Strategic Planning

AIDS Institute Strategic Planning

In 1989 the initial AIDS Institute strategic plan built the foundations of infrastructure, programming and the overarching continuum of care. The AI has since then worked from that foundation. The most recent update occurred in 2016 and the Strategic Profile that was created through that process summarizes the future direction of the New York State AIDS Institute for 2016 through 2020.

The Strategic Profile is an active, living tool with an increased focus on outcomes and evidence based practices. The strategic planning process is on-going at all levels of staffing.  The plan addresses infrastructure, financing, programming and policy. The plan is consistently evaluated.

Strategic Planning Profile

This Strategic Profile summarizes the future direction of the New York State AIDS Institute for 2016 through 2020. It includes the following major elements of the Institute's strategic plan:

  • Mission
  • Vision
  • Core Values
  • Guiding Principles
  • Strategic Map
  • Annual Strategic Priorities

AIDS Institute Annual Priorities

In addition to the strategic plan, the AIDS Institute reviews relevant public health concerns and priority populations on an annual basis and develops annual priorities in response. The 2017-2018 Priorities include:

  • Priority 1:  Increase HIV viral load suppression among Persons Living with HIV/AIDS (PLWHA)
  • Priority 2:  Reestablish a coordinated effort to reduce new HIV and STD infections among gay men and MSM, and transgender individuals.
  • Priority 3: Enhance statewide public health efforts addressing Hepatitis C Virus (HCV).
  • Priority 4: Address sexual health awareness, education, and treatment and care options for STDs, with increased focus on youth and young adults.
  • Priority 5:  Promote interagency collaboration to improve drug user health, with a specific focus on expanding access to sterile syringes, increasing safe syringe disposal resources and preventing overdose deaths.
  • Priority 6:  Increase access to PrEP and nPEP for individuals engaged in high-risk behaviors
  • Priority 7: Ending the Epidemic (ETE) in New York State

AIDS Institute Strategic Planning Champions

The Strategic Planning Champions are AIDS Institute staff that meet monthly to provide input into the implementation of the Strategic Plan within the AIDS Institute.  The Champions also bring information pertaining to executive office level strategic planning activities back to each Division and Office to both inform and elicit support for these efforts. AI Strategic Planning Champions have a genuine interest in strategic planning and are excited to champion these efforts with their colleagues.

Pre-Exposure Prophylaxis (PrEP)

Pre-exposure prophylaxis (PrEP) is a cornerstone of HIV prevention. However, it is underutilized, particularly by communities disproportionately affected by HIV.

Ending the AIDS Epidemic in NYS: Implemented in April 2015, the NYS Blueprint to End the AIDS Epidemic by 2020 presents recommended strategies from the Ending the Epidemic Task Force to achieve the first ever decrease in HIV prevalence and end the AIDS epidemic in New York State by the end of 2020. Toward that end, the 3-point plan calls for:

  • Identifying individuals with undiagnosed HIV.
  • Linking and retaining them in care that includes fully suppressive antiretroviral therapy.
  • Facilitating access to PrEP as a proven strategy to prevent HIV acquisition among individuals at high risk.

Access to PrEP as a pillar of this initiative emphasizes the safety and effectiveness of PrEP as a method to prevent HIV. Through years of experience and a growing body of evidence, it is now understood that individualization is key to increasing PrEP uptake. Individualized PrEP means:

  • Same-day initiation (not needing to wait for test results to start)
  • Daily or on-demand dosing (for cisgender men who have sex with men)
  • Truvada or Descovy (for cisgender men who have sex with men and transgender women; data are lacking for other populations)
  • Frequency of follow up visits can be modified
  • Alternative routine testing sites. While 3-month testing for HIV and STIs remains the standard, in-person visits to the doctor are not required and can take place at alternate sites. Self-collected swabs are a reasonable alternative.

The AIDS Institute conducts activities to increase availability of PrEP to all New Yorkers and beyond though on-going comprehensive strategic planning and implementation science processes, and can be categorized into five themes: (1) scientific groundwork; (2) regulatory/policy/financial groundwork; (3) stakeholder and infrastructure groundwork; (4) delivering PrEP; and (5) long-term monitoring. Specific efforts within each theme are organized and implemented based on the needs of key populations served (men who have sex with men, transgender and gender nonconforming persons, injection drug users (IDUs), HIV-negative partners in a sero-discordant sexual relationship; persons that have had multiple courses of non-occupational post-exposure prophylaxis (nPEP); and heterosexual women in areas of elevated seroprevalence); as well as geographic needs across the state.

Since the establishment of coordinated PrEP-related activities back in 2009, the AIDS Institute has achieved a wide variety of milestones through a statewide prevention strategy that aligns with the Ending the Epidemic Blueprint goal of reducing the number of new HIV infections. These milestones include the collection of community input; conducting community research and implementation studies; media campaigns; changes to public health laws and regulations; development of PrEP metrics; interactive data tools; and clinical best practices which, through regular surveillance of evidence and contributions of clinical experts, have evolved into a robust set of clinical recommendations. Read about these accomplishments and more in the latest Ending the Epidemic Activity Report.

Successful widespread implementation of PrEP requires collaboration between clinical providers, HIV testing programs, prevention programs and support services providers. AIDS Institute funded agencies are charged with establishing and maintaining a community network tasked with developing a PrEP care continuum that is responsive to community need, solidifies area capacity, and effectively and efficiently leads potential clients to engagement in PrEP services. Through this dedicated work, New York State leads the nation in % PrEP coverage (defined as number of persons prescribed PrEP / number of persons with PrEP indications) at 41.1%, per the CDC’s May 2020 HIV Surveillance Supplemental Report. The state with the next highest % PrEP coverage is Massachusetts at 33.4%.

Post-exposure Prophylaxis (PEP)

Post-exposure Prophylaxis (PEP) is medicine prescribed in emergency situations that can be taken by an HIV-negative individual that has been exposed to HIV. It is best to take it as soon as possible after exposure to HIV - ideally within 2 hours and not longer than 72 hours - because PEP is more effective at stopping the HIV virus from infecting the individual’s body the earlier it is taken.

The AIDS Institute has maintained clinical guidelines for the initiation of PEP since the late 1980’s. As scientific evidence has developed, the AIDS Institute has responded by issuing updates to the NYS clinical guidelines, which now include specific clinical recommendations to respond to occupational exposures, non-occupational exposures, and sexual assault (available at https://www.hivguidelines.org/pep-for-hiv-prevention/). Because treatment for exposure to HIV is urgent, the AIDS Institute continually works to increase timely access to PEP. These efforts include:

  • providing consumers with fast access to knowledgeable PEP providers through the NYS PEP Hotline: 844-737-4469 (24/7). The NYC PEP Hotline can also be reached 24/7 at 844-3-PEPNYC (844-373-7692);
  • connecting clinicians in NYS with PEP specialists through the NYS Clinical Education Initiative (CEI) Line: 866-637-2342;
  • calling on all emergency departments in NYS to have a PEP policy and procedure in place which includes having ARV medications available on site;
  • exploring best practices of implementing PEP in pharmacy settings as an additional point of access to PEP for New Yorkers, following the March 14th, 2017, NYS Board of Regents amendment to regulations allowing licensed pharmacists who are acting under a non-patient specific standing order from a licensed physician or nurse practitioner to dispense 7 days of PEP medication to individuals who present with a recent exposure to HIV; and
  • developing and disseminating resources for consumers to increase awareness of PEP (available at https://www.health.ny.gov/diseases/aids/general/prep/index.htm#pep).