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HIV Research Catalyst Forum April 21, 2010, Baltimore, MD A. Toni Young Executive Director

HPTN 065 TLC-Plus: Feasibility of an enhanced test, link-to-care plus treat approach for HIV prevention in the U.S. HIV Research Catalyst Forum April 21, 2010, Baltimore, MD A. Toni Young Executive Director Community Education Group. TLC+. Decrease in HIV Transmission.

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HIV Research Catalyst Forum April 21, 2010, Baltimore, MD A. Toni Young Executive Director

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  1. HPTN 065TLC-Plus: Feasibility of an enhanced test, link-to-care plus treat approach for HIV prevention in the U.S. HIV Research Catalyst Forum April 21, 2010, Baltimore, MD A. Toni Young Executive Director Community Education Group

  2. TLC+ Decrease in HIV Transmission Granich et al, 2009 Granich et al, 2009 Test and Treat enough HIV+ people

  3. High uptake of annual testing by all >15 year old individuals • All HIV+ individuals start ART immediately, irrespective of stage of HIV disease • 99% decrease in infectiousness • High adherence with ART • Low failure with first line ART Model Assumptions

  4. Study Communities Intervention communities Washington DC Bronx, NY Comparison communities Houston Philadelphia Chicago Miami

  5. Assesses feasibility and effectiveness outcomes, dependent on study component • Assesses the feasibility of using surveillance data for outcomes • All aim at determining feasibility of overall strategy • TLC-Plus is not designed to measure a change in HIV incidence Study Objectives and Outcomes

  6. TLC+ 065 Protocol Overview • PURPOSE • To evaluate the feasibility of an enhanced community-level HIV • test, link-to-care plus treat strategy in the U.S.

  7. Assesses feasibility and effectiveness outcomes, dependent on study component • Assesses the feasibility of using surveillance data for outcomes • All aim at determining feasibility of overall strategy • TLC-Plus is not designed to measure a change in HIV incidence Study Objectives and Outcomes

  8. Study Duration

  9. Financial incentives • Plans to minimize the risk of overuse of financial incentives • Address risk of migration from sites randomized to different interventions • Provider training • Supportive services for PLWH (mental health, substance use, adherence support) • Mapping of resources in the communities • Use of ART for achievement of maximal viral suppression • Timeliness and quality of surveillance data Key Issues Addressed

  10. FI for viral suppression SOC for viral suppression What Will the Study Entail • Expanded HIV Testing • Social mobilization • Universal offer of testing in ED/hospital admissions Test Linkage-to-Care Randomization of HIV Test Sites SOC to link to care FI to link to care Linkage-to-Care • Provider Training • Linkage to services [ SA, MH] • HIV prevention counseling • Maximize ART initiation per current guidelines Prevention for Positives Randomization of HIV+ Patients Initiate/Continue ART per current guidelines CARE plus SOC SOC alone • Provider & Patient Surveys • Knowledge & attitudes regarding ART & FIs Viral Suppression Randomization of HIV Care Sites Viral Suppression

  11. A. Toni Young 3233 Pennsylvania Avenue, SE Washington, DC, 20020 Tyoung@communityeducationgroup.org Thank You To HPTN and FHI for Use of Slides

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