The Mississippi Public Health Institute (MSPHI) program HEARD (Helping Empower, Advocate, and Reach the Delta) will increase engagement in care for adult Black females (ages 18 and over), including cisgender, transgender, nonbinary, and genderqueer/fluid individuals living with or at high risk for contracting HIV/AIDS, STIs, VH, or at-risk for substance use disorder (SUD) or mental health (MH) conditions in the Mississippi (MS) Delta. Population demographics include 74% Black, 24% White, and 2% Hispanic. Twenty-nine (29.8%) are living in poverty, 13.7% live without health insurance, and the median household income is $37,898. The geographic catchment area where services will be delivered is the 18-county MS Delta. In project year 1, MSPHI will prioritize two high-poverty, underserved counties, Leflore and Washington, with outreach extending into all Delta counties. MSPHI will expand services and increase community anchors in the following two years to reach all of the MS Delta.
HEARD will increase engagement in care for Black females who are living with or at high risk for contracting HIV/AIDS, STIs, VH, or at risk for SUD or MH conditions in the MS Delta. HEARD expects to serve 135 individuals in year one, 202 in year two, and 303 in year three, totaling 640 clients. Goal 1: Increase access to culturally appropriate, women-and family-centered, trauma-informed HIV/viral hepatitis services, including HIV and hepatitis B and C testing among Black females living in MS Delta. Obj 1.1: Across the full grant term (FGT), provide HIV/HBV/HCV Counseling, Testing, and Linkages (CTL) to at least 640 clients from the priority population and their partners. Obj 1.2: By Sept. 2027, refer 100% of HIV- persons to Pre-Exposure Prophylaxis (PrEP) and 100% of those who test positive for confirmatory testing and supportive clinical care. Obj 1.3: By Sept. 2027, refer 100% of clients who are HIV+ or at high risk for HIV into Choosing Life: Empowerment, Action, Results! (CLEAR). Goal 2: Expand access to services and increase engagement in care to reduce SUD and MH symptoms among Black females who are living with or at high risk for contracting HIV/AIDS, STIs, VH, or at risk for SUD or MH conditions living in MS Delta. Obj 2.1: Pre-screen 640 clients for alcohol, drug use, and HIV/AIDS using Screening, Brief Intervention, and Referral to Treatment (SBIRT). Obj 2.2: Increase the number of individuals linked to social support and substance use treatment services by referring 100% of those whose SBIRT score indicates a referral need. Obj 2.3: Distribute at least 75 naloxone and fentanyl kits in project year (PY) 1, 85 kits in PY2, and 100 kits in PY3 using program referral records. Obj 2.4: By Sept. 2027, refer to MH promotion and/or treatment 100% of clients with co-occurring MH issues and SUD, as indicated by their SBIRT score. Goal 3: Educate and empower Black females to increase their awareness of safer sex practices (e.g., condom use) and make informed decisions about their behavioral health, including trauma-related risk behaviors. Obj 3.1: Provide HIV prevention/intervention using the Safe in the City program to 500 clients annually. Obj 3.2: Hold at least 3 SISTA programs annually in the MS Delta to prevent HIV transmission by promoting consistent condom use. Obj 3.3: Increase HIV awareness by providing the HIV Knowledge Questionnaire–18 (HIV KQ-18) to 640 women within the priority population. Goal 4: Increase the capacity of community anchors to assist Black females who are living with or at high risk for contracting HIV/AIDS, STIs, VH, or at risk for SUD or MH conditions. Obj. 4.1: By Sept. 2027, achieve a 50% expansion in community anchors by increasing members, as measured by the number of new signed letters of commitment. Obj. 4.2: By Sept. 2025, provide capacity-building training in HIV and SUD trauma-informed approaches to 90% of community anchors, as measured by attendance rosters, to reduce SUD/MH stigma and increase knowledge.