PH-10-1-Strategic Plan Review

Division of HIV/AIDS Prevention Strategic Plan 2017 - 2020

DHAP Strategic Plan 2017-2020

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Message from Director

The Division of HIV/AIDS Prevention (DHAP) is pleased to present its updated Strategic Plan 2017–

2020. This Plan is DHAP’s blueprint for achieving its vision of a future free of HIV. The Plan

encompasses the strategic aspects of the Division’s work and will continue to serve as a practical

guide to inform the work and to ensure DHAP activities and resources are aligned with its priorities.

The Plan was updated to reflect the important advances made in prevention science, including—but

not limited to—the discovery of and increased use of pre-exposure prophylaxis (PrEP) as a highly

effective tool in HIV prevention; the identification of new interventions as part of the High-Impact HIV

prevention approach; the development and implementation of new testing technologies; and focused

efforts to improve outcomes along the HIV care continuum. The Plan emphasizes maximizing

DHAP’s impact, increasing internal and external coordination and collaboration, and ensuring

strategic allocation of resources. In this Plan, the Division also recognizes the need to remain flexible

as prevention science continues to evolve.

At the start of the strategic planning process, the Division updated the following high-level prevention

goals designed to guide its HIV prevention efforts:

• Prevent new HIV infections

• Improve health outcomes for persons living with HIV

• Reduce HIV-related disparities and health inequities

• Continually improve effectiveness and efficiency of operations

These goals align with national HIV prevention goals. In addition, the Division identified key objectives

and strategies to help in focusing its work on strategic efforts needed to advance these goals and to

attain a future free of HIV.

In developing these goals, objectives, and strategies, DHAP acknowledges that a range of social,

economic, and demographic factors make some Americans more vulnerable to HIV infection and,

once infected, to inadequate care. The Plan underscores the important role of partnerships in both

reducing HIV incidence and addressing these disparities that persist among populations and within

communities.

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To chart progress towards reaching these goals, DHAP has developed quantitative indicators that are

ambitious, yet feasible. Tracking these indicators will provide the Division with important data to

inform its planning and program activities, inspiring action in areas where improvement is needed.

The Division will continue to strive, working closely with its partners, to better use the data available at

local, state, and national levels to drive its actions, to inform priority setting, and to direct

programmatic and scientific endeavors. DHAP looks forward to collaborating with federal, state, and

local organizations to achieve the goals in this plan and mark progress towards a future free of HIV.

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Introduction

CDC has been at the forefront of HIV prevention efforts since the virus first emerged as a health

threat, and CDC maintains its leadership role in working towards a future free of HIV in the United

States. While the nation has come a long way, HIV continues to affect millions of individuals in the

United States. CDC’s latest estimates suggest that about 38,000 new infections occur each year and

that 1.1 million persons in the United States are now living with HIV. Of those 1.1 million, an

estimated 15%, or 1 in 7 persons, remain unaware of their infection. Analysis of surveillance data

continues to reveal dramatic disparities in rates of HIV infection—and in achieving key healthcare

objectives—among populations and by geographic region.

Since the release of the 2010 DHAP Strategic Plan, more HIV prevention tools have been developed

to help reduce new HIV infections and achieve national HIV prevention goals. Making the most out of

powerful biomedical prevention options, such as pre-exposure prophylaxis (PrEP) and antiretroviral

therapy (ART), requires that DHAP refines its strategies to best promote the use of these options.

Recently released HIV prevention modeling suggests that achieving national HIV prevention goals of

linkage to care, retention in care, and viral suppression (85%, 90%, and 80%, respectively), in

combination with the increased use of PrEP, would avert 185,000 new infections by 2020.

Already, CDC, the U.S. Department of Health and Human Services (HHS), and U.S. Preventive

Services Task Force (USPSTF) have produced updated recommendations that incorporate these

prevention tools. CDC developed guidelines and released recommendations focused on improved

screening of persons’ behaviors that could transmit HIV; use of ART for improving health and for

preventing HIV transmission; and encouraging providers to inform persons at high risk for HIV

infection about the availability of PrEP.

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In the updated DHAP Strategic Plan, DHAP will work closely with national, state, and local partners to

ensure that 1) HIV testing is simple, available, and routine; 2) persons living with HIV have their

infection diagnosed, are linked to care, and have access to the support services they need to stay

virally suppressed; and 3) persons at high risk for HIV infection have the prevention information and

tools needed to protect themselves from infection.

