U.S. Virgin Islands (USVI) Health Department

Leveraging Expertise to Improve HIV Care in the U.S. Virgin Islands

Eliminating HIV in a U.S. territory in the next 8 years may seem like a lofty goal, but the U.S. Virgin Islands Health Department is unrelenting in its pursuit of it. In 2022, PCDC worked with the U.S. Virgin Islands (USVI) Health Department and the Northeast Caribbean AIDS Education and Training Center (AETC) to convene the first ever USVI Health and HIV Equity Summit, a two-day learning event attended by 100 community health professionals and USVI residents on the campus of the University of the Virgin Islands on St. Croix, a Historically Black College and University (HBCU).

The USVI includes three islands in the Caribbean: St. Croix, St. Thomas, and St. John. The USVI Health Department provides comprehensive HIV surveillance, prevention and care services throughout the USVI, where 22% of residents have incomes below the poverty level and 30% of adults are uninsured. In 2020, almost 800 people were living with HIV in the territory.

The USVI Health Department sought help from PCDC to convene local providers and community members in pursuit of its goal to eliminate HIV in the territory by 2030. To create the event, PCDC drew from their expertise providing training and technical assistance to HIV treatment and prevention organizations through the CDC-funded High Impact Prevention in Health Care (HIP) program. PCDC assembled a diverse group of in-house curriculum specialists, content experts, trainers, and coaches to plan and deliver the summit.

The summit brought together clinicians, community health leaders, policymakers, and people with lived experience. The agenda was developed in close partnership with the local community. Local providers sought to learn about the latest biomedical advances in HIV care, including clinical guidelines, best practices in treatment, and PrEP (HIV prevention medication). Providers also wanted to learn strategies to make their practices more inclusive and explore the role of stigma as a barrier to quality HIV care.

PCDC recognized the importance of incorporating local culture into all aspects of the program. A faith leader began the summit with an invocation, followed by remarks from Territorial Governor Albert Bryan Jr. and other policymakers. Island health workers were formally recognized for their work during the COVID-19 pandemic. The event was livestreamed for individuals who could not travel to St. Croix. PCDC also planned an evening lecture on new developments in HIV treatment and prevention for 35 medical providers at a local restaurant as part of the conference activities.

From the earliest days of the planning process, the USVI Health Department was committed to having a panel of island residents with lived experience speak about stigma at the summit. This panel included the voices of people living with HIV and taking medication, and individuals at risk for HIV. Panelists spoke about the impact of stigma on accessing HIV care, and providers shared their experiences in creating more inclusive practices.

Dr. Tai Hunte-Ceasar, founding dean of the University of the Virgin Islands’ medical school, appreciated the event’s focus, noting that stigma stands in the way of effective HIV treatment and prevention. After attending the event, she shared that she hopes to see the day when getting an HIV test in the USVI is just as typical and accepted as getting a screening for high blood pressure.

Throughout the process, PCDC worked to build local knowledge and skills, so that community leaders could carry the work forward after the event. PCDC provided comprehensive event planning support and content development, but ultimately recognized that local leaders needed to maintain ownership over the process to ensure its sustainability after the summit was over. For all capacity-building learning events, PCDC designs interactive activities that encourage attendees to consider what they may do differently in the future and how they will sustain that change. Three months after the summit, PCDC hosted a four-part virtual learning series that reconvened many summit attendees, as well as new learners. Discussions are underway to host a follow-up event in 2023.