Merck announces a new collaborative effort to improve HIV care in the United States.

To help address remaining barriers to HIV care, especially among underserved populations, The Merck Company Foundation has established a three-year initiative—HIV Care Collaborative for Underserved Populations in the United States—to connect more people living with HIV to the care they need to stay healthy. The Foundation is committing $3 million to support local health departments in Atlanta, Georgia; Houston, Texas; and Philadelphia, Pennsylvania. Nearly a third or more of Americans known to have HIV in the United States are not in care, and these cities are among the top 10 with the highest HIV burden in the U.S.^1,2

Research shows that when you are able to connect those who are HIV-positive with ongoing care, it not only reduces HIV risk behaviors but also reduces viral load from antiretroviral therapy (ART), which collectively contribute to overall decreases in HIV transmission. That’s why the U.S. National HIV/AIDS Strategy (NHAS) calls for the establishment of “a seamless system to immediately link people to continuous and coordinated quality care when they are diagnosed with HIV.”³

In alignment with this overall NHAS goal, the Collaborative is tackling this challenge head on and will work to improve access to available healthcare for HIV-positive people by:

• Introducing innovative, community-based approaches with local health systems to improve timely access to quality HIV care for underserved adult populations

• Strengthening healthcare providers’ skills and relationships with patients

• Helping to reduce new HIV infections among populations at greatest risk

• Sharing important findings and lessons learned to further the development of innovative, multifaceted programs that improve the quality of healthcare for people living with HIV/AIDS

The Collaborative will not be starting from scratch at the three program sites, but will build on efforts already underway:

• Atlanta/Fulton County Department of Health and Wellness: Bridging the Gap will focus on HIV-positive clients referred to and enrolled in the county’s HIV Primary Care Clinic by implementing a community-based-care Linkage Coordinator and referral program.

• Houston Department of Health and Human Services: Expanded Linkage to Care Initiative (ELCI) will bring together healthcare providers, community groups, and researchers to launch community-wide System Navigator and Data Matching programs to identify all those living with HIV who have fallen out of care and re-engage them.

• The City of Philadelphia Department of Public Health: Engaging HIV+ Patients in Care Initiative will use System Navigator to help guide HIV patients through the local healthcare system to improve regular care, viral suppression, and management of HIV-related comorbidities and other chronic diseases.

The George Washington University (GWU) School of Public Health and Health Services will serve as the National Program Office for the HIV Care Collaborative. GWU will provide overall technical assistance to each of the program sites; help foster a “peer-learning” network among the health departments and local partners by regularly convening meetings and forums and by sharing best practices and challenges; and evaluate the progress and results of programs.

¹Mugavero, M.J., Lin, H.Y., Allison, J.J., Willig, J.H., Chang, P.W., J. et al., (2007) “Failure to Establish HIV Care: Characterizing the “No Show” Phenomenon,” Clinical Infectious Disease, 45, 127–30.

²Centers for Disease Control and Prevention, Estimates of new HIV infections in the United States. August 2008. www.cdc.gov/hiv/topics/surveillance/resources/factsheets/pdf/incidence.pdf.

³The White House Office of National AIDS Policy, National HIV/AIDS Strategy for the United States, July 2010. www.whitehouse.gov/sites/default/files/uploads/NHAS.pdf.