In February 2019, the U.S. federal government announced the Ending the HIV Epidemic: A Plan for America (EHE) – with a goal to decrease new HIV infections in the U.S. by 75% by 2025 and 90% by 2030. The initiative aims to capitalize on scientific advances in HIV diagnosis, treatment, and prevention to accelerate national progress in controlling the now 40-year-old HIV epidemic. The plan directs resources to geographic areas in the U.S. with the largest number of new HIV diagnoses each year. King County is one of the 57 regions funded.
EHE focuses on four “pillars” or strategies: 1) Diagnose, 2) Treat, 3) Prevent, and 4) Respond. King County’s EHE Plan aims to dramatically reduce new HIV infections by expanding access to HIV prevention and care resources to populations that have the hardest time using them.
King County’s Ending the HIV Epidemic Plan
King County is entering the fourth year of implementing the EHE Plan. The EHE team and community partners have made rapid and remarkable progress, implementing over 25 strategies across these four pillars. For example, opening three new low-barrier clinics and expanding access at two existing low barrier sites; working with health systems partners across the county to increase HIV testing in emergency departments; and supporting community-based organizations in their work with communities currently disproportionately affected by HIV.
Pillar 1, “Diagnose,” EHE aims to see an increase in HIV diagnoses through increased HIV testing. In 2021, there were 163 new HIV diagnoses in King County, a slight increase from 2020.
Pillar 2, “Treat,” EHE aims for at least 95% of people newly diagnosed with HIV to be quickly linked to care and at least 95% of people living with HIV to be virally suppressed. Locally, 86% of people with new HIV diagnoses were linked to care within one month and 87% of people living with HIV were estimated to be virally suppressed.
Pillar 3, “Prevent,” EHE aims to increase the use of Pre-Exposure Prophylaxis (PrEP) among men who have sex with men (MSM) at higher risk, and transgender persons who have sex with men. In 2021, approximately 64% of this group are currently on PrEP. This surpasses our previous goal of 50% and is quickly approaching our 2025 goal of 70%.
Pillar 4, “Respond,” EHE promotes a rapid prevention and treatment response to HIV outbreaks, which are often among persons who have common sex or needle-sharing partners. Response goals focus on increasing health department investigations (goal is ≥90%), and interviews among cluster members (goal is ≥70%). In 2021 we saw progress towards these goals. Approximately 78% of HIV-positive cluster members were investigated and 68% were contacted for an interview.
New Award for Partners
To elevate the work and success of EHE partners in King County, the EHE Program developed an Ending the HIV Epidemic Heroes Award. Our inaugural award goes to the EHE Emergency Department Collaborative, which brings together emergency departments county-wide to increase HIV testing and link people to HIV care. Emergency departments are often the only source of healthcare for some at highest risk for HIV, making ERs critical points of HIV testing and linkage to PrEP and HIV care.
Swedish Ballard Emergency Department is an EHE hero, demonstrating a tenfold increase in HIV testing in their emergency room (from 0.4% to 8.4%), greater than all other participating emergency departments. They developed innovative training approaches for staff, educational materials for patients, and are supporting other emergency department leaders to increase HIV testing in their settings. As a result, Swedish Ballard Emergency Department not only impacted the lives of King County residents treated at their facility, but also those of residents seen for emergency services across our region.
Congratulations to Swedish Ballard Emergency Department on this accomplishment!
To learn more about Ending the HIV Epidemic in King County, visit kingcounty.gov/EHE.