ESCALATE

“ESCALATE” trains and empowers participants to recognize and address HIV stigma within every level of the Ryan White HIV AIDS Program. ESCALATE will engage Stigma Reducing Teams (a minimum of two participant teams)  within the 57 jurisdictions identified in Ending the HIV Epidemic: A Plan for America (EHE) with a particular focus on reducing stigma towards transgender/gender nonconforming individuals, men who have sex with men, the Black/African-American community, Latinx experience, and Indian Country and Native Alaska. NMAC works in partnership with Abt Associates, TRX Development and NORC at the University of Chicago.

Central to the focus of ESCALATE are community involvement and cultural competency. HIV stigma is a multi-dimensional social issue with complexities and nuances. Understanding the needs of community is critical. ESCALATE engages subject matter experts from impacted communities throughout every aspect of the project including the curriculum design. This ensures cultural competency and also guarantees meaningful involvement . MIPA or the Meaningful Involvement of People Living with HIV and AIDS challenges the idea of creating a service or program without the intentional inclusion and advice of people with HIV.

The Challenge

Stigma remains a major obstacle to efforts to end the HIV epidemic by hindering specific communities from accessing HIV testing, prevention, and care and contributes to continued high rates of new HIV cases.

Focus Population

People with HIV (PWH) in urban, rural, and native communities; Ryan White Care Providers, Planning Councils,  in urban, rural, and Native communities. Special focus on transgender/gender non-conforming individuals, men who have sex with men, the Black/African-American community, and Latinx communities.

The Model

 ESCALATE provides a three-component program to mitigate and eliminate stigma in HIV-related service provision in the United States.

1. New and Innovative Training. ESCALATE focuses on training to reduce HIV-related stigma through evidence-informed interventions and strategies with an emphasis on cultural humility for HIV service systems, organizations, and individuals. The trainings are designed to reach up to 1,170 individuals in total over the four years of the program.
2. Targeted, Time-limited Technical Assistance (TA). ESCALATE will engage Abt Associates to develop targeted, time-limited TAs for up to 125 organizational entities over the four years of the cooperative agreement. Abt Associates will tailor technical assistance to the needs of each organization. TA is best suited for organizations looking to tackle a specific concern related to HIV-stigma on a one-to-one basis (meaning, one organization working with one TA provider).
3. Learning Collaboratives (LCs). NORC at the University of Chicago will partner with NMAC to implement three LCs during the cooperative agreement, using the Learning Collaborative Model developed by the Institute for Healthcare Improvement (IHI). NORC will develop curricula and activities with input from the ESCALATE Implementation Science Advisory Team (ISAT) and other subject matter experts (SMEs). LCs are best suited for organizations who have all the resources and preparations in place to begin implementing a stigma-reduction program or have already begun implementing such a program.

ESCALATE is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) and the Minority HIV/AIDS Fund as part of a financial assistance award totaling $1,600,906.100 percentage funded by HRSA/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by HRSA/HHS, or the U.S. Government.