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HIV/STD Program

HIV Components & Activities

 

HIV Care

Ryan White Program

Alaska’s HIV case management services for persons living with HIV/AIDS are funded by HRSA’s Ryan White Program by way of the HIV/STD Program and are overseen by the following organizations:
Services provided by, or funded through these organizations include medical and non-medical case management, education, counseling, advocacy, and other supportive services.
 

AIDS Drug Assistance Program (ADAP)

The HIV/STD Program oversees Alaska’s AIDS Drug Assistance Program (ADAP) with funding from HRSA’s Ryan White Program. ADAP assists with providing low/no-cost HIV prescription medications to persons living with HIV who have limited or no prescription drug coverage. ADAP benefits are directly administered and managed by Alaska AIDS Assistance Association (Four As).  

HIV Prevention

The HIV/STD Program provides funding for multiple agencies statewide to conduct HIV prevention activities, including HIV testing, PrEP education and referrals, condom distribution, and marketing/social media. Additionally, HIV prevention staff provide education and technical assistance around HIV Prevention, Testing, and Counseling best practices to community partners, medical staff, and social services providers. If you are interested in a training, please contact the HIV Prevention Coordinator.
 
The following agencies have been funded to conduct HIV prevention activities via the 2024-2027 HIV Prevention Grant.

HIV Surveillance

The HIV/STD Program monitors HIV across the state to better understand who is being infected and why, and to assess the impact of HIV prevention, testing, and treatment services across different populations and regions. Program staff provide surveillance data reports, cluster detection and response, and linkage to care and partner services to newly diagnosed persons.

HIV Cluster Detection and Response (CDR)

Definitions
  • Cluster: a group of people with new and existing HIV diagnoses who may be part of a network of HIV spread.
  • Outbreak: when the number of new HIV diagnoses is higher than what would be normally expected in an area or among a specific group of people in a given time period.
  • Detection: using data to understand where HIV transmission, or spread, is happening.
  • Response: moving resources where they are needed to provide prevention, treatment and testing, and other services people may need like housing and food.

How do we find clusters and outbreaks of HIV?

  • Field Tools
    • Providers: Health care providers or community partners might notice an unusual increase in diagnosis in a certain area or group of people, and report that to the health department.
    • Partner Services: Partner services field staff are health department workers who reach out to people newly diagnosed with HIV to offer support with partner notification and help get people linked to services. Because they are talking directly with people newly diagnosed with HIV, they can make certain connections, like if a group of people with new diagnoses may be part of the same social network.
  • Data Tools
    • Time-space: Time-space cluster analysis uses a computer program to track patterns of HIV diagnoses within certain timeframes and geographical areas. For example, the computer program may track a certain number of new diagnoses during the month of November (time) within a certain county (space).
    • Molecular analysis: Molecular analysis uses information from blood tests used in routine clinical care to monitor transmission patterns. When someone is newly diagnosed with HIV, or when they need to change their treatment, their doctor will take a sample of their blood and send it to the laboratory. The laboratory sequences a portion of genetic material of the HIV to see if the virus is resistant to any common HIV medications. The doctor can use the results from this test to pick the best HIV treatment for their patient. The sequence is then reported to the health department, where it is stored in a secure database. HIV changes over time in different ways in each person. When a group of people have viruses with similar molecular sequences, it suggests that little time has passed between when HIV was acquired and transmitted. This is often referred to as rapid transmission. When we see a larger than usual number of people newly diagnose with HIV whose HIV is molecularly similar, it tells us that HIV is being transmitted rapidly in that network – which is a sign to us that people in that network are not able to access the services they need.

    Responding to Clusters of HIV

    When rapid transmission of HIV is happening, it’s a sign to us that our usual system is not meeting the needs of the people involved. In these cases, we might decide a special response is needed. If so, public health field staff work together with community-based organizations, healthcare providers, and other partners to implement the response. This could include doing field outreach to do testing and education; making clinical services such as HIV treatment and PrEP more accessible; offering free and accessible prevention services such as condoms, PrEP, and safer injection supplies; and more, depending on what people linked to the cluster need most. That’s why clusters are so important. If we notice the cluster and identify people in need quickly enough, we can provide services, interrupt transmission, and prevent new infections of HIV. The response ends when all the people linked to the cluster have accessed HIV care and other services they need.

    Cluster Detection and Response Reports

    The Final Report for the 2023 [HIV] Rapid Qualitative Assessment. In 2023, the DOH HIV/STD Program requested CDC assistance in our response to a cluster of HIV diagnoses in the Fairbanks area. The CDC provided epidemiological support via review and analysis of cluster data provided by DOH and conducted a rapid qualitative assessment. The goals of this supports were to:
    • Characterize the HIV cluster in Alaska with respect to demographics, geography, and risk behaviors and document existing investigation response activities
    • Assess perspectives among key partners in healthcare and community-based organizations regarding knowledge of and factors related to the increase of HIV among gay, bisexual, and other men who have sex with men (GBMSM)
    • Examine factors potentially contributing to HIV transmission and facilitators and barriers to HIV prevention services among GBMSM
    • Develop recommendations for epidemiologic support and HIV prevention activities