DHAP also knows that it must prioritize efforts to reduce HIV-related health disparities and inequities.

To address these disparities requires that DHAP focus prevention efforts on disproportionately

affected populations and work towards reducing stigma and discrimination associated with HIV

infection. DHAP must work collaboratively with federal agencies, including the Health Resources and

Services Administration (HRSA), the Substance Abuse and Mental Health Services Administration

(SAMHSA), the U.S. Department of Housing and Urban Development (HUD), and others, to support

structural approaches to HIV prevention and care. Specifically, DHAP will support efforts to link

persons at high risk of transmitting HIV to support services designed to address structural barriers

that impact HIV prevention and care, including unstable housing, lack of education or employment,

and lack of adequate food to eat. These collaborations can maximize the effectiveness of HIV

prevention services and support optimal health outcomes.

Finally, in this plan, DHAP recognizes the need to remain flexible as prevention science continues to

evolve, and acknowledges the need to be prepared to integrate new strategies and implement new

tools, to further advance the public health response to HIV in the United States.

DHAP Strategic Plan 2017-2020

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Mission and Vision

Vision: A future free of HIV

Mission: To promote health and quality of life by preventing HIV infection and reducing HIV-related illness and death in the United States

DHAP Strategic Plan 2017-2020

Centers for Disease Control and Prevention National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention

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Core Values

Collaboration

Ensure cross-branch, office, and division, federal inter­

agency, and external partner interactions (e.g., science

activities, knowledge sharing).

Diversity

Recruit and maintain an inclusive and multi-disciplinary

workforce

Equity

Work to achieve optimal health for the populations we serve

Excellence

Achieve the highest standard of performance in science,

program, and policy

Innovation

Create an environment that encourages and values new

ideas

Integrity

Be accurate, consistent, honest, and accountable for

decisions and actions

Respect

Treat persons with professionalism and dignity;

value diversity and differences of opinion

Stewardship

Be a diligent steward of the use of resources to achieve

DHAP's public health mission

Transparency

Effectively and appropriately communicate to staff, partners,

and the public about our programs, policy, and science

DHAP Strategic Plan 2017-2020

Centers for Disease Control and Prevention National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention

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Core Functions

Core functions are essential, foundational activities that DHAP engages in to monitor the trends in

HIV; implement and evaluate prevention programs; communicate priorities, information, and guidance

to stakeholders and external partners; and support efficiency in the management and operations of

the Division. DHAP core functions are as follows:

Surveil lanee

Research and Development

Policy, Planning, and

Communications

Program Implementation, Evaluation, and

Capacity Building

Resource Management

DHAP Strategic Plan 2017-2020

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Goal 1: Prevent New HIV Infections

Over the past 5 years, advances in HIV testing services—such as delivery of couples’ counseling and

testing for gay, bisexual, and other men who have sex with men (MSM); increased routine screening

in clinical settings; and promotion of repeat testing for persons at ongoing risk for infection—have

been associated with increased uptake of testing in the United States (CDC, 2013). From 2008 to

2014, the proportion of persons with undiagnosed HIV infection decreased by an estimated 3.4% per

year. In 2014, 15% of persons living with HIV (PLWH) did not know they were infected. CDC will

continue to prioritize identifying all PLWH who do not know they are infected and ensuring that

persons at high risk of acquiring HIV have the biomedical and behavioral tools they need to protect

themselves from acquiring HIV infection.

The estimated annual HIV infections in the United States declined 18% from 2008 to 2014, in large

part because of federal HIV prevention and care efforts. CDC will continue this work to increase

provision and uptake of comprehensive HIV prevention services, including high-impact behavioral

and biomedical interventions, for all Americans and with a particular focus on persons at high risk of

acquiring HIV. CDC will also provide resources to health care providers to facilitate access to these

critical prevention tools. CDC will continue to develop communication campaigns and partnerships to

ensure that everyone knows the facts about acquisition and transmission of HIV, is aware of their HIV

status, and has access to tailored information and HIV prevention interventions to protect themselves

and their partners. CDC will also continue to conduct research on, and implementation of, highly

effective behavioral interventions.

