The Achieving Together Texas Plan was developed with six guiding principles to lead the work of ending the HIV epidemic in Texas: social justice, equity, integration, empowerment, advocacy, and community. When addressing empowerment and community, the plan states that we should support shared decision-making between people affected by HIV and providers and across systems. It also acknowledges that lasting change happens at the local level among people who are working together, without a partisan frame, to create a healthy community. Knowing that many ASOs, CBOs, health departments, and other service providers have been operating over the past two years with heroic determination and stamina, under enormous constraints in the midst of the Covid-19 pandemic, we sought to learn more about one administrative agency’s approach to ensuring that community and people living with HIV (PLWH) are included in their planning processes and programming.
Kaitlin Lopez, Grant Coordinator and Quality and AA Planning, with the Tarrant County Administrative Agency recently shared how she and her team actively involve the community and PLWH in their work to help end the HIV epidemic in their community. Tarrant County, home to Fort Worth, Arlington, Grand Prairie, and many other cities, is the third most populous county in Texas after Harris (Houston) and Dallas (Dallas) counties.
Tarrant County Administrative Agency (TC AA), located in Fort Worth, manages all funding for HIV/AIDS care and services in the North Central Texas region. Since 1991, the TC AA has been the only Ryan White recipient in the United States that coordinates all funding parts of the Ryan White Treatment Extension Act (Parts A, B, C, and D) along with Texas State Funds, Housing Opportunities for Persons with AIDS (HOPWA), and Ending the HIV Epidemic (EHE) funds from a single administrative office and with a single planning body. The TC AA presently does not deliver services to clients, but rather utilizes a network model and contracts with subrecipients to provide direct services to eligible individuals.
The TC AA has a number of initiatives currently underway aimed at reducing the impact of HIV in north central Texas including the “CQII Create + Equity Collaborative” which aims to improve viral load suppression and retention in care for: Black women, age 18–39 and Trans women, age 19–39 (CQII stands for “Center for Quality Improvement and Innovation”). Additionally, they provide targeted at-home testing for HIV and run a website and social media campaign tailored to the clients served in this jurisdiction.
You can find the TC AA and learn more about their work on their website: https://beathivtc.org and by following on social media:
One unique and inspiring way they involve the community in this initiative is to ensure that the faces photographed in the campaign are faces of PLWH who live and work in this community.
One standout feature of their work is their Health Improvement Team (HIT) HIV Community Advisory Board (CAB), which has over ten active members who are all living with HIV. This board assists in decision-making and creates initiatives to help improve health outcomes, increase patient satisfaction, and reduce barriers, disparities, and stigma. Additionally, the CAB participates in discussions to change the way services are delivered and how clients are engaged and retained in care. The CAB has developed three work products thus far:
- Thriving Guide: A local resource guide with Ryan White, EHE, and Prevention Resources
- Diagnosis to First Medical Visit Roadmap: A roadmap that outlines a client’s steps from diagnosis to their first medical appointment.
- First Medical Appointment to an Undetectable Status: A roadmap that outlines the steps a client should take to become undetectable.
The above resources are available in Spanish and English in clinics and local points of entry and can also be found online.
Kaitlin says they decided to take this community-centered approach after hosting numerous listening sessions with PLWH. The HIT HIV CAB has provided feedback to the TC AA that has also informed grant activities. PLWH were asking for help crafting initiatives related to stigma reduction, trauma-informed care, care coordination staff that were comfortable talking about sexual health, and resources that were accessible and customized to the community’s needs, in addition to engaging the community in a non-traditional manner. The TC AA hopes that all of these community-focused initiatives will lead to clients living with HIV getting linked to and retained in care, experiencing viral suppression and reaching undetectable status (see U=U), and reduced stigma around HIV within the Tarrant County community.
Kaitlin mentioned that COVID-19 continues to present challenges for outreach and community engagement opportunities. It has impacted the TC AA’s overall ability to create new outreach and community engagement activities. Organizations are prioritizing COVID-19 vaccines and are still focused on organizational recovery. Resources and staff are limited for those who would typically be involved in a partnership with the TC AA to implement new outreach and community engagement activities.
However, despite these challenges Kaitlin and her team offer the following advice to others looking to make an impact on ending HIV in their communities: Talk to your community and actively listen and create actual changes based on feedback from PLWH such as tangible work products and policy and procedural changes. She also underscores the importance of developing a community advisory board that represents your local epidemic and will engage and uplift the voices of PLWH.
We at Achieving Together Texas celebrate the work that the Tarrant County Administrative Agency is doing to end HIV in their community. They are bridging tools, technology, people, and passion while adapting systems and structures to make it easier for all people to access the HIV prevention, care, and treatment they need in order to thrive.
The Tarrant County AA team currently consists of:
Lisa Muttiah, Grants Manager
Renee Thomas, Grants and Data Coordinator
Kaitlin Lopez, Grant Coordinator, Quality and AA Planning
Rebecca Seymore, Financial Analyst
Dulce Lozano, Assistant Financial Analyst
Briana Umana, Office Manager
Damiya Pentecost, EHE Program Manager (not pictured)
Oscar Zuniga, Data Analyst (not pictured)
Brandon Bright, Community Engagement Specialist (Not Pictured)