The Houston Health Department (HHD) submits this application in response to the Centers for Disease Control and Prevention (CDC) notice of funding opportunity (NOFO) announcement number CDC-RFA-PS20-2005 to conduct both Component A (Behavioral Interview) and Component B (Medical Record Abstraction) of the Medical Monitoring Project (MMP). Houston ranks 10th nationally among Metropolitan Statistical Areas (MSAs) for HIV cases, and first in the state of Texas for the number of people living with the disease. As of September 30, 2019, approximately 19.1% of the 29,670 cases alive and living with HIV or AIDS in Houston/Harris County are presumed dead. Of the people living with HIV in Houston/Harris County, Texas, an estimated 5,855 (27%) are not receiving care and an estimated 3,324 (37%) are out-of-care. There is a need to engage or re-engage people diagnosed with HIV who have never been in care or who have subsequently fallen out of care. Thus, MMP is particularly important in this respect. MMP is an ongoing locally and nationally representative surveillance system that collects data on a probability sample of HIV-diagnosed adults in the United States. The use of the National HIV Surveillance System (NHSS) for sampling allows MMP to monitor clinical and behavioral characteristics of all adults with diagnosed HIV, regardless of whether or not they are receiving medical care and thus provides more accurate data estimates for monitoring and evaluation of national and local HIV/AIDS prevention strategies, policies and funding decisions. In line with the CDC project descriptions, the HHD has summarized in this application the proposed approach that includes the strategies and activities, evaluation and performance measurement, process measures and the work plans associated with Component A and B and the expected outcomes. The goal of these strategies and activities is to produce high-quality locally and nationally representative data on the behavior
al and clinical characteristics of all adults with diagnosed HIV; develop a strong data dissemination plan targeted at potential local and national users; enhance collaborations among federal, state and local partners in Houston/Harris County, Texas responsible for HIV case surveillance, prevention, and treatment; increase the proportion of persons who are linked to HIV medical care within three months of HIV diagnosis and decrease the number of new HIV infections, HIV-associated morbidity and mortality, and disparities in health outcomes during the performance period. The HHD has successfully executed the two previous MMP NOFOs, CDC-RFA-PS09-937 and CDC-RFA-PS15-1503, and has the experience, human resources and administrative capacity to effectively implement the activities outlined in the current MMP NOFO (CDC-RFA-PS20-2005).