FY24 PrEP Care Coordinator - Ending the HIV Epidemic: CL 2

Project Abstract Summary The Kentucky Department for Public Health (KDPH) proposes a multi-facetted approach to ending the HIV Epidemic in the commonwealth. These efforts focus on a combination of evidence-based, cost effective, and scalable structural, behavioral, and biomedical interventions that target persons with HIV (PWH), as well as those at elevated risk for HIV infection. Kentucky has two predominant, and vastly different, HIV disease patterns in urban and rural areas: urban areas account for nearly 70% of known cases and rural areas are impacted by late HIV diagnosis and high concurrent AIDS diagnosis rates. KDPH’s goal is to reduce new HIV infections in Kentucky from 330 per year to 30 within ten years. KDPH proposes a wide range strategies designed to address the diagnosis of HIV, the treatment of PWH through comprehensive medical care and supportive services, prevention of new HIV diagnoses, and response to HIV cluster outbreaks. For diagnosis, KDPH proposes a pilot of universal testing at a federally qualified health center serving one of the most high-risk populations in the state, western Louisville. KDPH also proposes piloting a Disease Intervention Specialist (DIS) focused specifically on the identification and retesting of HIV-negative persons at elevated risk for HIV infection. Finally, funds are proposed to expand HIV testing outreach through collaborations with community partners and local health departments to aid in the earlier identification and linkage to care of PWH. These strategies around HIV testing are designed to increase routine opt-out HIV screenings, local availability of and accessibility of HIV testing services, linkage to care for PWH, and routine rescreening among persons at elevated risk for HIV. For treatment of HIV, KDPH proposes the addition of two DIS/Linkage Navigators to work in rural Kentucky to increase rapid linkage to care of PWH. This proposed expansion of services also explores expanding access to the Kentucky AIDS Drug Assistance Program earlier in the continuum of care, prior to linkage of care. Finally, services will be expanded to offer additional support for non-Ryan White HIV AIDS Programs around HIV viral suppression and linkage to care to address all PWH in the state. These proposed treatment services are designed to increase rapid linkage to HIV medical care, early initiation of ART, and immediate re-engagement to HIV prevention and treatment services for PWH who have disengaged from care. For PrEP, KDPH proposes a significant expansion through the addition of providers willing to provide PrEP. This proposal also provides for a widespread education campaign on the benefits of PrEP for persons at elevated risk. Funds have been proposed to address barriers for persons currently seeking PrEP services such as medical transportation, laboratory expenses, and medication co-payments. Finally, strategies and activities will be implemented that increase access to syringe service programs (SSP) available in the commonwealth. These prevention activities are designed to increase awareness of and access to PrEP services as well as access to SSPs. For cluster response, KDPH will coordinate response efforts with the Kentucky Division of Laboratory Services, the Kentucky Health Information Exchange, and the DIS/Linkage Navigator. Expansions in HIV laboratory testing, sequencing, and data availability will improve the state’s ability to respond quickly to HIV outbreaks. These strategies and activities will lead to increased local health department and community engagement for cluster detection and response, improved surveillance data for real-time cluster detection and response, and improved policies and funding mechanisms to respond to and contain HIV clusters and outbreaks.