To work towards achieving the goal of preventing new HIV infections, DHAP will prioritize the

following primary prevention efforts:

• Diagnosing HIV infections by making HIV testing easy, accessible, and routine, including

increasing adherence to 2006 HIV screening recommendations.

• Increasing knowledge of, use of, support for, and adherence to PrEP and non-occupational

post-exposure prophylaxis (nPEP) for persons who could benefit from these regimens.

• Working to prevent HIV infections in communities experiencing increased injection drug use

and related risk of HIV transmission.

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Note. Recent policy changes, likely due to national trends in opioid and heroin misuse, may

result in greater use of syringe services programs.

• Ensuring persons have access to condoms and effective behavioral interventions, so they

have the tools needed to protect themselves from becoming infected with HIV.

• Increasing awareness of HIV, reducing HIV-related stigma, and promoting HIV testing and

proven HIV prevention strategies through key communication campaigns and messaging

among populations most affected by HIV.

• Conducting research designed to identify innovative, cost-effective, and high-impact prevention

strategies needed to protect persons most at risk of HIV infection.

Goal 1 and its corresponding objectives and strategies will help ensure that all PLWH know their

status and that those persons at high risk of acquiring HIV have access to the key risk-reduction tools

that they need to stay healthy.

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Goal 1: Prevent New Infections

O bj

ec tiv

es Increase the percentage of persons living with HIV who know their

serostatus to at least 90%

Increase the number of persons who are using PrEP by 500%

St ra

te gi

es

Increase use of high-impact prevention strategies for communities that are at highest risk for HIV infection

Support development of new—and the use of existing—technologies that will enhance early diagnosis and identify networks to target testing and prevention interventions to reduce risk of HIV transmission

Improve HIV screening in clinical settings, particularly in hospitals and hospital emergency rooms

Collaborate with partners to identify and address structural barriers to implementing routine opt-out HIV screening in clinical settings

Develop and evaluate behavioral and structural interventions that support biomedical prevention strategies

Expand availability, access, and uptake of—and improve adherence to—behavioral and biomedical interventions (e.g., PrEP, PEP, treatment)

Increase the proportion of providers who are aware of and prescribe PrEP

Strengthen collaboration with and leverage governmental and nongovernmental partnerships and establish new partnerships to increase testing and improve PrEP uptake

Develop and use evidence-based social marketing and education campaigns, and leverage digital tools and new technologies to reach gay, bisexual, and other MSM, particularly MSM of color and young MSM, and transgender persons

DHAP Strategic Plan 2017-2020

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Goal 1: Indicators of Progress

Aware of HIV status: Increase the percentage of persons living with HIV who know their serostatus to 90%. [National-level indicator #1]

Number of new diagnoses: Decrease the number of new HIV diagnoses by 25% among persons of all ages during the calendar year reported to CDC within 18 months of the diagnosis year. [National-level indicator #2; HP2020]

Use of PrEP (National-level developmental indicator): Increase the number of adults prescribed PrEP by at least 500%.

Late stage diagnosis: Decrease the percentage of persons aged ≥13 years with HIV diagnosed at stage 3 (AIDS) within 3 months after initial HIV diagnosis in a calendar year by 25%. [HP2020]

Nonsterile injection: Decrease the percentage of persons who inject drugs, are at risk for HIV, and use nonsterile injection equipment by 25%.

High-risk sex among HIV negative MSM: Decrease the percentage of MSM who engage in high-risk behaviors by 25%.

High-risk behaviors among young MSM: Reduce the percentage of young gay and bisexual males in grades 9–12 who have engaged in HIV risk behaviors by at least 10%. [National-level indicator #3]

DHAP Strategic Plan 2017-2020

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Goal 2: Improve Health Outcomes for Persons Living with HIV

Since 2003, reducing the transmission of HIV and improving health outcomes for PLWH has been a

cornerstone of DHAP’s prevention efforts. A growing body of evidence shows that the majority of HIV

infections in the United States could be averted by increasing the percentage of PLWH whose

infection has been detected and diagnosed and by ensuring they receive early, ongoing care and

treatment to become virally suppressed. Specifically, persons who had undiagnosed HIV infection

and persons with diagnosed HIV but not retained in medical care were responsible for 91.5% of the

estimated 45,000 HIV transmissions in 2009(Skarbinski et al., 2015).

