The first in a three-part series of conversations about an epidemic health centers have been on the front lines of addressing for decades: HIV (human immunodeficiency virus) and AIDS (acquired immunodeficiency syndrome). In this episode, HIV expert Nick Diamonds leads a conversation about new strategies for preventing HIV transmission. Guests featured in this episode:Robyn Neblett Fanfair, MD, MPH, Acting Division Director, Division of HIV PreventionCenters for Disease Control and PreventionJuan Carlos Loubriel, Director of Community Health and WellnessWhitman-Walker HealthCraig Thompson, CEO, AIDS Project Los Angeles (APLA) HealthModerator: Nick Diamond, Manager, Editorial Services, Elizabeth Glazer Pediatric AIDS FoundationEpisode transcriptEpisode transcriptNick Diamond: I want to start with Robyn by asking you, "What excites you the most about the new evidence based-strategies introduced for people who are HIV negative and want to stay that way?" Dr. Robyn Neblett Fanfair: Thanks to a robust toolbox that includes pre-exposure prophylaxis, post-exposure prophylaxis, treatment as prevention, and syringe service programs, we now have more tools than ever available for HIV prevention, and we must realize the full potential of these tools, we understand how important it is to make sure that it gets into the hands of everyone who needs them. So what excites me a lot right now is a status neutral approach to HIV prevention, which we believe can really help improve access, reduce stigma, and help prioritize health equity. So as far as exciting strategies go, it's really about reframing how we think about traditional HIV service models to better reach people where they are with the services that they need. So no matter their HIV status, we know that people need similar health care as well as essential support services. These can include medical care, housing, transportation, and employment. A status neutral approach can create a one door approach for HIV prevention and treatment, which can help normalize both. It eliminates HIV stigma by integrating prevention and care instead of supporting separate systems. And we believe it can enable people to know their status by making HIV testing and next approaches, whether they're behavioral or biomedical prevention, more accessible, and it can advance health equity by connecting people to the services they need regardless of their HIV status. So those are just a few things that I think are really exciting in HIV prevention right now.Nick Diamond: And Juan Carlos, I want to turn it over to you to ask about your experience and programs at Whitman-Walker. Would you talk a little bit about what your health center is doing to improve HIV prevention services in the community? I know Robyn just talked about this toolkit; are you seeing the implementation of things in those toolkits at the health center? Juan Carlos Loubriel: Yes, indeed. We are very excited about this new approach. Whitman-Walker Health delivers tailored education and sexual health services that are sex-positive and inclusive. Our training and linkage efforts are community-based service delivery interventions. They promote access to effective tools for HIV prevention and timely diagnosis. We also provide immediate access to nPEP (non-occupational post exposure prophylaxis) and PrEP (post exposure prophylaxis) for HIV prevention. We provide early diagnosis and prompt linkage to medical care, including ART (antiretroviral therapy). And these efforts occurred alongside treatment of HIV and other chronic diseases. We strive to eliminate barriers to care. And to do this, we deliver status neutral services and connect clients to medical, behavioral health, harm reduction, and social services through customized risk reduction. Staff provide health literacy and education for clients on understanding and navigating the medical system at every stage of the care continuum. And we need to understand that education is also a necessary component to normalize conversations around sex, so we want to increase client’s active participation in care decisions so they can make informed decisions about their sexual health and HIV risk. And these services help move these clients along the continuum from prevention to care, and there are entry points to care in each of our programs. Nick Diamond: One thing that's really exciting about this conversation is that we're convening a really diverse group of stakeholders, from government to community health centers, and the response to HIV, and Juan Carlos, I might ask if you have a question for Dr. Fanfair related to HIV prevention from your perspective, working in community health, you know, with an opportunity to engage government?Juan Carlos Loubriel: Yes, definitely, Doctor Fanfair, you know, over the past 40 years, there have been many HIV prevention best practices, including condom use and PrEP. And my question is, what do you see as an HIV prevention best practice coming in...
