A coalition of federal and private partners has slashed AIDS rates among disadvantaged people by customising care for local conditions. Via a dozen community groups, the coalition provided services as diverse as telemedicine for rural Alabama, where people struggle to reach doctors, and special support for former prisoners also suffering from addiction and homelessnes
Results & Impact
Access to Care saved up to $8.84 in future HIV-related medical care for every dollar spent, and surpassed national viral suppression rates by 27%. It also helped 5,181 low-income and marginalised people without regular access to care receive HIV/AIDS treatment
The Social Innovation Fund, AIDS United, Johns Hopkins University, 14 private funders, 12 community organisations
The project used 12 different community organisations to tailor AIDS care to specific local conditions, ranging from telemedicine in rural Alabama to special support for former prisoners who also have complicating problems like alcoholism. Federal funds were matched by 14 private and philanthropic backers
Low-income people, patients
Cost & Value
The initiative raised $28 million over six years through matchfunding
The biggest challenge for grantees was meeting the data requirements set by Johns Hopkins and the Social Innovation Fund. While some struggled to meet data collection expectations in the first few years of the program, the organisations reported that building an increased capacity for data ultimately helped them improve their programs
A partnership to treat people with HIV/AIDS has exceeded national virus suppression rates and slashed costs by tailoring care to 12 marginalised communities.
The initiative raised $28 million in federal and private funds through matchfunding, with which it connected 5,181 low-income people who lacked regular access to HIV/AIDS treatment to direct service organisations across the US. Programs varied from a telemedicine scheme for impoverished people in rural Alabama to a service connecting at-risk former prisoners with care.
“We used a community-specific approach because each community has strengths and challenges unique to it. Health care delivery is a local problem, and the solutions are, too,” said Erin Nortrup, Director of Program Operations at AIDS United.
AIDS United, a national non-profit aimed at ending the HIV/AIDS epidemic, partnered with the Social Innovation Fund, which provides community-based non-profits with federal funding. They worked with Johns Hopkins University, 14 private funders and 12 grantee organisations from 2010 to 2016.
The Social Innovation Fund financed Access to Care on the condition that AIDS United match funding with private fundraising. All grantee organisations were also required to raise the same amount of funding they received from Access to Care with local fundraising efforts.
“By matching contributions from federal government with 14 private national funders and then again at the local level, we leveraged funding that we’d never get from a sole source. The scale and scope afforded by this unique funder mix allowed us to improve the health of over 5,100 people and generate statistically significant results that will guide the field in the future,” said Nortrup.
The 12 grantees organisations delivered patients services, for which AIDS United provided technical assistance and program support. John Hopkins’ Bloomberg School of Public Health was chosen by the Social Innovation Fund to evaluate the project outcomes, cost and the community impact.
Medical AIDS Outreach of Alabama (MAO), for example, used telemedicine to extend care to people living with HIV in rural Alabama who had trouble getting to doctors, pharmacy consultations and mental health counselling. With remote access to care, 94% of program participants continued their HIV treatment. MAO has expanded its telemedicine network from one clinic in one location to 10 clinics in two locations.
In Philadelphia, ActionAIDS helped at-risk prisoners with AIDS/HIV transition back into society while continuing treatment. They focused on people struggling with mental health problems, drug or alcohol dependency and homelessness, who were considered more likely to give up on care. The program retained 84% of patients in HIV care services.
Access to Care initiatives saved up to $8.84 in future HIV-related medical care for every dollar spent, and surpassed national viral suppression rates – a low level of HIV in the body – by 27%. Viral suppression is the goal of HIV treatment, and is instrumental in protecting the patient’s health and reducing the risk of transmission.
The biggest challenge for grantee organisations was meeting the data requirements set by Johns Hopkins and the Social Innovation Fund. Increasing their internal capacity for data collection was difficult during the first years of the initiative – but ultimately proved beneficial to the organisations, said Nortrup: “Many [said] that this growth and strengthening of their capacity to collect data and evaluate their programs has been vital in their ability to improve programs and apply for additional funding.”
According to the most recent Centre for Disease Control data (2011), only 30% of the 1.2 million Americans living with HIV had achieved viral suppression – meaning that just 3 out of every 10 people living with the virus have it under control. The US National HIV/AIDS Strategy emphasises the necessity of public-private partnerships to end the HIV epidemic.
In the world of AIDS treatment and research, “the cascade of care” refers to the many steps a person must take between diagnosis and viral suppression. Keeping people moving along the “cascade”, a complex and daunting task for patients, is a constant challenge for organisations involved in AIDS care.
(Picture credit: Pixabay/DarkoStojanovic)