{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T04:10:51Z","timestamp":1789099851206,"version":"build-2803163510"},"reference-count":62,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2024,7,22]],"date-time":"2024-07-22T00:00:00Z","timestamp":1721606400000},"content-version":"vor","delay-in-days":21,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Int AIDS Soc."],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Four counties within the Atlanta, Georgia 20\u2010county eligible metropolitan area (EMA) are currently prioritized by the US \u201cEnding the HIV Epidemic\u201d (EHE) initiative which aims for a 90% reduction in HIV incidence by 2030. Disparities driving Atlanta's HIV epidemic warrant an examination of local service availability, unmet needs and organizational capacity to reach EHE targets. We conducted a mixed\u2010methods evaluation of the Atlanta EMA to examine geographic HIV epidemiology and distribution of services, service needs and organization infrastructure for each pillar of the EHE initiative.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We collected 2021 county\u2010level data (during June 2022), from multiple sources including: AIDSVu (HIV prevalence and new diagnoses), the Centers for Disease Control and Prevention web\u2010based tools (HIV testing and pre\u2010exposure prophylaxis [PrEP] locations) and the Georgia Department of Public Health (HIV testing, PrEP screenings, viral suppression and partner service interviews). We additionally distributed an online survey to key local stakeholders working at major HIV care agencies across the EMA to assess the availability of services, unmet needs and organization infrastructure (June\u2212December 2022). The Organizational Readiness for Implementing Change questionnaire assessed the organization climate for services in need of scale\u2010up or implementation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We found racial\/ethnic and geographic disparities in HIV disease burden and service availability across the EMA\u2014particularly for HIV testing and PrEP in the EMA's southern counties. Five counties not currently prioritized by EHE (Clayton, Douglas, Henry, Newton and Rockdale) accounted for 16% of the EMA's new diagnoses, but &lt;9% of its 177 testing sites and &lt;7% of its 130 PrEP sites. Survey respondents (<jats:italic>N<\/jats:italic> = 48; 42% health agency managers\/directors) reported high unmet need for HIV self\u2010testing kits, mobile clinic testing, HIV case management, peer outreach and navigation, integrated care, housing support and transportation services. Respondents highlighted insufficient existing staffing and infrastructure to facilitate the necessary expansion of services, and the need to reduce inequities and address intersectional stigma.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Service delivery across all EHE pillars must substantially expand to reach national goals and address HIV disparities in metro Atlanta. High\u2010resolution geographic data on HIV epidemiology and service delivery with community input can provide targeted guidance to support local EHE efforts.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jia2.26322","type":"journal-article","created":{"date-parts":[[2024,7,23]],"date-time":"2024-07-23T04:45:24Z","timestamp":1721709924000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Ending the HIV Epidemic in Metropolitan Atlanta: a mixed\u2010methods study to support the local HIV\/AIDS response"],"prefix":"10.1002","volume":"27","author":[{"given":"Micah","family":"Piske","sequence":"first","affiliation":[{"name":"Centre for Advancing Health Outcomes St. Paul's Hospital  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2513-3718","authenticated-orcid":false,"given":"Bohdan","family":"Nosyk","sequence":"additional","affiliation":[{"name":"Centre for Advancing Health Outcomes St. Paul's Hospital  Vancouver British Columbia Canada"},{"name":"Faculty of Health Sciences Simon Fraser University  Burnaby British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin C.","family":"Smith","sequence":"additional","affiliation":[{"name":"Positive Impact Health Centers  Atlanta Georgia USA"},{"name":"Harvard T.H. Chan School of Public Health  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bianca","family":"Yeung","sequence":"additional","affiliation":[{"name":"Centre for Advancing Health Outcomes St. Paul's Hospital  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Enns","sequence":"additional","affiliation":[{"name":"Centre for Advancing Health Outcomes St. Paul's Hospital  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao","family":"Zang","sequence":"additional","affiliation":[{"name":"Division of Health Policy and Management School of Public Health University of Minnesota  Minneapolis Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7728-0587","authenticated-orcid":false,"given":"Patrick S.","family":"Sullivan","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Emory University Rollins School of Public Health  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wendy S.","family":"Armstrong","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases Department of Medicine Emory University School of Medicine  Atlanta Georgia USA"},{"name":"Grady Health System  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melanie A.","family":"Thompson","sequence":"additional","affiliation":[{"name":"Thacker &amp; Thompson  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaea","family":"Daniel","sequence":"additional","affiliation":[{"name":"Nell Hodgson Woodruff School of Nursing Emory University  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0153-3517","authenticated-orcid":false,"given":"Carlos","family":"del Rio","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases Department of Medicine Emory University School of Medicine  Atlanta Georgia USA"},{"name":"Grady Health System  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,7,22]]},"reference":[{"key":"e_1_2_12_2_1","unstructured":"U.S. Census Bureau Population Division.Vintage 2022 Population Estimates. 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