Hamilton County Public Health; Support and Scale Up of HIV Prevention Services in Sexual Health Clinics - According to the U.S. Census Bureau, in 2022, Hamilton County had a population of 825,037 (51% female and 49% male). In that same year, there were 95 new reported diagnoses of HIV infections in Hamilton County, 78% of which were male (people assigned male sex at birth), and 52% of which were 20-34 years of age. Seventy-two percent of new diagnoses in 2022 were among Black/African American people, while 25% were among White people. Among males, the leading mode of transmission was male-to-male sexual contact and among females, the leading mode of transmission was heterosexual contact. In recent years, the percentage of diagnoses in Hamilton County attributable to injection drug use has decreased but was previously a significant risk factor in Hamilton County and remains a concerning trend nationally. At the end of 2022, there were 3,312 persons living with diagnosed HIV infection in Hamilton County. Seventy-seven percent of persons living with diagnosed HIV infection are male, and those who are aged 55-64 years have the highest number of persons living with diagnosed HIV, compared to other age groups. Black/African American people make up about 59% and White people make up 31%. The rate for Black/African American people was more than four times as high as that for white people (ODH EE Epidemiologic Profile 3/1/2020). With these funds HCPH plans to expand access to clinical care, outreach, and targeted marketing to reach more women, sex workers, transgender people, and younger people who are at high risk of contracting HIV, in addition to men who have sex with men. The HCPH clinic relocated to a new space in December of 2023 allowing HCPH to significantly increase testing, treatment, and prevention capacity, while also creating a space that is welcoming to all patients seeking sexual health care. With this funding, HCPH will 1) ensure targeted outreach and focus groups among these populations, 2) enhance our data collection processes to ensure an accurate reflection of the population served, 3) provide services to a more diverse patient population in Hamilton County, and 4) provide services to additional groups of the most vulnerable and marginalized in our jurisdiction. By working with new and existing partner agencies, HCPH will reach more of the LGBTQ+ population, sex workers, and vulnerable women who are not always priority populations in sexual health prevention efforts. The overall goals of this proposal are to strengthen the HCPH clinic infrastructure and improve service delivery of HIV and STI services and to foster strategic partnerships in support of ending the HIV epidemic (EHE). To achieve this goal, HCPH will implement and strengthen various interventions. By the end of the performance period, the following outcomes are expected to be achieved: 1) enhanced adoption of optimal sexual health services and clinic models for the provision of quality STI-related clinical care, 2) increased understanding of and responsiveness to patients’ experiences, satisfaction, and needs, 3) increased identification of new HIV and STI infections and of persons with HIV who are out of care or not virally suppressed, 4) increased persons eligible for PrEP who were prescribed PrEP at the clinic, 5) increased collaboration and engagement with local partners and community members to inform sexual health service delivery, especially among priority populations affected by HIV/STI, 6) increased rapid linkage to HIV medical care for persons newly diagnosed with HIV in the clinic, 7) increased receipt of recommended, timely STI prevention and treatment interventions for patients and their partners, 8) increased receipt of rapid antiretroviral therapy in the clinic for persons with newly diagnosed HIV, 9) sustained community partnerships to inform strategic EHE planning and activity implementation, and 10) increased clinic capacity to provide affirming, stigma- and discrimination-free HIV prevention and linkage to care services.
