Ending the HIV/HCV/Syphilis Epidemics in Indian Country II (ETHIC II) - To address the rates of HIV, HCV and syphilis that disproportionately affect Alaska Native and American Indian (AN/AI) communities, ANTHC is proposing to work on projects that address Focus Area One and Focus Area Two. The programs collaborating on this proposal include the ANTHC HIV/Early Intervention Services Program (HIV/EIS), the Liver Disease and Hepatitis Program (LDHP), and the HIV/STD Prevention Program. These three programs have worked in collaboration for many years to support HIV, HCV, and STI (syndemics) prevention, clinical care and treatment improvements and initiatives across the Alaska Tribal Health System (ATHS) to support Tribal Health Organizations (THOs), community partners, and individuals for overall health and wellness across the state. The HIV/STD Prevention Program is proposing to address Focus Area One through two goals that center Tribal health and promote collaboration and connection for syndemics prevention and care statewide. These goals include: 1) Strengthen Partnerships within and across THOs to improve systems of care for AN/AI people and 2) Increase knowledge and awareness of the relationship between sexual health and overall health and well-being. This program will establish a statewide syndemics prevention and care network within the ATHS. In tandem with the establishment of the statewide Tribal network, the program also proposes to continue hosting the local ‘Tribal Campus HIV/STI Collaborative Gathering’, a network established in 2024 for HIV/STI professionals to gather and collaborate on prevention, treatment and care needs local to the ANTHC/ANMC/SCF shared campus in Anchorage. Also, a Master of Public Health Student Intern will be onboarded to work towards enhancing syndemics prevention among college-aged youth, by providing training to young-adult serving staff that highlights the relationship between sexual health and overall health and wellbeing. All programming will be supplemented with syndemics prevention resources, such as the iKnowMine.org website, a critical resource for rural, Tribal partners in Alaska to achieve syndemics prevention and care outreach at the local level. HIV/EIS and LDHP will lead projects under Focus Area Two. Objectives include: 1) Strengthen partnerships between the HIV/EIS and LDHP programs, initially with the ANMC Walk-In/Urgent Care Clinic, and then broadly across the ATHS, 2) Review and refine STI treatment policies for non-AN/AI partners, 3) Enhance follow-up for individuals who initiate PEP to increase the rate of post PEP lab completion and linkage to care for additional prevention services as indicated, 4) Increase HIV viral suppression rate to 93% by increasing provider appointment availability with walk-in access options, enhanced partnerships with service agencies and DOC for improved linkage to care prior to release, and enhanced treatment adherence options, 5) Prioritize timely STI treatment, with expanded iwantthekit testing options this initiative aims to ensure individuals who test positive through the program receive notification and linkage options for treatment within 72 hours, 6) Provide training modules on best practices for HCV, HIV, and STI management, 7) Increase participation of Infectious Disease and LiverConnect ECHO members in presenting cases during ECHO sessions by 20% by 2027, and 8) Target outreach efforts to focus on re-engaging individuals lost to HCV follow-up in Anchorage and rural areas, aiming for a 10% annual increase in re-engaged patients and improved continuity of care annually. Overall, these initiatives represent a transformative approach to healthcare in Alaska, with a focus on optimizing patient care, streamlining processes, and enhancing provider knowledge to improve health outcomes for vulnerable AN/AI populations across the state. Our teams are known as experts in our respective fields of HIV, HCV and STD prevention, screening, management, and treatment in Alaska across the ATHS.
