Support and Scale Up of HIV Prevention Services at Public Health - Seattle & King County's SexualHealth Clinic - Sexual health clinics (SHC) can play a critical role in Ending the HIV Epidemic in the U.S. (EHE). However, too often, these clinics have accomplished less than they might. In this application, Public Health – Seattle & King County proposes activities to increase the number of patients serviced in its SHC and improve the services the clinic provides. Proposed work will strengthen the clinics infrastructure and improve service delivery to address the syndemic of HIV and other sexually transmitted infections (STIs) and foster strategic partnerships in support of EHE. Work will focus on two priority populations: 1) Men who have sex with men (MSM) and transgender/nonbinary (trans/NB) persons, particularly non-White MSM/Trans/NB persons, and 2) heterosexuals at elevated risk for syphilis, including persons who use substances, are unstably housed, and/or engaged in exchange sex. SHC-based infrastructure changes will include development of an action plan to address gaps in service, implementation of evidence-based and -informed approaches (e.g., electronic health record improvements, online appointing, increased express care, telemedicine), assessment of patient experiences, and adoption of a whole-person approach to care. Efforts to foster strategic partnerships will include work with CBOs, community providers, and our health department, working with EHE and Ryan White planning bodies, and engagement with priority populations through work with existing collaborators and formation of a new community collaboration group. The activities will enhance adoption of optimal sexual health services and increase each of the following outcomes: 1) understanding of and responsiveness to patients’ needs, 2) identification of new HIV and STIs, 3) use of HIV preexposure prophylaxis, 4) collaboration and engagement with local partners and community members to inform sexual health service delivery, 5) rapid linkage and relinkage to HIV care and initiation of antiretroviral therapy, 6) receipt of recommended, timely STI prevention & treatment, 7) sustained community partnerships to inform EHE planning and implementation, and 8) clinic capacity to provide affirming, stigma- and discrimination-free HIV prevention and linkage to care services. Together, these outcomes will advance the overarching goal of ending the HIV epidemic.
