SCALABILITY OF INTERVENTIONS

Scalability is the ability of a system, process, or intervention to adapt to meet a larger population in a cost-effective manner. HIV testing and condom distribution are scalable interventions implemented by each Nevada jurisdiction.

HIV testing is expected to be maintained at the same level, or increase annually, based on available resources and targeted priority populations. Jurisdictions are directed, based on the HIV testing strategies and processes listed above, to achieve at least a 1% positivity rate within funded testing activities and target 75-85% of tests to high-risk populations.

The partnership between the state Ryan White Part B, Southern Nevada Part A, the Southern Nevada Health District, and the state HIV Prevention Program of implementing the ARTAS intervention is an example of scaling up linkage to care initiatives addressing the vulnerabilities and needs of newly diagnosed individuals. This model is being reviewed for implementation in other jurisdictions in Nevada.

Provide counseling or referrals to voluntary family planning programs for women and men in HIV prevention, treatment and care programs—ideally at the same site.

Provide HIV prevention messaging and support, as well as HIV testing and counseling, within antenatal care, maternal and child health, and family planning programs for both men and women.

Ensure access to contraceptive commodities for HIV-positive clients who wish to delay or prevent pregnancy.

Develop and disseminate technical guidance materials related to HIV/FP and HIV/MNCH integration.

Strengthen the policy environment for appropriate integration of HIV with other health platforms, including FP and primary care.

Evaluate the efficiency and effectiveness of integrated service delivery, including HIV/FP and HIV/MNCH integrated services.

Support quality assurance efforts to improve integrated health services for women, importantly transgender.

Conduct operations or implementation science research on effective integration approaches.

Strengthen public health and primary health care systems, including commodity procurement, information systems, and logistics and distribution systems designed to improve the availability of HIV and FP commodities and to improve essential primary care and health maintenance services.

The principles of voluntarism and informed choice are prerequisites for good quality of care and must form the basis of integrated programs.

1. Provide condoms free of charge.

2. Conduct wide-scale distribution.

3. Implement a social marketing campaign to promote condom use (by increasing awareness of condom benefits and normalizing condom use within communities).

4. Conduct both promotion and distribution activities at the individual, organizational, and environmental levels.

5. Target:

a. Individuals at high-risk

b. Venues frequented by high-risk individuals

c. Communities at greatest risk for HIV infection

d. The general populations within jurisdictions with high HIV incidence.

6. Supplement the condom distribution program with more intense risk reduction interventions, or other prevention or health services, for individuals at highest risk. Integrate distribution program activities within other community-level intervention approaches to promote condom use and other risk reduction behaviors.

7. Establish organizations support for condom distribution and promotion activities in traditional and non-traditional venues.

8. Conduct community-wide mobilization efforts to support and encourage condom use.

DIRECT

CUSTOMER RELATIONSHIP

Gay Men

Men who have Sex with Men

Women

Straight Men

Transgender

Non-Gender Conforming

Transgender