The County’s Role in Providing an HIV Care Continuum

Counties—especially county health departments—play a key role in working side-by-side with federal, state and local partners to tackle the HIV epidemic and support a robust HIV care continuum. NACo partnered with Med-IQ to develop The County’s Role in Providing an HIV Care Continuum, a report that explores how counties can support HIV prevention, diagnosis, medical treatment and long-term care. The report features data from a recent NACo survey about county HIV services, as well as real-world perspectives and observations from county health officials.

This report highlights proven strategies to prevent and treat HIV infection that are key to ending the HIV epidemic. Key strategies include:

  • Most people living with HIV who start taking Anti-Retroviral Therapy (ART) as prescribed achieve an undetectable level of HIV by approximately 6 months after beginning treatment; once the virus is undetectable, the person cannot sexually transmit HIV even if they have unprotected sex. This concept is known as “Undetectable = Untransmittable,” or “U = U.”

  • Pre-exposure prophylaxis (PrEP) is a medication that people with an increased risk of HIV can take to prevent getting HIV from sexual activity or injection drug use. When taken as prescribed, PrEP reduces the risk of getting HIV from sex by about 99 percent and by at least 74 percent from injection drug use.

NACo Survey Key Takeaways

In August 2021, NACo conducted a survey of 54 health officials from 58 counties across the U.S. about the HIV services they provide. The majority of survey respondents were county health department officials or county health care providers who work in HIV testing or treatment services. Key findings of the 2021 NACo survey include:

  • Most counties surveyed provide HIV testing (87 percent) and 39 percent offer at-home testing
  • More than one-half (56 percent) of counties surveyed provide HIV treatment, including access to free or affordable ART (76 percent of those that provide HIV treatment)
  • Nearly all counties surveyed provide prevention services, such as:
    • Community outreach and education about HIV (87 percent)
    • Condom provision programs (84 percent)
    • Multimedia prevention and education strategies (67 percent)
    • PrEP or referrals to healthcare providers who prescribe PrEP (56 percent)
    • Needle exchange programs (47 percent)
  • Counties also reported best practices to testing and treatment for HIV, including:
    • Offering walk-in visits and providing low-cost or free HIV testing to anyone wanting a test and ensuring confidentiality and privacy
    • Using rapid-result HIV tests and at-home testing kits and establishing mobile testing services and drive-through testing sites
    • Offering HIV testing at needle/syringe exchange sites
    • Ensuring same-day linkage to HIV care and treatment after a positive HIV test result
    • Having dedicated staff to support and follow up with newly diagnosed patients
    • Increasing use of telehealth services
    • Facilitating patient access to food pantries and transportation services

More information and resources on this topic are available here.

Med-IQ empowers individuals at every level of the healthcare delivery system with the knowledge they need to continuously improve provider performance and patient outcomes. Med-IQ has delivered unique educational experiences and services across the country and around the world, has been extensively published, and is proud to be one of the most award-winning accredited medical education providers in the United States.

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