ZERO is Possible Initiative
Introduction
Over the course of three decades, Human Immunodeficiency Virus (HIV) has gone from being a mysterious terminal illness, to a medical challenge inspiring massive global mobilization, to its current reality as an understood and very manageable chronic health condition. Similarly, Hepatitis C (HCV) holds the title of “the fastest viral disease ever to be identified and cured,” with just 25 years between its discovery in 1989 and availability a 90% effective curative treatment in 2014. (source)
Today, we are equipped with the knowledge and resources to end the HIV epidemic and eliminate HCV. Expert stakeholders from throughout the state have contributed their knowledge and passion to advancing this work, by collaborating on this statewide initiative to help make ending the HIV epidemic and eliminating HCV achievable goals for Indiana.
Zero is Possible: Indiana’s Plan to End HIV and Hepatitis C (ZIP-IN Plan) represents a collaborative effort, informed by healthcare and community partners across the state, and is aligned with the national Ending the HIV Epidemic: A Plan for America (EHE) and the Viral Hepatitis National Strategic Plan for the United States: A Roadmap for Elimination, 2021-2025. The ZIP-IN Plan presents an approach to collectively address HIV and HCV, due to the shared high-risk populations, barriers to treatment, healthcare providers and community support networks, and opportunities to develop a comprehensive, whole-person approach to patient care, counseling, and treatment. The strategies within the ZIP-IN Plan were developed in consultation with a wide array of healthcare providers, community partners, and people with lived experience, who participated in listening sessions, focus groups, surveys, and technical workgroups over a research and planning period spanning more than a year.
Plan Input
The ZIP-IN Plan was developed in 2020 with input from over 300 individuals and 100 agencies. The comprehensive process included:
10 Regional Listening Sessions with Continuum of Care (CoC) regions across the state, 130+ attendees
7 CBOs covering 9 CoC Regions gathered input from community members with lived experience through the Community Voice Project
44 key informant interviews to gather perspectives on priorities and interests
3 IDOH staff Listening Sessions with a total of 46 staff
69 IDOH HIV/STD/VH Division Staff completed a Culture and Capacity Survey
Attended and observed meetings, conferences, trainings and events (CoC meetings, CAG meetings, Harm Reduction Coalition meetings, HCV and HIV Project ECHO sessions)
Incorporated data and recommendations generated through the Marion County EHE Planning ProcessConsulted Statewide Consumer Needs Assessment of PLHIV report (December 2019) and other relevant documents and plans
Collected and analyzed statewide and regional EHE and HCV indicators Mapped county of residence of clients engaged in services, by provider to better understand service utilization patterns
Conducted environmental scan of resources for PLHIV and PLHCV (29 agencies completed survey, compiled data for a total of 205 organizations)
~300 stakeholders included on Planning Contact list
Alignment with National Goals
The ZIP-IN Plan goals are aligned with the national Ending the HIV Epidemic plan, as well as the Viral Hepatitis National Strategic Plan.
Ending the Epidemic: A Plan for America has a goal of reducing new HIV infections by 75% in five years and by 90% in 10 years. To achieve these goals, the plan focuses on four key strategies that together can end the HIV epidemic in the US: Diagnose, Treat, Prevent, and Respond.
To measure success, Ending the Epidemic: A Plan for America proposes the following indicators:
The Viral Hepatitis National Strategic Plan for the United States: A Roadmap to Elimination sets forth a clear vision for how the US will be a place where new viral hepatitis infections are prevented, every person knows their status, and every person with viral hepatitis has high-quality healthcare and treatment and lives free from stigma and discrimination. In pursuit of this vision, the Hepatitis Plan has established five primary goals:
Prevent new viral hepatitis infections
Improve viral hepatitis-related health outcomes of people with viral hepatitis
Reduce viral hepatitis-related disparities and health inequities
Improve viral hepatitis surveillance and data usage
Achieve integrated, coordinated efforts that address the viral hepatitis epidemics among all partners and stakeholders
To measure success, Viral Hepatitis National Strategic Plan for the United States: A Roadmap to Elimination proposes the following indicators: