In Addressing HIV, the U.S. Has a Lot to Learn From Namibia

There are six countries that have reached "90–90–90" targets meaning, "90 percent of people with HIV in a country know their status, 90 percent of those diagnosed are on treatment, and 90 percent on treatment are virally suppressed." The solutions that have worked for these countries, like cross-sector partnerships and evidence-based prevention campaigns, are now models for regions still fighting to reduce rates.

An organization aimed at providing peer support for gay black men living with HIV that started in Atlanta, Georgia has now gained an international following. Because the program is not federally funded, data can be difficult to gather; however, "self-reported data from its members including medication type and adherence, CD4 cell count, and demographic information" shows a significant increase in members adhering to their medical regimen.

South Africa is looking to tackle their HIV epidemic by changing the perception around preventative measures such as the PrEP prevention pill. Desmond Tutu Foundation’s PrEP program focuses on marketing the PrEP pill to those with a high risk for contracting HIV and so far has distributed the medication to 12,000 people.

The Access to Health and Rights Development Initiative (AHRDI) in Lagos, Nigeria has offered health services to over 2,000 LGBTI men since 2013 despite the nation's widespread homophobia. Because it is still dangerous to identify as or ally with homosexuality following the 2014 passage of the Same-Sex Marriage Prohibition Act, all AHRDI's clients come from word-of-mouth referrals to receive condoms, lube, HIV testing, and more.

Rather than treat opioid users like criminals, Vancouver has deemed it a public health crisis. The city, especially its downtown east side, witnessed 1,500 deaths in just one year from opioid use. Its approach is unique and multi-pronged – making Narcan, an overdose antidote, available to everyone, opening safe injection sites, and having a police presence – without arrests – on blocks where using remains high.

Two of America’s largest cities, New York City and San Francisco, are working to reduce HIV rates by bringing better health care options closer to the communities and connecting individuals with resources such as insurance and payment methods. Although the two cities are using different approaches, both are seeing early success in fighting against the epidemic.

The Wise Up Campaign works to increase HIV testing rates and reduce transmission of the disease through educational efforts and connecting with young people, a particularly high-risk group, to spread awareness and connect them with necessary resources. Since forming, the campaign has reached over 500,000 young people with HIV counseling and testing, as well as condom distribution, and has even trained several young volunteers to continue spreading the message to their peers.

In Kenya, sex workers face disproportionately high rates of STIs, compounded by widespread antimicrobial resistance and stigma that keeps many from seeking care in public hospitals. In response, the Center for Health Solutions, working alongside the Kisumu County Government and the Kisumu Sex Workers Alliance, launched a community-based program offering free STI screening, lab testing, and peer education to over 50 registered sex workers. The program uses an outreach-first model, finding and linking sex workers to care rather than waiting for them to navigate hostile clinical environments.

Health care providers at Summa Health Pride Clinic in Akron, Ohio are transforming the way care is offered to trans and gender nonconforming people by working to reduce barriers that they often face. All staff undergo LGBTQ+ sensitivity training and the clinic is adorned with Pride flags – two parts of the clinic's overall "blueprint," which doctors say "can be duplicated anywhere in the country."

In parts of Uganda, ride-sharing has been transformed into a medical delivery service to ensure that those who are unable to travel to their doctor for antiretroviral refills have access to the medications they need to stay healthy. Although the program is limited in terms of the areas it can serve due to cost, doctors in the region hope to continue and expand the program after seeing such success since implementation.