Texas Enhanced Comprehensive HIV Prevention Planning (ECHPP) Project: Dallas HIV Testing
In 2013, among adult and adolescent males and females 13 years and over, the diagnosed infections attributed to male-to-male sexual contact (68%, including male-to-male sexual contact and injection drug use) and those attributed to heterosexual contact (25%) accounted for approximately 93% of diagnosed HIV infections in the United States.1 Ensuring that individuals have access to testing services and treatment is crucial to limiting the spread of HIV.
In 2010, CDC funded a 3-year demonstration program for the 12 municipalities with the highest number of people living with AIDS in the United States.2 The project, Enhanced Comprehensive HIV Prevention Planning Project (ECHPP), supported grantees in program planning and implementation to reduce new HIV infections, link people with HIV to care and treatment, reduce HIV-related health disparities, and achieve a more coordinated response across the U.S. To address the ECHPP goals in Dallas, one of the funded municipalities, the Texas Department of State Health Services (DSHS) refocused its HIV prevention activities on reducing new HIV infections and HIV-related health disparities, particularly among the men who have sex with men (MSM) population.
In 2010, at the start of ECHPP, the Texas DSHS conducted a situation analysis in Dallas that found that 40% of health department counseling and testing efforts were directed toward MSM, but only 5% focused on black/African American MSM; MSM accounted for 67% of people living with HIV in the Dallas area and 70% of all new HIV diagnoses; 25% of MSM who tested HIV-positive were new diagnoses; and 54% were unaware of their infection. Given the high rates of HIV among the MSM population, the Texas DSHS strategically targeted the MSM community by selecting Dallas providers and testing services in high morbidity areas. Additionally, the use of nucleic acid amplification testing at the Dallas County Health Department Laboratory enabled the early identification of infections.3
These efforts led to positive outcomes in terms of testing of the MSM and black/African American MSM communities and increasing the proportion of the population with knowledge of their HIV status. From 2010 to 2013, there was an increase in CDC-funded HIV testing among MSM overall and among black/African American MSM, with the number of tests increasing by 214% for all MSM and by 573% for black/African American MSM over the 4-year period. In 2010, there were 1,781 total tests among MSM and 312 among black/African American MSM, and by 2013, there were 5,584 tests among MSM and 2,100 among black/African American MSM.3 The Texas DSHS reports that these testing trends were largely driven by local ECHPP objectives to improve targeting of MSM in non-clinical settings. As testing increased, large pools of undiagnosed individuals were reached and, once those individuals had been diagnosed, HIV-positivity rates began to decline. Dallas is an example of the importance of targeted outreach, specifically for hard-to-reach populations, for increasing HIV testing and identification of HIV-positive individuals in the community. To learn more about ECHPP and what other cities are doing to address this issue, visit http://www.cdc.gov/hiv/prevention/demonstration/echpp/.
Texas Enhanced Comprehensive HIV Prevention Planning Project
Disclaimer: Reference in this web site to any specific product, process, service, organization, or company does not constitute its endorsement or recommendation by U.S. Government or the U.S. Department of Health and Human Services.