Why It Matters

To stop HIV in Iowa, we must focus on the health and well-being of people living with HIV (PLWH). Starting treatment as soon as possible after being diagnosed, and staying in treatment, is the best way for PLWH to achieve their best health outcomes, including viral suppression. To do this, PLWH need access to high quality medical care and support services.

 

Where We Stand Today 

Benefits of HIV Medical Care and Treatment
 

HIV treatment has come a long way since HIV was first discovered in 1981. When taken as prescribed, HIV medication can make the amount of HIV in a person's blood too small to measure. This is called being undetectable. Being undetectable helps people living with HIV (PLWH) have long and healthy lives and helps prevent further complications associated with the virus. It also protects the health of their sex partners.​

 

However, health disparities still remain among certain populations. PLWH who identify as part of one or more of the following populations are less likely to achieve viral suppression (an undetectable viral load): ​

  • Black/African American (U.S.-born and non U.S.-born)

  • Non U.S.-born Latinx

  • Ages 15-24

  • Men who have sex with men (as mode of exposure to HIV)

  • People who inject drugs (as mode of exposure to HIV)

  • People with an unreported mode of exposure

  • PLWH not engaged in Ryan White case management

U = U 
 

People living with HIV who have an undetectable viral load cannot transmit the virus sexually. This is called U=U, or Undetectable = Untransmittable. As such, supporting people living with HIV in achieving an undetectable viral load is one of the most effective strategies to stop the transmission and acquisition of HIV in Iowa.

U=U illustration

What We're Doing Now

Ryan White Services in Iowa

 

In Iowa, PLWH can access many different medical and support services through Ryan White agencies located throughout the state. All Ryan White services are intended to help people living with HIV get into and stay in medical care.

 

Examples of these services include (but are not limited to):

 

  • HIV medical care; 

  • Case management; 

  • Help paying for housing, transportation, food, health insurance costs, etc.;

  • Providing or paying for mental health services; 

  • Direct access to medications through the AIDS Drug Assistance Program (ADAP).

Stethescope and meds
Data to Services/Re-engagement Program 

 

The IDPH and partners across the state, including Disease Intervention Specialists (DIS) and Ryan White providers, provide additional services to individuals who have fallen out of medical care. The goal of this program is to re-engage PLWH who have fallen out of care back into medical services and other support services, if needed.

Challenges, Gaps, & Barriers

Challenges faced by some people living with HIV
  • ​Homelessness

  • Location of HIV medical provider (e.g., need to travel long distances) 

  • Substance use (e.g., drugs, tobacco, alcohol)

  • Mental illness & trauma

  • Stigma & discrimination

 
Barriers
  • Lack of affordable and high quality housing

  • Ryan White funding limitations

  • Staff turnover at some Ryan White agencies

 
 
 
A doctor explains test results to his elderly patient

To stop HIV in Iowa by 2030, this focus area must:

  • Engage with and learn from PLWH to inform our larger direction and strategies. 

  • Identify and re-engage PLWH who have fallen out of regular medical care.

  • Increase HIV medication adherence

  • Increase retention in HIV medical care and viral suppression, especially among disproportionately impacted populations of PLWH. 

  • Address social determinants of health and co-occurring conditions that exacerbate HIV-related disparities

 
 

Process for Community Engagement 

Engagement Focus

This focus area will gather information from community partners throughout the state to better understand the challenges and barriers faced by people living with HIV in Iowa.

 

What we learn will inform and support our work towards the following goals:

Pill bottle and tablets.png
Medication adherence

Increase HIV medication adherence in PLWH

Doctor and patient
Re-engagement

Re-engage PLWH who have fallen out of care

Retention in medical care
Retention in medical care

Increase retention in HIV medical care

U=U
Viral suppression

Increase viral suppression 

Three houses with trees
Social determinants of health

Address social determinants of health & co-occurring conditions that exacerbate HIV-related disparities

Stigma icon
Stigma

Reduce stigma towards PLWH

Gathering Feedback

Focus Groups
  • Ryan White agency staff by region
     

  • HIV medical providers
     

  • Primary care providers who serve PLWH
     

  • HIV telemedicine staff from partnership between Dubuque and Des Moines
     

  • Disease Intervention Specialists (DIS) and Data to Services Program staff from Bureau of HIV, STD, and Hepatitis, Iowa Department of Public Health (IDPH)
     

  • Pharmacy staff who routinely serve PLWH

 

Key Informant Interviews
  • PLWH, especially representatives from prioritized populations

Surveys
  • ​PLWH who receive Ryan White services
     

  • Regional Health Specialists (RHS), from NuCara Capacity Extension Program

Resources

Iowa Department of Public Health | Bureau of HIV, STD, and Hepatitis

Iowa Department of Public Health | Bureau of HIV, STD, and Hepatitis

Iowa Department of Public Health | Bureau of HIV, STD, and Hepatitis

man talking with case manager in his office