Early linkage to care and treatment, especially when viral suppression is attained and sustained, is

positively correlated with better health outcomes, thus helping PLWH live longer, healthier lives and

lowering their risk of transmission of HIV to others. In the United States, the percentage of persons

with newly diagnosed HIV infection who were linked to medical care within one month of diagnosis

increased to 75% in 2015 (up from 70.2% in 2010). Viral suppression rates are improving. In 2014,

57.9% of persons with diagnosed HIV infection were virally suppressed (up from 46.0% in 2010). The

viral suppression rates for persons in medical care are higher. The annual rate of deaths per 1,000

persons living with diagnosed HIV infection has decreased from 19.4 in 2010 to 15.2 in 2014.

To work towards achieving the goal of improving health outcomes for PLWH, DHAP will prioritize the

following prevention efforts:

• Working with health departments and community-based organizations (CBOs) to improve

linkages to care and increase viral suppression rates in communities most affected by HIV.

• Examining new approaches, including studies of clinical, behavioral and structural

interventions, to help persons with HIV stay in care and adhere to their medications.

• Developing guidelines and launching educational campaigns to help health care providers

better support HIV testing, care, treatment, and prevention.

• Working with states to improve the completeness of their laboratory data and reporting of viral

suppression information.

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• Advancing efforts to use state and local public health information to identify persons living with

HIV who have fallen out of HIV medical care and work to link, engage, re-engage, and retain

them in care.

• Expanding Data to Care programs, targeting persons who have fallen out of care or never

entered care following an HIV diagnosis, and working to improve viral suppression among

those with a diagnosis of HIV infection.

• Expanding experience and developing guidance on investigating and intervening in growing

clusters of HIV infection.

• Expanding capacity to collect and analyze molecular data to all jurisdictions.

Goal 2 and its corresponding objectives and strategies will help in assuring that all persons with

diagnosed HIV are rapidly linked to, and remain engaged in, care to improve HIV-related health

outcomes, to reduce the impact of related comorbidities, and to reduce transmission of HIV to

uninfected persons. DHAP will also work closely with partners to ensure public health staff and

providers are working together to achieve viral suppression goals and to ensure PLWH are protected

from other infectious comorbidities.

Goal 2: Improve Health Outcomes for Persons Living with HIV

O bj

ec tiv

es Increase the percentage of persons with diagnosed HIV who are linked to care within one month of diagnosis

Increase the proportion of PLWH with sustained viral suppression

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es

Expand uptake of behavioral and structural interventions for PLWH to improve outcomes along the care continuum, particularly for engagement and re-engagement in care

Identify and support approaches to link newly identified HIV-infected persons to immediate treatment

Collaborate with partners and build strategic alliances between public health and clinical care sectors to optimize clinical care and prevention services for PLWH

Support integrated screening, prevention, and treatment programs for STD, viral hepatitis, and tuberculosis comorbidities that affect the health of PLWH

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Goal 2: Indicators of Progress

Linked to care: Increase the percentage of persons newly diagnosed linked to HIV medical care within 1 month of diagnosis to at least 85%. [National-level indicator #4]

Retention in care: Increase the percentage of persons with diagnosed HIV infection who are retained in HIV medical care to at least 90%. [National-level indicator # 5]

Viral suppression among persons living with diagnosed HIV infection: Increase the percentage of persons with diagnosed HIV infection who are virally suppressed to at least 80%. [National-level indicator #6]

Deaths: Reduce the rate of deaths among persons with diagnosed HIV infection by at least 33%. [National-level indicator #8]

High-risk sex among HIV-positive persons: Reduce the percentage of persons with diagnosed HIV infection who are engaging in HIV risk behaviors by 25%.

Homelessness: Reduce the percentage of persons with HIV medical care who are homeless to no more than 5%. [National-level indicator #7].

DHAP Strategic Plan 2017-2020

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Goal 3: Reduce HIV-related Disparities and Health Inequities

Despite intensive prevention efforts, DHAP’s HIV surveillance data show that certain populations and

geographical areas in the United States continue to be disproportionately affected by HIV. While there

are an expanding number of biomedical options for HIV prevention, certain populations will continue

to be at greater risk of HIV infection, because of disparate access to and use of medical care.

