Baltimore has a long history of being hit hard by the HIV epidemic. Baltimore City Health Department (BCHD) has had an active HIV prevention outreach program since 2004, including HIV testing in communities at risk of HIV, ensuring those who are HIV positive are in medical care (referred to as linkage to care),  and educating the community on behavior change, such as abstinence and condom use. Because the risk of acquiring HIV is related to many socio-cultural, economic, political and legal factors, these methods alone are not enough to combat the epidemic. .

BCHD has recently expanded their HIV prevention program through the Initiative to Maximize Prevention, Access, Care, and Treatment (IMPACT) collaborative. This innovative, multi-pronged, multi-disciplinary initiative sheds light on stigma associated with HIV, address the particular needs of each individual, enhances the voice of the community in HIV prevention, and builds collaborations among HIV prevention partners across Baltimore City. This city-wide collaborative includes hospital-based and community HIV providers, community advocacy organizations, faith-based groups, and community based organizations who address access to HIV prevention and treatment services, and is the first of its kind addressing HIV in Baltimore.

As part of IMPACT, HIV prevention interventions are designed by and for people living with HIV and those at highest risk for acquiring HIV. Clients’ voices are acted on in more effective and intentional ways than ever before. For example, social media campaigns and community story telling events enhance the voice of the HIV community, decrease stigma associated with HIV, and promote HIV prevention services.   

One of the newer HIV prevention services is PrEP, or pre-exposure prophylaxis. PrEP is a pill people at high risk of HIV can take to prevent them from acquiring HIV if they are exposed to it. Through IMPACT, BCHD has established a city-wide collaborative to provide PrEP to those at risk of HIV. Individuals from the LGTBQ community work as Peer Navigators.  They effectively and credibly serve their community by linking people to PrEP preventive care, or HIV treatment services.

 “The IMPACT Collaborative has created great synergy across the city in addressing HIV prevention and care,” said Dr. Patrick Chaulk, Assistant Commissioner of the Bureau of HIV/STD Services. “We are diligently trying to frame our work around the issue of medical mistrust…[it] is central to creating welcoming environments for all patients. Mistrust also can go beyond the health care system to many other public institutions.”

BCHD is tackling the HIV epidemic from many angles so that stigma no longer prevents Baltimoreans from getting tested, treated, or educated about the realities of HIV. These interventions do not just sound effective; they are effective. Between 2010 and 2016 the number of new HIV infections in Baltimore declined by 45.2%.