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LoginFlorida Department of Health in Miami-Dade County
Engaging State and Local Officials in Reducing New HIV Infections in Miami-Dade County
Erika Coello, MPH
Condom Distribution Coordinator
Erika.Coello@flhealth.gov
786.566.6651
Miami
Fl
33125
Your summary must address all the questions below:
Since the beginning of the HIV/AIDS epidemic, more than 70 million people have been infected and 35 million have lost their lives to the disease. Miami-Dade County leads the nation with the highest HIV infection rates. 1 in 108 whites, 1 in 31 blacks, and 1 in 127 Hispanics, accounted for the staggering rate of 1 out of 84 Miami-Dade County adult residents living with HIV or AIDS in 2017. There were 1,195 new HIV cases reported in 2017, increasing the total number of persons living with HIV/AIDS in Miami-Dade County to 27,969.
As of 2017, Miami-Dade County had the highest density in the state of Florida with a total population of 2,754,749 residents, with Hispanics accounting for 68% of the population. The key populations at the greatest risk of acquiring HIV, include gay and bisexual men of all races and ethnicities, Black men and women, Latinos and Latinas, and individuals struggling with addiction (primarily intravenous drug users). HIV/AIDS continues to be an issue in communities where HIV cases are most heavily concentrated due to the lack of community awareness.
To address the daunting HIV/AIDS statistics, County Commissioner Sally A. Heyman sponsored a resolution, which was unanimously approved by the Board of County Commissioners, establishing the inaugural “Getting 2 Zero” HIV/AIDS Awareness Week on the 3rd week of February every year, creating a County-wide HIV/AIDS awareness campaign and branding of Miami-Dade County’s first condom wrapper. The inaugural “Getting 2 Zero” campaign aimed to engage state and local officials to take action and broaden community awareness about safer sex practices, HIV testing, and treatment, with goals to increase condom distribution and HIV testing by at least 5% in 2018, reduce stigma, and reduce new HIV infections within Miami-Dade County.
The Florida Department of Health and The Miami-Dade Office of Community Advocacy launched the colorful and bold marketing campaign, “Getting 2 Zero” in three languages on National Condom Day, February 14, 2018. Throughout the third week of February 2018, thirteen events were held to raise awareness on HIV/AIDS and increase condom distribution and testing efforts in Miami-Dade County. The County-wide campaign aligned with Florida’s plan to eliminate HIV transmission and reduce HIV-related deaths, by increasing HIV awareness and community response through outreach engagement, and messaging.
Campaign objectives were met within the first quarter of the campaign launch. The inaugural “Getting 2 Zero” campaign was successful in highlighting HIV awareness, testing, and treatment, and promoting condom-use County-wide. Collaboration with state and local officials, funding provided by the Department of Health, sponsorships secured for events, and new and old partnerships were all factors that led to the success of the campaign.
A Model Practice must be responsive to a particular local public health problem or concern. An innovative practice must be -
What tool or practice did you use in an original way to create your practice? (e.g., APC development tool, The Guide to Community Preventive Services, HP 2020, MAPP, PACE EH, a tool from NACCHO’s Toolbox etc.)
Is the current practice evidence-based? If yes, provide references (Examples of evidence-based guidelines include the Guide to Community Preventive Services, MMWR Recommendations and Reports, National Guideline Clearinghouses, and the USPSTF Recommendations.)
The County-wide HIV/AIDS awareness campaign targeted all Miami-Dade County residents. It is estimated that approximately 40% of the population in Miami-Dade County were reached during the inaugural “Getting 2 Zero” HIV/AIDS campaign. This figure was determined by individuals reached during health fairs, testing and condom distribution events, and the number of exposures to various types of media/advertisements during the campaign.
Prior to the campaign, targeted outreach, HIV testing, educational sessions, and condom distribution were strategies that the STD/HIV Prevention and Control program utilized to address the issue of lack of community awareness on HIV/AIDS. Despite these strategies, the issue remained at hand and stigma continued to pose barriers to prevention, testing, and treatment. To combat this, an innovative and large scale marketing campaign was launched and was the first of its kind within the County. Collaboration between the County and the STD/HIV Prevention and Control program saw another first in the history of the program, the launch of the Miami-Dade County branded condom.
Engaging elected officials proved to be successful as events were secured in their respective districts. Condom dispensers were installed in County facilities, increasing public exposure, and HIV testing and prevention efforts. The “Getting 2 Zero” HIV/AIDS awareness campaign increased community awareness on HIV/AIDS on a level never seen before as 30 more businesses and organizations established partnerships with the Florida Department of Health to support the campaign. The involvement, commitment, and unwavering support from the community and City, County, and State officials during the “Getting 2 Zero” campaign contributed to the success of the campaign.
The LHD should have a role in the practice’s development and/or implementation. Additionally, the practice should demonstrate broadbased involvement and participation of community partners (e.g., government, local residents, business, healthcare, and academia). If the practice is internal to the LHD, it should demonstrate cooperation and participation within the agency (i.e., other LHD staff) and other outside entities, if relevant. An effective implementation strategy includes outlined, actionable steps that are taken to complete the goals and objectives and put the practice into action within the community.
In 2016, the Condom Distribution Program Coordinator at The Florida Department of Health in Miami-Dade County received technical assistance from various Health Departments across the nation, to brand a Miami-Dade condom wrapper with a prevention message that will aim to reduce new HIV/STI infections, discourage resale, and increase condom distribution in Miami-Dade County.
New York City, Los Angeles County, and Toronto Health Department offered their expertise and shared their experiences and challenges faced during the branding and marketing process. The Florida Department of Health in Miami-Dade County fostered a partnership with the Office of Community Advocacy, which led to the approval of resolution by Board of County Commissioners on June 22, 2017, establishing the 3rd week as the “Getting 2 Zero” HIV/AIDS Awareness Week and approval for condom branding and distribution of condoms in County facilities.
Official meetings with the Miami-Dade Office of Community Advocacy, commission staff and communications team in the County began on July 2017. The activities for the “Getting 2 Zero” campaign were secured by the Florida Department of Health and Office of Community of Community Advocacy in Miami-Dade County.
During scheduled meetings, partners and sponsors were secured for the campaign and media contracts with Outfront Media, Clear Channel, and All-Star Media were executed. Media advertisements were placed throughout Miami-Dade County on December 31, 2017. In addition, a social media content calendar was created to promote the campaign, HIV/AIDS awareness days, and community events. Collaboration with Florida Department of Health internal agencies and community-based organizations led to the success of the campaign. Organizations included campaign message on digital screens in STI clinics, displayed posters in common areas, and promoted on social media platforms.
In 2018, promotion of the Getting 2 Zero” campaign and branded condom included several tv and radio interviews, ribbon cutting ceremony to mark the kickoff of the “Getting 2 Zero” Miami-Dade awareness campaign, a presentation by The Florida Department of Health Administrator Dr. Lillian Rivera to the Board of County Commissioners, which included HIV/AIDS statistics, resources, and information on the “Getting 2 Zero” campaign. The unveiling of the first Miami-Dade County branded condom occurred on February 14, 2018, during a press conference in History Miami.
The timeframe of the campaign was approximately six months. Stakeholder engagement, collaborations, and partnerships occurred on a regular basis through community mobilization events, legislation, and policy, which assisted the Department of Health in furthering prevention activities at the local level.
Working in partnership with the Office of Community Advocacy facilitated the accessibility and availability of condoms in County facilities, through the installation of condom dispensers.
Opportunities exist to expand partnerships through new and non-traditional partners, which include but are not limited to barbershops, tattoo parlors, additional County facilities, and parks, to further the objectives of the campaign, including increasing condom distribution and HIV testing in Miami-Dade County.
Evaluation assesses the value of the practice and the potential worth it has to other LHDs and the populations they serve. It is also an effective means to assess the credibility of the practice. Evaluation helps public health practice maintain standards and improve practice. Two types of evaluation are process and outcome. Process evaluation assesses the effectiveness of the steps taken to achieve the desired practice outcomes. Outcome evaluation summarizes the results of the practice efforts. Results may be long-term, such as an improvement in health status, or short-term, such as an improvement in knowledge/awareness, a policy change, an increase in numbers reached, etc. Results may be quantitative (empirical data such as percentages or numerical counts) and/or qualitative (e.g., focus group results, in-depth interviews, or anecdotal evidence).
The “Getting 2 Zero” campaign objectives were to increase HIV testing and condom distribution by at least 5% in Miami-Dade County. The Florida Department of Health in Miami-Dade County (FDOH-MDC) STD/HIV Prevention and Control Program had notable increases following the campaign launch. From Quarter 4 - 2017 to Quarter 1 - 2018, there was an increase of 17 percent in condom distribution and an increase of 197 percent in HIV testing. Condom distribution continues on an upward trend and goals to make condoms available, accessible, and acceptable in the community are being met. Overall, there was an immediate increase in condom distribution and HIV testing associated with the “Getting 2 Zero” campaign launch. The County-wide marketing campaign, “Getting 2 Zero” improved community awareness and the engagement between state and local officials with ongoing collaboration to increase condom distribution via condom dispensers in publicly accessible County facilities. Officials continue to support the campaign by securing and hosting events for HIV testing and education and condom distribution in high-risk areas.
The data collected were individuals reached during health fairs, testing and condom distribution events, and the number of exposures to various types of media/advertisements during the campaign.
An outcome form was administered after each health fair and testing event. Community providers and Florida Department of Health personnel were instructed to document the people reached and services provided at the end of each event.
Sustainability is determined by the availability of adequate resources. In addition, the practice should be designed so that the stakeholders are invested in its maintenance and to ensure it is sustained after initial development (NACCHO acknowledges that fiscal challenges may limit the feasibility of a practice's continuation.)
The STD/HIV Prevention and Control program allocated funds for the “Getting 2 Zero” HIV/AIDS awareness campaign in Miami-Dade County based on a surplus of $200,000 in the budget. The program maximized and leveraged resources by receiving in-kind services and partnering with Miami-Dade County Office of Community Advocacy, community-based organizations, colleges/universities, Miami Airport, and Port of Miami. The in-kind services included: designs for overall campaign, printing, production, placement of posters and banners, venues for campaign events, radio and television advertisements, and social media campaign. The allocated budget allowed for The Florida Department of Health to execute contracts with three well-known media companies in Miami-Dade, All Star Media, Clear Channel, and Outfront Media. The campaign targeted highly impacted zip codes and message focused on HIV awareness, testing, and treatment. Statements such as “Make HIV History,” “No New HIV Infections,” “Zero Discrimination and Stigma,” and “Zero AIDS-Related Deaths in Miami-Dade County” were utilized in all traditional and digital outreach initiatives and visuals. Advertisements were placed on trains and stations, buses and shelters, gas toppers, and were shared on various social media platforms such as Facebook, Instagram and Twitter. Locations included Miami International Airport, Port of Miami, South Florida colleges and universities, and storefronts. A cost/benefit analysis was not performed during the initial phase of campaign; however, it will be considered for the next phase of the campaign in 2019.
There is sufficient stakeholder commitment to sustain the “Getting 2 Zero” HIV/AIDS awareness campaign with limited funding. The Florida Department of Health in Miami-Dade County and Office of Community Advocacy were successful in securing partnerships and in-kind services from various entities throughout the County during the inaugural “Getting 2 Zero” campaign. The resolution in place added credibility to the campaign, which led to the numerous new partnerships and sponsorships that are now committed to continue working towards the same goal. Collaboration between the Florida Department of Health in Miami-Dade County, the Miami-Dade Office of Community Advocacy and elected officials is helping to reach the goal of reducing new HIV infections, increasing access to care, reducing the stigma, and promoting health equity in local communities.
Sustaining this campaign will involve The Florida Department of Health to continue working with The Office of Community Advocacy in Miami-Dade County to move forward with the campaign on an annual basis as the resolution calls for, with no funding attached. Establishing new partnerships and seeking sponsorships with several agencies to promote the campaign throughout the County and scheduling meetings throughout the year with organizations serving the high-risk population throughout Miami-Dade County. Solidifying partnerships with the City, County, State organizations to increase condom distribution and testing in high-risk areas in Miami-Dade County will be key in sustaining and enhancing the campaign. If funding is limited, The Florida Department of Health will continue to work with community agencies to host free community events on an annual basis during the “Getting2 Zero” awareness week and promote campaign through in-kind services.
