Human immunodeficiency virus (HIV) infection, when untreated, leads to acquired immunodeficiency syndrome (AIDS), susceptibility to other infections, co-morbid conditions, and ultimately premature death. For individual and public health reasons, improving all elements of the HIV care continuum has become a priority for controlling the epidemic in the United States (U.S.).
The Los Angeles County Department of Public Health - Division of HIV and STD Programs (LAC DPH-DHSP) proposes to continue conducting the Medical Monitoring Project (MMP) in LAC from June 1, 2020 to May 31, 2025. LAC will implement 5 strategies : [(1) preparation, (2) sampling and data collection activities, (3) data management and dissemination, (4) quality assurance and evaluation, and (5) collaboration, training and engagement] in order to achieve the following CDC required outcomes measures by the end of the project period: 1) Quality and quantity of staff for implementing MMP and other surveillance activities; 2) Referrals to HIV care linkage, retention services, and ancillary services among recruited persons with unmet needs; 3) Knowledge related to local and national behavioral and clinical characteristics of people living with HIV in LAC; 4) Quantity and quality of collaboration with federal and local stakeholders; 5) Use of MMP data to inform local and national prevention and care efforts; 6) Use of MMP data to inform allocation of HIV funding and resources at the local and national levels; and 7) Use of MMP data to inform local and national HIV prevention programs.
An annual representative sample of 400 persons who were diagnosed with HIV and are currently residing in LAC will be selected and LAC staff will locate, recruit, and enroll sampled persons into MMP. Participants will be administered a telephone or in-person interview and will consent to a medical record abstraction. Persons determined to be out-of-care will be referred to LAC DPH-DHSP’s Linkage and Re-Engagement in HIV Care Program (LRP) for linkage or re-engagement in HIV medical care.
Use of the NHSS as a sampling frame will allow MMP to monitor clinical and behavioral characteristics of all diagnosed HIV-infected adult persons, whether or not they are receiving medical care. This will enable LAC DPH-DHSP to estimate key indicators on a representative sample of HIV positive persons, including those who are newly-diagnosed and not in regular HIV care, which can be used to shape needed interventions to improve timely linkage, engagement and retention in HIV care, health outcomes for HIV-infected persons (such as viral load suppression), and ultimately reductions in new HIV infections.