Minneapolis “Fast Track” to combat HIV

On Monday, the City Council’s Public Health, Environment, Civil Rights, and Engagement Committee heard an update about the city’s Fast Track initiative to combat HIV. Fast Track is a “global partnership between high HIV burden cities” with a goal to “end AIDs as a public health threat by 2030.”

The Minneapolis Fast Track initiative, which got up and running last year, is focused on 4 long-term outcomes:

  • 90% of people living with HIV (PLWHIV) will know their status;
  • 90% of people who know their HIV-positive status will receive treatment;
  • 90% of PLWHIV on HIV treatment with have suppressed viral loads; and
  • Zero stigma and discrimination against PLWHIV

HIV has become a chronic disease. With proper treatment, people living with HIV can live long and otherwise healthy lives. Access to medical care can also eliminate the risk of transmitting the virus to others. The problem is people can’t receive that care unless they know they’re infected (go get tested).

Some items included in the city’s Fast Track action plan:

  • Engage communities and organizations hardest hit by HIV in recent years. This includes men who have sex with men (66% of all diagnoses) and the African American community (45% of all diagnoses). Among female diagnoses, 33% were US-born African American. 36% were foreign-born African American.
  • Encourage “opt out” HIV testing as a part of STD screening. The current practice at clinics is that you have to opt-in.
  • Develop criteria for clinics to be designated with city’s “seal of approval” for providing automatic “opt-out” STD testing and culturally sensitive care.
  • Work with city housing staff to address the need for affordable housing among those living with HIV.
  • Reduce the stigma of HIV. This could include working with the city’s Civil Rights Department to combat discrimination against people living with HIV

School-based clinics in Minneapolis currently offer STD screening, which includes opt-out, rapid testing for HIV. Rapid tests provide results within 20 minutes, eliminating the problem of people not returning for their results.

Minneapolis Deputy Health Commissioner Noya Woodrich said that part of achieving the Fast Track goals will be about supporting, but not duplicating, the work of others. She said that Hennepin County and the State of Minnesota “have very robust plans as it relates to HIV.”

Woodrich: “We are going to use things that we are good at to help support that work. For instance, the Minneapolis Health Department has a fairly good reputation and history of engaging in communities of color.”

Hennepin County’s effort to end the HIV epidemic, called Positively Hennepin, is led by Jake Maxon. He told city council members that while advancements in medical care have turned HIV into a manageable lifelong condition, affordable housing is often the foundation for that care:

  • “Today we know that people living with HIV, when they’re taking their medicines as prescribed, it’s impossible for the virus to be transmitted sexually.”
  • “Our public health research is finally catching up to the fact that access to affordable housing is essential health care for people living with HIV.”
  • “As housing and pharmaceutical costs rise, HIV’s disproportionate impact on these communities will become more severe.”
  • “If the course of the epidemic does not change…half of all black American men who have sex with other men will live with HIV.”

Maxon went beyond the human toll to describe the economic impact of 4,700 Hennepin County residents (including more than 3,100 Minneapolis residents) who currently live with HIV. Their medical costs amount to $108 million annually. Their lifetime medical costs are estimated at $1.8 billion.

Ward 8 Council Member Andrea Jenkins reiterated several times during Monday’s meeting the importance of targeted outreach to black women, who make up a disproportionate share of female infections:

“If we’re going to address this disease and get to our Fast Track goals, we really have to be fully inclusive of the entire community that is being impacted by this chronic illness. People can live longer lives, but only if they are getting tested, and becoming aware of their status, and having targeted outreach. Sometimes the outreach that is specific or successful with gay white men is not the same outreach that’s going to bring in women of African and African American descent.”