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Ohio's integrated HIV plan sees successes, state well positioned to help end HIV

Community Solutions Team
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August 12, 2019
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In Ohio, HIV prevention and care for people living with HIV was independent until federal funders – the Centers for Disease Control and Prevention (CDC) and the Health Resources and Services Administration (HRSA) – required us to think of the services as a continuum and create an ‘integrated’ plan for HIV for Ohio, considered a national best practice. The planning process for a state plan, which was led by a steering committee, kicked off in 2016, and was thorough; it yielded a 5-year plan (2017‒21) with eight thoughtful goals, supporting strategies and renewed partnerships with state agencies to accomplish them. The Ohio Department of Health rightly recognized the need to reorganize staff and resources to meet the goals of the plan and dedicated the following 12 months to hiring for critical positions and beginning to implement the plan where possible with existing staff and community partners.

 In Ohio, HIV prevention and care for people living with HIV was independent until federal funders required us to think of the services as a continuum and create an ‘integrated’ plan for HIV for Ohio, considered a national best practice.

As the plan was implemented, Ryan White program clients saw an open (expanded) drug formulary, as well as increased access to transportation to attend to their health care. The addition of Ryan White case managers also decreased caseloads, ‘innovation’ grant programs were established to support people living with HIV who are not engaged in their health care and we saw a redistribution of unspent funds to HIV prevention, which has been chronically underfunded in Ohio.

Data presented at the steering committee meeting last month showed these changes have been successful. We have increased viral suppression among Ohioans living with HIV compared to the time before the integrated plan went into effect. This is important as achieving viral suppression benefits not only the person living with HIV but also means fewer new HIV infections, a global movement known as U=U or undetectable = untransmittable.

 In the last 18 months, the state has initiated a PrEP assistance program, as well as a successful HIV testing algorithm for community-based HIV testing ‒ to ensure we reach individuals most in need of prevention resources while ensuring these resources keep HIV negative Ohioans negative.

In the last 18 months, the state has initiated a PrEP assistance program, considered the best in the country, as well as a successful HIV testing algorithm for community-based HIV testing ‒ to ensure we reach individuals most in need of prevention resources while ensuring these resources keep HIV negative Ohioans negative. A Determination of Need was filed and approved by the CDC, which allows the state to utilize federal funds for much needed syringe services programs to relieve the HIV burden among Ohioans who inject drugs, amidst the state’s ongoing opiate crisis. The state also released the first HIV care continuum for Ohio, showing what proportion of people living with HIV are linked to medical care, retained in care and have suppressed viral loads. And fully staffed, the Ohio Department of Health quickly updated the integrated plan to better align with the National HIV/AIDS Strategy and began revamping the state’s ‘hotline’ – OHIV.org – as a robust resource for both Ohioans living with HIV and at risk of exposure.

 This year’s State of the Union included a national call to end HIV by 2030.

This year’s State of the Union included a national call to end HIV by 2030. Ohio is well positioned to help achieve this goal, with leadership at the Ohio Department of Health and in impacted counties; the integrated plan; and the expansion of model programs and eligibility for Ohioans participate in them. State and local planners can now consider where we can best and quickly use funds where gaps exist, complementing and leveraging existing resources.

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