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 biomedical intervention to prevent HIV infection.  PrEP is a six-prong intervention for people who are HIV negative that includes: 1) taking one pill once a day; 2) periodic HIV testing; 3) counseling about the use of condoms to prevent STIs; 4) education about harm reduction options; 5) STI testing; and 6) counseling to promote adherence to the once-a-day PrEP medication.

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, 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 to just 750 by the end of 2020. These milestones include:

(a) a negotiated medicaid payment for PrEP;

(b) funding an ongoing PrEP consumer awareness campaign (see www.PrEPforSex.org for details);

(c) implementing a PrEP Assistance Program (PrEP-AP), to provide reimbursement for monitoring and care services delivered to uninsured and underinsured persons on PrEP;

(d) publishing an MMWR Article: “Vital Signs: Increased Medicaid Prescriptions for Preexposure Prophylaxis Against HIV Infection – New York, 2012 – 2015” showing PrEP use by Medicaid-insured persons increased substantially in the years following statewide efforts to increase knowledge of PrEP among potential prescribers and candidates for PrEP;

(e) conducting the Targeted PrEP Implementation Project (TPIP) assessed PrEP implementation in “real world” clinical settings (report available at www.health.ny.gov/diseases/aids/providers/reports/docs/prep_implementation.pdf);

(f) identifying at least one PrEP prescriber in every county of the State, publicly posted at www.health.ny.gov/diseases/aids/general/prep/provider_directory.htm;

(g) funding PrEP Specialists within clinical settings to reach and engage individuals within communities most vulnerable to HIV infection;

(h) funding the PrEP Detailing Project which exceeded the goals set for educating clinical and nonclinical providers on PrEP implementation; and

(i) publishing the PrEP Clinical Guideline “PrEP To Prevent HIV Acquisition” at https://www.hivguidelines.org/prep-for-prevention/prep-to-prevent-hiv/#tab_0 along with corresponding collateral materials to facilitate usage of guideline recommendations.

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.

Post-exposure Prophylaxis (PEP)

Post-exposure Prophylaxis (PEP) is medicine that can be taken by an HIV-negative individual that has been exposed to HIV. If PEP is taken as directed and taken as soon as possible after exposure, it can stop the HIV virus from infecting the individual’s body.

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:

(a) calling on all emergency departments in NYS to have a PEP policy and procedure in place which includes having ARV medications available on site;

(b) 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;

(c) 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); and

(d) negotiating an expedited process for patients on NYS Medicaid to receive their PEP medication.