Susan P Buchbinder1,2,3,4, Diane V Havlir2,4. 1. Bridge HIV, San Francisco Department of Public Health, San Francisco, CA. 2. Department of Medicine, University of California, San Francisco, San Francisco, CA. 3. Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA. 4. Zuckerberg San Francisco General Hospital, San Francisco, CA.
Abstract
BACKGROUND: Building on several decades of innovative HIV prevention and treatment programming in San Francisco, in 2014, a small group of academic, civic, and community leaders launched Getting to Zero San Francisco, a city-wide consortium focused on getting to zero HIV infections, zero HIV-related deaths, and zero HIV stigma and discrimination. SETTING: San Francisco city and county. METHODS: The consortium operates under the principles of collective impact composed of 5 components: a common agenda, shared measurement, mutually reinforcing activities, continuous communication, and organization backbone. Two flagship initiatives are described: citywide scale-up of pre-exposure prophylaxis and rapid antiretroviral therapy upon diagnosis. RESULTS: The number of new HIV diagnoses declined by over 50% from 399 to 197 from 2013 to 2018; the time from diagnosis to viral suppression decreased from 134 to 62 days during that period. However, continued racial/ethnic disparities in new HIV diagnoses and viral suppression rates point to the need for the Getting to Zero San Francisco committees to focus on racial/ethnic equity as a primary focus. Cisgender and transgender women, people who inject drugs, and people who are homeless also have lower viral suppression rates; ongoing initiatives are attempting to address these disparities. CONCLUSION: A collective impact implementation strategy that operates by unifying municipal organizations toward a common goal was associated with citywide gains in reducing new HIV diagnosis and time to viral suppression in San Francisco. Formal evaluation of this strategy will help elucidate under which conditions this approach is most likely to succeed.
BACKGROUND: Building on several decades of innovative HIV prevention and treatment programming in San Francisco, in 2014, a small group of academic, civic, and community leaders launched Getting to Zero San Francisco, a city-wide consortium focused on getting to zero HIV infections, zero HIV-related deaths, and zero HIV stigma and discrimination. SETTING:San Francisco city and county. METHODS: The consortium operates under the principles of collective impact composed of 5 components: a common agenda, shared measurement, mutually reinforcing activities, continuous communication, and organization backbone. Two flagship initiatives are described: citywide scale-up of pre-exposure prophylaxis and rapid antiretroviral therapy upon diagnosis. RESULTS: The number of new HIV diagnoses declined by over 50% from 399 to 197 from 2013 to 2018; the time from diagnosis to viral suppression decreased from 134 to 62 days during that period. However, continued racial/ethnic disparities in new HIV diagnoses and viral suppression rates point to the need for the Getting to Zero San Francisco committees to focus on racial/ethnic equity as a primary focus. Cisgender and transgender women, people who inject drugs, and people who are homeless also have lower viral suppression rates; ongoing initiatives are attempting to address these disparities. CONCLUSION: A collective impact implementation strategy that operates by unifying municipal organizations toward a common goal was associated with citywide gains in reducing new HIV diagnosis and time to viral suppression in San Francisco. Formal evaluation of this strategy will help elucidate under which conditions this approach is most likely to succeed.
Authors: Donna Hubbard McCree; Austin M Williams; Harrell W Chesson; Linda Beer; William L Jeffries; Ansley Lemons; Cynthia Prather; Madeline Y Sutton; Eugene McCray Journal: J Acquir Immune Defic Syndr Date: 2019-05-01 Impact factor: 3.731
Authors: Maria I Lopez; Jennifer Cocohoba; Stephanie E Cohen; Nikole Trainor; Montica M Levy; Betty J Dong Journal: J Am Pharm Assoc (2003) Date: 2019-08-09
Authors: Adam W Carrico; Peter W Hunt; Torsten B Neilands; Samantha E Dilworth; Jeffrey N Martin; Steven G Deeks; Elise D Riley Journal: J Acquir Immune Defic Syndr Date: 2019-01-01 Impact factor: 3.731
Authors: Michael S Saag; Constance A Benson; Rajesh T Gandhi; Jennifer F Hoy; Raphael J Landovitz; Michael J Mugavero; Paul E Sax; Davey M Smith; Melanie A Thompson; Susan P Buchbinder; Carlos Del Rio; Joseph J Eron; Gerd Fätkenheuer; Huldrych F Günthard; Jean-Michel Molina; Donna M Jacobsen; Paul A Volberding Journal: JAMA Date: 2018-07-24 Impact factor: 56.272
Authors: Harry Jin; Adedotun Ogunbajo; Matthew J Mimiaga; Dustin T Duncan; Edward Boyer; Peter Chai; Samantha E Dilworth; Adam W Carrico Journal: Drug Alcohol Depend Date: 2018-09-13 Impact factor: 4.492
Authors: Erika G Martin; Roderick H MacDonald; Daniel E Gordon; Carol-Ann Swain; Travis O'Donnell; John Helmeset; Adenantera Dwicaksono; James M Tesoriero Journal: Public Health Rep Date: 2020 Jul/Aug Impact factor: 2.792
Authors: Jared M Baeten; Thesla Palanee-Phillips; Nyaradzo M Mgodi; Ashley J Mayo; Daniel W Szydlo; Gita Ramjee; Brenda Gati Mirembe; Felix Mhlanga; Portia Hunidzarira; Leila E Mansoor; Samantha Siva; Vaneshree Govender; Bonus Makanani; Logashvari Naidoo; Nishanta Singh; Gonasagrie Nair; Lameck Chinula; Urvi M Parikh; John W Mellors; Iván C Balán; Kenneth Ngure; Ariane van der Straten; Rachel Scheckter; Morgan Garcia; Melissa Peda; Karen Patterson; Edward Livant; Katherine Bunge; Devika Singh; Cindy Jacobson; Yuqing Jiao; Craig W Hendrix; Zvavahera M Chirenje; Clemensia Nakabiito; Taha E Taha; Judith Jones; Kristine Torjesen; Annalene Nel; Zeda Rosenberg; Lydia E Soto-Torres; Sharon L Hillier; Elizabeth R Brown Journal: Lancet HIV Date: 2021-02 Impact factor: 12.767
Authors: Catherine A Koss; Diane V Havlir; James Ayieko; Dalsone Kwarisiima; Jane Kabami; Gabriel Chamie; Mucunguzi Atukunda; Yusuf Mwinike; Florence Mwangwa; Asiphas Owaraganise; James Peng; Winter Olilo; Katherine Snyman; Benard Awuonda; Tamara D Clark; Douglas Black; Joshua Nugent; Lillian B Brown; Carina Marquez; Hideaki Okochi; Kevin Zhang; Carol S Camlin; Vivek Jain; Monica Gandhi; Craig R Cohen; Elizabeth A Bukusi; Edwin D Charlebois; Maya L Petersen; Moses R Kamya; Laura B Balzer Journal: PLoS Med Date: 2021-02-09 Impact factor: 11.069
Authors: Kate M Mitchell; Dobromir Dimitrov; James P Hughes; Mia Moore; Eric Vittinghoff; Albert Liu; Myron S Cohen; Chris Beyrer; Deborah Donnell; Marie-Claude Boily Journal: Epidemics Date: 2020-11-20 Impact factor: 4.396
Authors: Erin C Wilson; Christopher J Hernandez; Susan Scheer; Dillon Trujillo; Sean Arayasirikul; Sofia Sicro; Willi McFarland Journal: AIDS Behav Date: 2021-08-14
Authors: Jason S Melo; Nancy A Hessol; Sharon Pipkin; Susan P Buchbinder; Ling C Hsu Journal: Open Forum Infect Dis Date: 2022-06-24 Impact factor: 4.423
Authors: F Hovaguimian; E Martin; M Reinacher; M Rasi; A J Schmidt; E Bernasconi; E Boffi El Amari; D L Braun; A Calmy; K Darling; V Christinet; C Depmeier; C Hauser; S Läuchli; J Notter; M Stoeckle; B Surial; P Vernazza; P Bruggmann; P Tarr; D Haerry; R Bize; N Low; A Lehner; J Böni; R D Kouyos; J S Fehr; B Hampel Journal: HIV Med Date: 2021-10-03 Impact factor: 3.094
Authors: Catherine A Koss; Edwin D Charlebois; James Ayieko; Dalsone Kwarisiima; Jane Kabami; Laura B Balzer; Mucunguzi Atukunda; Florence Mwangwa; James Peng; Yusuf Mwinike; Asiphas Owaraganise; Gabriel Chamie; Vivek Jain; Norton Sang; Winter Olilo; Lillian B Brown; Carina Marquez; Kevin Zhang; Theodore D Ruel; Carol S Camlin; James F Rooney; Douglas Black; Tamara D Clark; Monica Gandhi; Craig R Cohen; Elizabeth A Bukusi; Maya L Petersen; Moses R Kamya; Diane V Havlir Journal: Lancet HIV Date: 2020-02-19 Impact factor: 12.767