Special Projects of National Significance - Demonstration/Implementation Sites - Abounding Prosperity, Inc. (AP, Inc.) will implement, adapt, document, evaluate and disseminate a replicable, intervention-based street medicine approach to addressing the needs of unsheltered homeless people living with HIV. The priority populations include disproportionately impacted PLWH in Dallas County and Tarrant County, TX, who have unmet health needs and risk factors including mental health and substance use disorders (SUD) who face social determinants of health and barriers to care. AP, Inc. will implement a street medicine intervention that delivers services directly to unsheltered homeless PLWH in their environment, ensuring that those who are unable or unwilling to visit traditional healthcare facilities can still access services and remain engaged and retained in HIV care and treatment. AP, Inc., will recruit and enroll 100 clients in the street medicine intervention by the end of the first year and integrate the street medicine intervention into the organization’s operations by the end of the initiative. Operations of the street medicine team will follow an outreach model that involves community mapping priority areas in the service area based on incidence and prevalence data; frequently engaging with the local community and members of the priority population to build trust over time; recruiting participants into the intervention; implementing street medicine services; and making referrals and linkages into additional prevention, health and social services using a syndemic approach that addresses the interconnected health and social needs of unsheltered homeless PLWH. AP, Inc.’s proposed project will address gaps in access to care, linkage to care, retention in care, and viral load suppression rates for the priority population. AP, Inc. will collaborate with the Capacity Building Provider and the Evaluation Provider to adapt, document, evaluate, and disseminate an approach that is evidence-based, replicable, and effective at improving access, engagement, and retention in HIV care and social supports for unsheltered homeless PLWH. AP, Inc. will coordinate its project development, implementation and evaluation activities with the Evaluation Provider and work collaboratively on all aspects of a multi-system evaluation grounded in implementation science frameworks. AP, Inc. will participate in evaluation and dissemination activities including the development of implementation manual/toolkits, site visits, annual national multijurisdictional meetings, multi-system learning sessions, and other activities as coordinated and conducted by HRSA and the project partners.
