Melanie Thompson: A strategy to end AIDS in Fulton County

This is our time. The time to end the AIDS epidemic in our community is now.

Now we have effective treatment capable of preventing progression to AIDS in people with HIV, often allowing them to live a normal lifespan. Now we have the tools to vastly decrease new HIV infections through effective treatment of people who have HIV (treatment is prevention) and combination prevention strategies including pre-exposure prophylaxis (PrEP) for those who do not. And now we have a blue ribbon task force on HIV/AIDS to provide transparency, leadership, and a Strategy to End AIDS in Fulton County. The question is no longer, “Can we do it?” but “Will we do it?”

Our answer has been disappointing thus far. Finally, it is time to say, “Yes, we can and we will!” And we must say it in unison, as a community. Will you be part of that voice?

San Francisco implemented an aggressive plan to offer immediate treatment to everyone with HIV and to greatly increase availability of PrEP, and has recently announced that both HIV infections and deaths are down. The District of Columbia, home of the nation’s highest HIV rates, has reduced its new diagnoses by 60 percent in six years. New York state has committed to “Ending the Epidemic” by 2020.

Now is our time.

On World AIDS Day 2014, Fulton County Board of Commissioners Chairman John Eaves and Commissioner Joan Garner participated in an event at which they heard that Atlanta’s young black gay and bisexual men are infected with HIV at rates similar to parts of Africa. They also heard that, as of that date, metro Atlanta ranked first nationally in its rate of new HIV diagnoses, and that, after 30 years, we still have no coordinated strategy to attack this problem.

Commissioner Garner asked, “What can Fulton County do?” The response was, “Take leadership.” And Chairman Eaves responded, “We will do it.” Two weeks later, they led the Board of Commissioners in creating the Fulton County Task Force on HIV/AIDS. This sentinel moment marked the first time that elected officials have taken concrete action to seriously address our epidemic.

The Task Force adopted as its primary mission to create and oversee the implementation of a “Strategy to End AIDS in Fulton County.” The Task Force adopted the overall goals of the 2020 National HIV/AIDS Strategy as the key goals of the new Fulton County strategy. These goals are to:

  • Reduce new HIV infections
  • Increase access to care and improve health outcomes for people living with HIV
  • Reduce HIV-related disparities and health inequities
  • Achieve a more coordinated local response to the epidemic

The strategy timeline has two phases. The first phase will develop broad objectives that align with these four goals. This phase is beginning now, and its preliminary results will be presented during World AIDS Day 2015. The second phase will develop specific action plans for every objective. Each action plan will include accountability, a timeline, measurable outcomes, and a cost estimate. The full strategy will be complete by National HIV Testing Day, June 27, 2016.

With input from colleagues in New York, Chicago, San Francisco, and elsewhere, the Task Force has created a plan to accomplish this work. The strategy will be developed through the work of five committees: Prevention and Care, Data and Evaluation, Social Determinants of Health, Policy, and an Executive Committee. Committees will include community advocates, service providers, government and community leaders, and experts in HIV and other “bad bugs” (sexually transmitted diseases, viral hepatitis, and tuberculosis) that disproportionately affect people living with HIV and, in some cases, make HIV transmission more likely.

But the Task Force cannot be successful without robust community engagement and input. The Community Engagement Plan is evolving, and initially includes a community-wide survey tool to receive recommendations for strategy objectives, and a series of four community listening sessions for direct feedback to the Task Force in October and November. The survey is now available online via Survey Monkey. Community Listening Sessions will be advertised in Georgia Voice, as well as through social media and other outlets.

The HIV/AIDS epidemic has plagued metro Atlanta, including Fulton County, for far too long. We have lost too many and continue to see too many suffer needlessly. We have seen our government agencies waste valuable resources because of poor leadership, planning and execution. The Task Force has already played a crucial role in bringing these issues to light, and will continue to provide transparency and oversight with the full support of our Fulton County Commissioners. Now we have a chance. Will we take it?

Make a recommendation. Attend a meeting. Get involved. Thank your commissioners for creating and supporting the Task Force.

This is our time. Together, we can do this, but we must act now. AIDS isn’t over—but it could be.

Melanie Thompson, MD is principal investigator of the AIDS Research Consortium of Atlanta (ARCA) and Chair of the Prevention and Care Committee of the Task Force.

Contact the Task Force directly at fchatf.gov@gmail.com