Because biomedical prevention options are delivered through a medical system that at risk persons

may not trust, be able to access, and/or be able to afford, they might not realize the full prevention

benefits of these tools. DHAP is committed to achieving health equity for all Americans affected by

HIV, by reducing HIV-related disparities and health inequities.

In 2015, despite representing only 2% of the population, MSM accounted for 67% of HIV diagnoses.

While annual HIV diagnoses among MSM and black MSM stabilized from 2010–2014, black MSM

remain disproportionately affected by HIV compared to MSM of other races/ethnicities and diagnoses

of HIV among Hispanic/Latino MSM increased. Although DHAP’s expanded and targeted testing

efforts have increased the number of persons who know their HIV status, far too many young people

are still unaware of their status. In 2014, the highest percentage of undiagnosed infections (44.4%)

was among persons aged 13–24 years. Regarding outcomes for persons living with HIV, 57.9% of

persons with diagnosed HIV were virally suppressed in 2014. However, young people (aged 13–24

years) compared to other age groups and blacks compared to other racial and ethnic groups had

lower rates of viral suppression. HIV was the 8th leading cause of death for persons aged 25–34

years.

To work towards reducing HIV-related disparities and health inequities, DHAP will prioritize the

following prevention efforts:

• Collecting and reporting data on HIV-related disparities;

• Developing interventions, partnerships, and communication efforts that increase capacity to

effectively deliver critical services to disproportionately affected key populations.

• Addressing the social and structural factors that can influence health outcomes.

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DHAP will target efforts to address HIV-related health disparities to the following populations: MSM,

especially young black and Hispanic MSM; persons who inject drugs; transgender persons; and

persons living in the southern United States.

Goal 3 and its corresponding objectives and strategies are designed to help DHAP in achieving its

health equity goals. Success in this area is contingent upon building key partnerships with

government partners, educational institutes, employment agencies, harm reduction organizations,

mental health services and substance use disorder treatment, and other social service agencies that

are primarily charged with addressing social and structural factors that lead to health inequities and

disparities.

Goal 3: Reduce HIV-related Disparities and Health Inequities

O bj

ec tiv

es

Reduce disparities in the rate of diagnoses

among (1) gay, bisexual men; (2)

young black gay and bisexual men;

(3) black women; and (4) persons living in

the South

Increase the percentage of youth and persons who

inject drugs who are virally suppressed

Reduce stigma and discrimination associated with the acquisition and

transmission of HIV

St ra

te gi

es

Increase the number of interventions available and trainings given to improve the capacity and cultural competency of providers and programs that deliver services to the most disproportionately affected populations, especially in the South

Develop, implement, and evaluate evidence-based interventions designed to reduce disparities in diagnosis, viral suppression, and access to PrEP, especially for MSM, young black and Latino MSM, black women, persons living in the South, and transgender persons

Establish and enhance partnerships to address misconceptions, stigma, and discrimination that impede HIV prevention and care for the most disproportionately affected populations, especially MSM of color and transgender persons

DHAP Strategic Plan 2017-2020

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Goal 3: Indicators of Progress

Disparity MSM: Reduce the disparity in the rate of new diagnoses in gay and bisexual men by at least 15%. [National-level indicator #9]

Disparity young black MSM: Reduce the disparity in the rate of new diagnoses in young black gay and bisexual men by at least 15%. [National-level indicator #9]

Disparity black women: Reduce the disparity in the rate of new diagnoses in black women by at least 15%. [National-level indicator #9]

Disparity South: Reduce the disparity in the rate of new diagnoses in the southern United States by at least 15%. [National-level indicator #9]

Viral suppression—Youth: Increase the percentage of youth with diagnosed HIV infection who are virally suppressed to at least 80%. [National-level indicator #10]

Viral suppression—PWID: Increase the percentage of persons who inject drugs with diagnosed HIV infection who are virally suppressed to at least 80%. [National-level indicator #10]

Viral suppression –Transgender (National-level developmental indicator): Increase the percentage of transgender women in HIV medical care who are virally suppressed to at least 90%.

Stigma (National-level developmental indicator): Decrease stigma among persons with diagnosed HIV infection by at least 25%.

