New York City Health + Hospitals: Comprehensive Community-Driven Sexual Health - Overview The proposed project seeks to strengthen clinic infrastructure at NYC Health + Hospitals (H+H) while improving service delivery, fostering strategic partnerships, and integrating existing sexual health resources to better support the New York City (NYC) Ending the HIV Epidemic (EHE) plan. H+H is the largest municipal healthcare system in the US. It includes 11 acute care hospitals, a federally-qualified health center (FQHC) network, and a health plan. Purpose Through the integration and expansion of services, priority populations will have increased access to high quality sexual health services that address the HIV/STI syndemic, such as HIV testing, three-site STI testing, treatment of HIV and/or STIs, recommended vaccinations, and comprehensive Pre-exposure Prophylaxis (PrEP) and non-occupational post exposure prophylaxis (nPEP) services. The priority populations served will include women of color, minority adolescents/ young adults, men who have sex with men (MSM) and transgender, gender non-conforming (TGNC) individuals. The proposed program seeks to improve and expand sexual health services within two community FQHCs and through a mobile sexual health clinic. To ensure the effectiveness of the program, responsiveness to priority populations, and high quality of care, we will work with strategic partners, including the NYC Department of Health and Mental Hygiene (DOHMH), the NYC EHE planning bodies, the NYC STD/HIV Training Center, a coalition of community-based organizations (CBOs) and community advocates, and CDC and non-CDC funded programs within H+H and across NYC. Outcomes Strengthen clinic infrastructure and improve service delivery While the sexual health infrastructure at H+H is significant, gaps exist in our efforts to support priority populations. These gaps include: (1) uneven access to services, (2) patients with acute sexual health needs related to STIs obtaining treatment quickly, and (3) need for improvement in the quality of care provided. To address this, we will expand existing sexual health care to develop two express model sexual health clinics and one mobile sexual health clinic. The proposed program will add dedicated, grant-funded staff at H+H’s East New York and Gouverneur FQHCs to support the enhancement of services to align with recommendations for quality STI and HIV prevention services and implement express model sexual health clinics. The teams hired for the FQHCs will also staff 1-2 night shifts at the mobile sexual health clinic – providing approximately 75% of their time within the brick-and-mortar clinics, and 25% of their time in the mobile clinic. The mobile clinic will provide on-site healthcare at nightlife and commercial sex venues to effectively provide STI and HIV prevention services at locations where priority populations met for sex. The proposed program will expand access for individuals at high need not currently served, improve the quality of care provided, and integrate efforts to further the reach and avenues of care access for priority populations. Foster strategic partnerships: H+H is committed to excellence and equity in healthcare, demonstrated by providing services grounded in the voices of the people we serve and effectively responding to their needs. This health equity commitment is a cornerstone of the NYC EHE plan. The proposed program will exemplify this through multiple actions that build partnership, engagement with the priority populations. This will include the development of a Community Advisory group that includes representatives from priority populations, administering a Community Needs Assessment and working directly with community partners to guide clinical improvements. An example of this is the proposed mobile sexual health clinic – a direct response to community desire for mobile health units for STI and HIV testing and referral to high quality, affirming sexual health care.
