The Need for Comprehensive, Independent Evaluation of the National HIV/AIDS Strategy

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The Importance of Independent Evaluation HealthHIV is committed to advancing the National HIV/AIDS Strategy (NHAS) through the dissemination of information collected via assessment of the strategy and the implementation among the HIV community and the larger health care community. An overall, unbiased, assessment of the NHAS is essential in determining the longterm impact of the tactics within. Only through honest assessment of the implementation of Strategy will the Administration, the HIV and the wider public health community know and be able to communicate the successes related to the NHAS and the ways in which we might overcome the challenges in furthering the vision of the NHAS.

Why HealthHIV HealthHIV is in a unique position to assess the NHAS over time. As a national HIV non-profit representing a broad constituency of HIV primary care providers and with a research and evaluation capability, HealthHIV is in a distinct position to independently assess the NHAS and provide the HIV and public health communities an overall assessment of the NHAS and its potential impact, we have the flexibility to be unbiased and be able to look at the overall strategy and not just individual components therein. HealthHIV will: • Provide an overall assessment of the achievements credited to the NHAS among government agencies, the national HIV groups, and community-based groups including community health centers.

• Employ our vast network of public health and primary care partnerships to coordinate the definition and measures of the NHAS success, the rigorous methods with which to measure, the assessment of the ‘reach’ of the NHAS to the wider public health community, as well as recommendations for highlighting the accomplishments and overcoming the challenges to implementation.

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Evaluation In the initial weeks following the release of the NAS, HealthHIV will monitor reaction to, as well as movement on, implementation of the NHAS by: Focusing on racial/ethnic disparities and those disparities that exist based on geography, sexual orientation, gender, and risk behaviors such as drug use.

Identifying ways in which the NHAS promotes enhancements to care and treatment for PLWHA. Reviewing the NHAS for specific tactics in preventing HIV in relation to other federal strategies like HealthyPeople2020.

HealthHIV will release “NHAS at 200 Days” report which will describe the efforts to date of the Administration and the AIDS community in disseminating the Strategy and in any progress made in implementation of the Strategy.

Describing the reactions to and the progress in implementing the NHAS where addressing health disparities are concerned.

Analyzing reactions to and progress in implementing the strategies identified to enhance and promote access and linkages to care.

Analyzing reactions to and progress in the adoption of the specific prevention tactics recommended by the NHAS. HealthHIV will continue to monitor the NHAS throughout its first year. We are especially interested in gauging the dispersion of the NHAS into the wider public health/health care fields and the ability of the strategy to cross over in co‐morbidities like hepatitis, sexually transmitted infections, and other chronic diseases like diabetes. Though we do not anticipate a great deal of change in the available measures indicating reductions in disparities, improved access to care, and/or reductions in prevalence, we do anticipate being able to articulate some changes in administrative policy, the focus of funding, and other recommendations emanating from federal and state governments.

Specific Questions The true impact of the NHAS will be measured in years, not weeks. For this reason, HealthHIV intends to monitor press, epidemiological trends, shifts in administrative policy, as well as shifts in federal and state policies as they relate to the overarching goals of the NHAS. Does the strategy resonate with the population overall? Which groups are active in implementation of the strategy? Are shifts in outcomes realized and can those outcomes be correlated with the strategy?

What impact has the NHAS had on HIV related health disparities? Overall health disparities?

The ongoing analysis will provide a long term look at the impact of the NHAS on access and linkages to care for PLWHA. Have more PLWHA been linked to care? At what point in disease progression are PLWHA linked to care? What are the overall health outcomes of PLWHA? Only through the ongoing analysis will HealthHIV be able to articulate the long term impact of the NHAS on reduction of HIV prevalence in the US overall or specific regions/ states. It takes time to collect these data and it can be challenging to make connections between a NHAS and the prevention of transmission.

The NHAS presents a bold vision for HIV/AIDS in the United States: to become a place where new HIV infections are rare, PLWHA have access to the life‐saving care they need, and we will all be free of HIV‐related stigma and discrimination. The broad monitoring/evaluation questions proposed in the Federal Implementation Plan accompanying the NHAS are critical questions which must be frequently asked of all organizations providing HIV services‐ not just the government. If we are truly to realize the ambition of the NHAS, constant evaluation will be necessary to assess real‐time progress in achieving the steps laid out in the Strategy and then use those findings to refine and propel the NHAS into perpetuity.

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About HealthHIV HealthHIV is a national, 501(c)(3) non-profit working with organizations, communities and professionals to advance effective prevention, care, and support for people living with, or at risk for, HIV/AIDS through education and training, technical assistance and capacity building, advocacy, and health services research and evaluation. HealthHIV supports primary care providers treating HIV, as well as community and faith-based organizations involved in HIV prevention, care and treatment. HealthHIV, through a five-year cooperative agreement from the Centers for Disease Control and Prevention, will lead a project to increase HIV awareness among mayors in the United States. This project, Exchange & Engage, will facilitate and strengthen collaborative efforts relative to active information exchange, communication, consultation, technical assistance, and problem solving between mayors, local and state health department officials, community-based organizations and other public and private sector organizations regarding HIV prevention.

For more information on resources available to mayors, please email research@healthhiv.org