Sunday, May 11, 2025
5/11/2025
OP EARLY INTERVENTION SERVICES WITH RESPECT TO HIV DISEASE - I. Project Abstract Summary: The University of Iowa HIV Clinic in Iowa City and outreach clinic request continued funding for Part C EIS primary outpatient health care and support services for eligible PLWH. We are not applying under the Minority AIDS Initiative. We request funding preference for providing services in rural and underserved areas as 36.8% of our patients live in rural areas, US Census. We also request consideration for an increased burden with respect to number of patients, lack of other available providers in the area, and travel to obtain care. We serve patients throughout the state as the only RWHAP C program providing a full range of primary, specialty medical care, and Part B services. Most of our patients live in the Eastern part of Iowa excluding the Quad Cities, the location of another. We model the Iowa Department of Health & Human Services (IDHHS) Care Continuum of linkage and engagement, care, treatment, retention, and adherence to achieve positive health outcomes and viral load suppression as outlined in the Iowa Comprehensive Plan: 2022-2026 (IDHHS, 2022). We have successfully achieved these goals, as we retained 96% of our 851 patients (RSR 2023) who received a service in 2023, with 97.0% suppressed viral load. Iowa HIV epidemiology: As a statewide resource and the largest HIV clinics in Iowa, our RWHAP C clinic mirrors state epidemiological statistics closely. One quarter of Iowans diagnosed with HIV received care in our clinic in 2023. This includes 27% of newly diagnosed cases. Although Iowa is a low incidence state with estimated prevalence of 111.1 per 100,000 in 2023, HIV continues to be a major health problem. In 2023, 139 Iowans were diagnosed with HIV, the highest number of new diagnoses in recent memory. Our clinic saw 40 of these new diagnoses and added another 51 patients who newly transferred into our care. While surveillance data is not yet available for the state of Iowa, the new HIV cases are primarily among men (87%) and 15 to 44 years of age (71%). More than half of our new diagnoses were either Black/African American or Latino. In Iowa, the disproportionate impact of HIV is related to communities of color due to complex social determinants of health, especially foreign-born Hispanic/Latino, Asian and US-born non-Hispanic Black/African American. Black, non-Hispanic persons account for 4% of the population, yet 25% of new HIV diagnoses in 2022. Hispanic persons make up 6% of the population yet accounted for 19% of new HIV diagnoses in 2022. The goal at UIHC is to reduce disparities and improve health equity for Black/African American patients aged <35 years of age. Moreover, the new HIV diagnosis in youth (15-24 years) is concerning with a sustained increase in diagnosis since 2018 and accounted for 23% of new cases in 2022. Our viral suppression rate has exceeded 92% since 2017 and rose to 97% in 2023. Noted that we did not include any clients who received RWPC elsewhere in this report per the 2011 and 2015 guidance. Key services to be supported: Core medical services account for 75.2% of our effort ($450,275), including medication and specialty services, salary support for 1.3 FTE total-ID & Psych physicians (0.45 FTE), ID PA (.10 FTE), 2 ARNPs (ID & Psych) (0.75 FTE). Further salary support (0.49 FTE) was used for medical case management. Clinical quality management ($76,633) is conducted jointly by social worker, nurse, and our program administrator. Support services cover program nurse, ARNP and Admin Srvcs Coordinator for adherence counseling ($41,196), EFA assistance and travel support, and our administration costs ($30,963) cover personnel, overhead, and office supply costs.
HHS’ Tracking Accountability in Government Grants System (TAGGS) website provides access to detailed descriptions of grants, loans, aggregated direct payments and other types of financial assistance awarded by the HHS Operating Divisions (OPDIVs) and the Office of the Secretary Staff Divisions (STAFFDIVs).