.
“EHE funding was the engine we needed to set the program in motion. These services are filling a critical gap in HIV prevention for people in our county.”
– Dr. Sentayehu Bedane
Countywide Services Manager, DeKalb County Board of Health
The Ending the HIV Epidemic initiative aims to provide more resources to communities disproportionately affected by HIV and reach more minority populations at risk. Expanding access to PrEP is a central part of the initiative. PrEP is a daily pill that’s up to 99% effective in preventing sexual HIV transmission. Today, however, PrEP isn’t being prescribed to enough people who could benefit from it, especially young people and racial and ethnic minorities. Among the clients seen at T.O. Vinson Health Center, many don’t have a consistent primary health care provider; instead they access sporadic care at public health centers where the few physicians who could prescribe PrEP are stretched thin. Some don’t believe they are at risk for HIV or are afraid to try PrEP due to misinformation about side effects. Many, especially those without health insurance, assume they can’t afford PrEP medications. And some simply have never heard of this prevention method.
PrEP could have a big impact in DeKalb County, an area with demonstrated success serving racial and ethnic minority populations and where the HIV diagnosis rate is four times higher than in the U.S. overall. But, until recently, the county didn’t have the resources or provider capacity to provide PrEP assessments, education, and support at local health centers. Thanks to new funding through the federal Ending the HIV Epidemic initiative, and an innovative new model for offering PrEP, RNs at T.O. Vinson Health Center are now better able to deliver the intervention to people who could benefit from it.
“Our team has long wanted to offer PrEP to the community,” said Dr. Sentayehu Bedane with the DeKalb County Board of Health. “EHE funding was the engine we needed to set the program in motion. These services are filling a critical gap in HIV prevention for people in our county.”
Disclaimer: These stories do not represent endorsements by CDC of any organization or company mentioned.