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There is no one-size-fits-all approach to EtE initiation and implementation, although there are some commonalities across plans. Successful planning usually involves partnership and shared leadership between community leaders, activists, service providers, representatives from academic institutions, and public health officials. Frequently, the first step is setting up an initial large planning meeting to establish community leadership, develop partnerships with other key stakeholders, and develop a plan of action for drafting a broader EtE plan. From there, a jurisdiction can determine the best way to develop a written strategy—such as the formation of a multi-stakeholder task force— mobilize community and key stakeholders and, ultimately, gain political support.

Examples of specific timelines from New York and Houston’s EtE initiatives are highlighted on the next page.

Most plans contain the following elements:

  • Defined, quantifiable targets for ending HIV/AIDS as an epidemic in your city/county/state. Clear, evidence-based objectives are essential for all EtE plans.
  • Cost and cost savings modeling: in order to get political buy-in for an EtE plan, it’s important to determine what financial resources are needed for an EtE initiative to be implemented, as well as estimating the short- and long-term savings to the healthcare system for each infection averted. Click here for some New York-focused resource estimates drafted by TAG and Housing Works.
  • Specific recommendations/objectives for:
    • HIV prevention
    • Access to care and treatment
    • Surveillance and data
    • Addressing structural and social barriers
  • Strategies for implementing the plan. As with all planning processes, it is essential to establish a timeline, specific tasks, and leadership for meeting the recommendations and facilitating ongoing engagement. Establishing ways to monitor and evaluate progress is also critical.
  • Community coalition building and participation in all aspects of plan development

The plan can serve as a blueprint or roadmap for achieving drastic cuts in new infections in your jurisdiction.

Each plan should be tailored to the needs of the people living with HIV and the communities most impacted in that state, county, or city. This has to include testing, treatment, and PrEP/PEP. In addition, many jurisdictions are implementing policies and programs to address structural and social drivers, like homelessness/housing instability (especially for LGBT youth), HIV criminalization, harm reduction/syringe access, healthcare access for transgender communities, etc. This is an essential component of EtE initiatives—communities cannot access treatment and prevention tools when there are significant barriers. Treatment and prevention plans developed by public health departments sometimes overlook these contextual issues, adding to the need for their inclusion in EtE plans.


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