Supporting HIV Programs During the COVID-19 Pandemic Response

Like everyone else across the country and the globe, we are adjusting the way we work and responding as best we can to meet the needs of our clients and partners working on the frontlines of the COVID-19 pandemic response, including those who are simultaneously working to end the HIV epidemic. 

Through our work with Ryan White HIV/AIDS Program (RWHAP) recipients and providers, health departments, community-based organizations, and HIV planning groups, we hear about the effects of COVID-19 on HIV service delivery and program management, how programs are adapting, and where gaps remain. In response, JSI is developing resources, facilitating opportunities for peer-to-peer learning, sharing best practices for virtual engagement, and collaborating with federal partners and other key stakeholders to document and meet the needs of HIV programs across the country. Here are a few examples of what we are hearing and how we are responding:

• Through our Planning CHATT project, we’ve heard how RWHAP planning councils and planning bodies (PCs/PBs) are struggling to conduct legislatively mandated activities because they are not able to meet in person. Some jurisdictions have been able to relax in-person meeting regulations, but conducting virtual meetings presents new challenges for participation, including lack of home internet and computers and insufficient minutes on cell phone plans to accommodate increased use. PCs/PBs have an essential role in designing an equitable service system for people with HIV, the importance of which is only heightened during this pandemic response. COVID-19 is further exposing and compounding the same health inequities and disparities our HIV response has been dealing with for 40 years. We convened the planning council support staff in each RWHAP Part A jurisdiction to understand their ability to operate virtually and to share strategies and resources to plan HIV services remotely.
  
• Through multiple engagement points with RWHAP recipients and subrecipients, we know they are concerned about how COVID-19-related job losses are disrupting health care access. In response, we compiled information about Special Enrollment Periods to share with RWHAP providers and stakeholders through our ACE TA Center project, which supports access to health care coverage for people living with HIV. We also took time during an ACE TA Center webinar in April on Medicare basics for RWHAP clients to highlight potential sources for continued health care coverage during transitions, which many people with HIV are facing because of COVID-19’s affect on employment and other life events. Options discussed included Medicare, Marketplace Special Enrollment Periods, Medicaid, and the Children’s Health Insurance Program, as well as the availability of financial support for premiums and out-of-pocket costs through the RWHAP.  
• Through the Special Projects of National Significance initiative Strengthening Systems of Care for People with HIV and Opioid Use Disorder (OUD), we’ve heard how access to syringe services has been curtailed by COVID-19, as well as how harm reduction programs are adapting to meet the needs of people who use drugs. For example, programs are shifting from indoor, fixed-site models to outdoor, delivery, and mail-based models. Some have been able to relax or remove policies, such as 1:1 syringe exchange, that can limit the number of syringes a program is able to distribute to clients. During a recent webinar for the nine states partnering with JSI on this project, we heard about other challenges and solutions to provide services, such as shifting to telehealth appointments, ensuring staff on the frontlines have personal protective equipment and the value of increased communication with clients during this difficult time. We are monitoring these adjustments to assess their effect on service delivery for people with HIV and OUD and inform our ongoing work to enhance system-level coordination and networks of care.

The COVID-19 pandemic has not diminished the importance of responding to the HIV epidemic. In fact, COVID-19 has exacerbated persistent challenges to our efforts. However, it has also demonstrated that our decades of experience with the HIV epidemic and the infrastructure, programs, and workforce established in response can guide the current pandemic response.  We will continue to highlight how HIV programs across the country are responding, what we are learning from their experiences, and how our services are adapting and expanding alongside our clients’ and partners’ needs.

Written by: Aisha Moore, Project Director, and Gretchen Weiss, Senior Consultant