DHAP Strategic Plan 2017-2020

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Goal 4: Continually Improve Effectiveness and Efficiency of Operations

DHAP recognizes that ensuring the efficiency and effectiveness of its programs is more than just

allocating resources and is committed to continually improving the systems and performance

management practices, and to strengthening the workforce and infrastructure needed for continued

success in reducing HIV infection in the United States.

To achieve the goal of continually improving effectiveness and efficiency of operations, DHAP will

prioritize the following efforts:

• Maximizing the efficiency and effectiveness of its processes.

• Creating a work environment that ensures a skilled and motivated workforce.

• Promoting employee satisfaction, growth, and retention.

• Continuing to implement strategies to effectively recruit, employ, and promote qualified

members of the workforce for DHAP positions that reflect the populations most affected by

HIV.

Goal 4 and its corresponding objectives and strategies are designed to make sure that the DHAP

workforce is trained and empowered to best address urgent threats to the public’s health and to

ensure DHAP administrative and management processes maximize the effectiveness and impact of

the Division.

DHAP Strategic Plan 2017-2020

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Goal 4: Continually Improve Effectiveness and Efficiency of Operations O

bj ec

tiv es Recruit and retain a

highly qualified, satisfied, and motivated

workforce

Ensure effective use of intramural and extramural resources through robust

resource and program management

Maximize the efficiency of administrative processes

St ra

te gi

es

Regularly review and identify opportunities to improve scientific, policy, and communication clearance processes

Actively support an effective learning environment that promotes sharing critical knowledge across DHAP and other NCHHSTP divisions and prioritizes educational opportunities, training, and mentorship for staff

Foster a work environment that promotes a healthy work-life balance and a culture of recognition for employee contribution and achievement

Align resources to—and regularly track and report progress on—the DHAP strategic plan

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Goal 4: Indicators of Progress

By 2020, the Best Places to Work index score from the Federal Employee Viewpoint Survey (EVS), an internal tool used by the Federal government to assess employee satisfaction, will meet or exceed the CDC agency score.

By 2020, the Employee Engagement Index score from the Federal Employee Viewpoint Survey (EVS), an internal tool used by the Federal government to assess whether employees feel engaged and motivated to accomplish the mission, will meet or exceed the CDC agency score.

By 2020, at least 89% of document submitted to CDC’s electronic clearance system for scientific documents will be cleared by DHAP within 30 days.

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Appendix 1: Key Indicators

Goal Objective Indicator

Prevent New Infections

1) Increase the percentage of persons living with HIV who know their serostatus to at least 90%

1. Aware of HIV status: Increase the percentage of persons living with HIV who know their serostatus to 90%. [National-level indicator #1]

2. Number of new diagnoses: Decrease the number of new HIV diagnoses by 25% among persons of all ages during the calendar year reported to CDC within 18 months of the diagnosis year. [National-level indicator #2; HP2020]

3. Use of PrEP (National-level developmental indicator): Increase the number of adults prescribed PrEP by at least 500%.

4. Late-stage diagnosis: Decrease the percentage of persons aged ≥13 years with HIV diagnosed at stage 3 (AIDS) within 3 months after initial HIV diagnosis in a calendar year by 25%. [HP2020]

5. Nonsterile injection: Decrease the percentage of persons who inject drugs, are at risk for HIV, and use nonsterile injection equipment by 25%.

6. High-risk sex among HIV negative MSM: Decrease the percentage of MSM who engage in high-risk behaviors by 25%.

7. High-risk behaviors among young MSM: Reduce the percentage of young gay and bisexual males in grades 9–12 who have engaged in HIV risk behaviors by at least 10%. [National- level indicator #3]

2) Increase the number of persons who are using PrEP

Improve Health

Outcomes for Persons Living

with HIV

1) Increase the percentage of persons diagnosed with HIV who are linked to care within one month of diagnosis

1. Linked to care: Increase the percentage of persons with newly diagnosed HIV infection linked to HIV medical care within 1 month of diagnosis to at least 85%. [National-level indicator #4]

2. Retention in care: Increase the percentage of persons with diagnosed HIV infection who are retained in HIV medical care to at least 90%. [National-level indicator # 5]

DHAP Strategic Plan 2017-2020

Goal Objective Indicator

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2) Increase the proportion of PLWH with sustained viral suppression

3. Viral suppression among persons living with diagnosed HIV infection: Increase the percentage of persons with diagnosed HIV infection who are virally suppressed to at least 80%. [National-level indicator #6]

4. Deaths: Reduce the rate of deaths among persons with diagnosed HIV infection by at least 33%. [National-level indicator #8]

5. High-risk sex among HIV-positive persons: Reduce the percentage of persons with diagnosed HIV infection who are engaging in HIV risk behaviors by 25%.

