Whitman-Walker Health Provides HIV Prevention to D.C.’s Most Vulnerable Populations

Whitman-Walker Health’s mobile unit provides HIV and STI testing and educational materials about PrEP and other types of prevention.Whitman-Walker Health HRSA BPHC exit disclaimer (WWH) provides primary care, behavioral health, dental care, pharmacy, and supportive services aimed at engaging and retaining patients in HIV and primary care. WWH is dually funded by HRSA’s Health Center Program and Ryan White HIV/AIDS Program with five locations in the District of Columbia, a city with high HIV prevalence rates.

Approach

WWH provides HIV outreach, testing, prevention, and treatment to thousands of patients each year, serving populations most at risk for HIV infection. They provide comprehensive and integrated care to all patients, regardless of HIV status. All staff are trained on HIV care and treatment, how to discuss sexual histories with patients, and using culturally responsive and inclusive language that avoids stigmatizing behavior. Staff will discuss how navigating relationships in communities with high rates of HIV puts one at increased risk for infection and avoiding language characterizing certain behaviors as being “high risk.”

Outreach

WWH provides targeted outreach and testing services in the community utilizing its mobile testing van program. The WWH mobile testing van visits 10 plus sites around the DC Metro area every month and conducts HIV testing clinics. A major component of this outreach focuses on grocery stores, youth hang-outs, and clubs, making this strategy an important one to help identify individuals with HIV and link them to care. Health center staff distribute palm cards about Pre-exposure Prophylaxis (PrEP) and non-occupational post-exposure prophylaxis (nPEP) to educate the community about HIV prevention. WWH outreach addresses barriers to PrEP and HIV care, such as medication side effects, payment for testing and medications, and where to get services. WWH has an active youth peer outreach program to reach youth aged 13-24. Trained youth peer educators provide HIV, STI, and pregnancy education to their peers. These roles are an effective outreach tool and also serve to launch career paths and increase college attendance for the youth peer educators.

Testing

WWH encourages quarterly screening for HIV and other sexually transmitted infections. The two main health center clinics and WWH’s Freestyle Peer Education Center offer free, walk-in HIV/STI testing and counseling daily, during regular business hours. Prevention counseling provides individuals with an individualized, client-centered risk reduction plan, which supports each client in lowering their risk for HIV infection/transmission. It augments HIV testing by empowering each person with education, options, and strategies to help stem infection rates. In addition, WWH offers a free, walk-in HIV and STI testing and same day-PrEP at their twice-weekly evening sexual health clinic. Self-test kits are used to increase patient privacy and reduce barriers to testing. Primary care patients are encouraged to all be screened annually for HIV based on sexual activity, engagement in survival sex, relationship power imbalance, and history of HIV and STIs exposure.

Prevention

PrEP conversations begin early in the patient’s engagement with the clinic, during HIV and STI screening, and continue through their primary care experience. PrEP navigators are available for assistance with insurance, benefits, appointments, and medication adherence. Candidates receive provider assessment and counseling, same-day phlebotomy, and an initial 30-day prescription. Both sites have a 340B pharmacy, and medication payment assistance is available to those who do not have coverage. PrEP clinic is available for follow-up visits, which is a concierge-level service, providing quick access to quarterly visits, labs, and dispensing medication.

WWH’s PrEP program has grown from 20 patients in 2013 to a current average of 70 to 80 new PrEP patients a month and 2,000 patients a year; 65% of PrEP patients are retained during the year.

HRSA visits WWH

A team from HRSA, including Health Center Program Chief Medical Officer Dr. Judy Steinberg, visited Whitman-Walker Health in D.C. to learn more about what health centers can do to prevent HIV and end the epidemic. During our visit to WWH, our team interviewed a PrEP patient, a clinician who prescribes PrEP, and a PrEP navigator. Hear more about WWH's HIV outreach, testing, and prevention program from those who know it personally.

 

Date Last Reviewed:  June 2019


More Information

HRSA HIV Webpage

Whitman-Walker Health’s Outreach Language and Materials HRSA BPHC exit disclaimer

Health center's Uniform Data System (UDS) data

For more information about this promising practice, contact: Megan Coleman, Family Nurse Practitioner, Director of Community Based Research