According to Toyin Adeyemi, MD, an infectious disease specialist who is Cook County Health's ( CCH ) senior director of HIV services, the statewide Getting to Zero initiative, aimed at virtually eliminating new HIV transmissions in the state by the year 2030, has given way to a number of healthcare-delivery changes at CCH.
Those changes, Adeyemi explained, are intended to ease patient access for prevention and treatment services.
"For the first time, we have a Cook County integrated HIV program, where all of our programming is combined," she said. "We have six different sites where we provide HIV care, but we're harmonizing our best practices and making sure that our patients who are seen anywhere in our health system can get the same quality primary, HIV prevention and specialty care, either close to home or close to work."
Adeyemi's organization has a major role to play among service providers in Cook County. Its HIV integrated programs care for one in four persons living with HIV in the county, as well as one in six persons living with HIV in the state. The system's Ruth M. Rothstein CORE Center cares for about 5,000 persons annually, which is one in five Chicagoans with HIV.
The overall goals of the Getting to Zero initiative are getting 20 percent more people with HIV in the state virally suppressed—at which they'll have effectively zero percent chance of transmitting the virus—and 20 percent more percent more Illinoisans who are eligible to use the PrEP ( pre-exposure prophylaxis ) intervention to do so. CCH has visioned about 22 long-term goals, and 78 long-term strategies, in addressing HIV prevention and treatment.
The more clients that can be linked to the county's continuum of healthcare, Adeyemi said, the more they'll be engaged in their own care in the long term. "We find people through emergency rooms or outreach efforts, to connect them to a site that is convenient for them, which is a big part of [increasing] access," she added.
Another important part of the CCH initiative has been the availability of asymptomatic STI screening at CCH's 14 ambulatory clinic sites: "I do a lot of training with the providers … to be able to provide to offer walk-in testing and also have PrEP 'champions and ambassadors' at those sites so we can, at every STI treatment or testing encounter, have the opportunity to offer PrEP, because we need to increase [its] uptake throughout the health system," Adeyemi said.
Indeed, the county has a number of regional PrEP coordinators, so that even if a site does not offer PrEP-related services, its healthcare providers can engage the coordinators to connect patients to those services at a convenient location. Adeyemi also said that persons who test positive for HIV can often be linked to anti-retroviral medications the same day if they so choose. CCH doubled down on increasing the speed of Medicaid and insurance determinations to ensure that there are fewer interruptions in therapy for patients; such interruptions, Adeyemi added, "are a big part of why people are not becoming suppressed."
Another component, one that has only recently become a focus of HIV service providers, is addressing the needs of long-term survivors of HIV, who often face complications in conjunction with social isolation.
"We already have a program in place, the [CORE] Healthy Aging Initiative for seniors living with HIV, so we are going to be a part of leading that effort," Adeyemi said.
For more information, see cookcountyhealth.org/service/hiv-aids-program/ or call 312-572-4500 .