6. Homelessness: Reduce the percentage of persons in HIV medical care who are homeless to no more than 5%. [National-level indicator #7]

Reduce HIV- related

Disparities and Health Inequities

1) Reduce disparities in the rate of new diagnoses among (a) gay, bisexual men; (b) young black gay and bisexual men; (c) black women; and (d) persons living in the South

1. Disparity MSM: Reduce the disparity in the rate of new diagnoses in gay and bisexual men by at least 15%. [National-level indicator #9]

2. Disparity young black MSM: Reduce the disparity in the rate of new diagnoses in young black gay and bisexual men by at least 15%. [National-level indicator #9]

3. Disparity black women: Reduce the disparity in the rate of new diagnoses in black women by at least 15%. [National-level indicator #9]

4. Disparity South: Reduce the disparity in the rate of new diagnoses in the southern United States by at least 15%. [National-level indicator #9]

5. Viral suppression—Youth: Increase the percentage of youth with diagnosed HIV infection who are virally suppressed to at least 80%. [National-level indicator #10]

6. Viral suppression—PWID: Increase the percentage of persons who inject drugs with

2) Increase the percentage of youth and persons who inject drugs who are virally suppressed 3) Reduce stigma and discrimination associated with the acquisition and transmission of HIV 4) Ensure effective use of intramural and extramural resources through robust resource and program management

DHAP Strategic Plan 2017-2020

Goal Objective Indicator

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5) Maximize the efficiency of administrative processes

diagnosed HIV infection who are virally suppressed to at least 80%. [National-level indicator #10]

7. Viral suppression—Transgender (National- level developmental indicator): Increase the percentage of transgender women in HIV medical care who are virally suppressed to at least 90%.

8. Stigma (National-level developmental indicator): Decrease stigma among persons with diagnosed HIV infection by at least 25%.

Continually Improve

Effectiveness and Efficiency of Operations

1) Recruit and retain a highly qualified, satisfied, and motivated workforce

1. By 2020, the Best Places to Work index score from the Federal Employee Viewpoint Survey (EVS), an internal tool used by the Federal government to assess employee satisfaction, will meet or exceed the CDC agency score.

2. By, 2020, the Employee Engagement Index score from the Federal Employee Viewpoint Survey (EVS), an internal tool used by the Federal government to assess whether employees feel engaged and motivated to accomplish the mission, will meet or exceed the CDC agency score.

3. By 2020, at least 89% of document submitted to CDC’s electronic clearance system for scientific documents will be cleared by DHAP within 30 days.

2) Ensure effective use of intramural and extramural resources through robust resource and program management

3)Maximize the efficiency of administrative processes

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Appendix 2: Definitions

1) Vision: A short statement of DHAP’s aspirations for the future. 2) Mission: A succinct description of the fundamental purpose of the organization. 3) Goals: Broadly defined outcomes. 4) Objectives: The specific, measurable, achievable, and realistic results to be achieved within 5

years. 5) Strategies: Plans or methods to achieve the objectives. 6) Guiding Principles: Factors that guide senior leadership decision making. 7) Core Functions: Key areas that represent DHAP’s essential body of work funded by the

federal government to carry out its public health mission. These include the following 5 areas: Surveillance; Resource Management; Program Implementation, Evaluation, and Capacity Building; Policy, Planning, and Communications; and Research and Development.

8) Core Values: Principles that guide how an organization thinks and works together, and how they serve their communities.

9) Indicators: Ambitious, feasible, and measurable targets that chart progress towards successful implementation of the strategic plan and the impact of strategic plan efforts.

10) Core Activities: Routine, foundational efforts necessary to maintain steady progress towards realizing DHAP’s vision.

11) Strategic Activities: Prioritized, targeted efforts that are essential to accelerate progress towards achieving the specific objectives and goals laid out in the DHAP strategic plan.