Background: The St. Louis region carries the highest burden of STI and HIV infections in Missouri, particularly St. Louis City and St. Louis County. In 2019, St. Louis City and County accounted for 1 in every 3 of the total STI diagnoses in the state for chlamydia, gonorrhea, and syphilis. Moreover, the St. Louis region represents 35% of the state’s total general population, but 49% of HIV disease incidence and 48% of prevalence. Men represent over 80% of new and cumulative cases of HIV in the region, and men who have sex with men (MSM) account for 57% of new diagnoses and 64% of all people living with HIV (PLWH). Rates of new HIV disease cases are 10.2 times higher among Black people and 4.5 times higher among Hispanic persons than among White people, and 78.5% of new HIV disease cases are ages 13-44, with 1 in 4 cases being diagnosed among youth ages 13-24. While Black people carry the highest burden of HIV disease, they are more likely to have current evidence of HIV care (71.4%) than Whites (66.4%) or Hispanics (60.2%). These data are the basis of the proposed target population: Black and White MSM, Hispanic/Latino and non-Hispanic/Latino, ages 13-49.
Vivent Health has a 35-year history of delivering high-quality, innovative services to communities with high-risk of HIV infection and PLWH. Demographics of the 2,409 clients with HIV served by Vivent Health align with the target population, with 60% of clients being MSM and 58% of clients being people of color, primarily Black. Vivent Health’s HIV Medical Home is the only one of its kind in St. Louis, offering HIV/STI prevention services in the same location as a range of integrated services for PLWH: case management; medical care for HIV, PrEP, and STIs; food pantry; dental care; behavioral health; and a full-service pharmacy. The agency is positioned in the 63103 zip code, among the top four St. Louis City zip codes with the highest rates of HIV/AIDS incidence and prevalence, syphilis, tuberculosis, hepatitis B, and suicide.
Purpose: With $601,207 in CDC funding and partnerships with Washington University and an external evaluator, Vivent Health will provide a comprehensive high-impact HIV prevention program to reduce new HIV infections, increase access to care, improve health outcomes, and reduce HIV-related health disparities in the St. Louis region.
Outcomes: Proposed outcomes align with the Ending the HIV Epidemic as well as local and statewide jurisdictional HIV prevention plans:
• DIAGNOSE: Increased persons aware of their HIV status. Increased receipt of integrated screening.
• TREAT: Increased receipt of HIV medical care and ART among newly-diagnosed PLWH and previously -diagnosed PLWH. Increased access to Partner Services.
• PREVENT: Increased access to PrEP. Increased availability of condoms.
Vivent Health will also work closely with community stakeholders on program promotion and recruitment and with local/ state health departments on HIV cluster response.