Via Care and its CBO subcontractor, East LA Women’s Center (ELAWC), have designed a comprehensive, high-impact HIV prevention program to address the needs of high-risk heterosexual, low-income adult Latina/Hispanic women ages 18-64 in East Los Angeles. East LA is part of Los Angeles County, one of the geographic areas most significantly impacted by HIV in the US, as per Ending the HIV Epidemic: A Plan for America (EHE) initiative to eliminate HIV in the country. Latinas in Via Care’s service area are vastly underserved and under-resourced for HIV prevention interventions. In LA County, 75% of women who contract HIV do so from heterosexual sex and the remaining 25% from sharing contaminated injection equipment. While Latinas represent only 5.2% of the HIV cases in the County, cisgender women, the Latinx community, and people who inject drugs (who will be significantly represented among the target population for the proposed project) experience worse HIV health disparities than other groups. These include the lowest rates of linkage to and engagement in care, PrEP coverage, awareness of HIV status, and recent participation in HIV testing. Yet, despite being a key population of focus in LA County’s Ending the HIV Epidemic Plan, women of color, particularly Latinas in East LA, have thus received scant attention when compared to other groups. This group faces significant social determinants of health-related barriers to HIV prevention services that include poverty; cultural stigma around sexuality and HIV; low health literacy and awareness of HIV; unstable housing; and exposure to gender-based violence.
In response to the existing epidemiological data, guidance from the LA County’s proposed Ending the HIV Epidemic plan, decades of experience with the target population, and consultation with DHSP, Via Care proposes a new initiative, Comprehensive HIV Intervention for Community-based Awareness and Services (“CHICAS”). Under the CDC PS21-2102 opportunity, CHICAS will target adult high-risk heterosexual Latinas, many of whom are survivors of gender-based violence (GBV), are women who inject drugs (WWID), are exiting LA County jails (reentry women), and have other characteristics that pose high risk for HIV infection and result in poor health outcomes for people living with HIV (PLWH) in and nearby East LA neighborhoods.
Over the 5-year grant period, CHICAS will reach more than 15,000 women with brief HIV education presentations via outreach by Community Health Promotoras. A total of 6,200 HIV screenings will be conducted, 75% of which will be rapid tests with the targeted critical subpopulations and 25% with Latinas during routine medical visits at Via Care FQHC clinics. Sixty percent of HIV testing events will include integrated testing for STD, viral hepatitis and/or TB. CHICAS will identify 45 newly diagnosed and 45 previously diagnosed PLWH among the target population in East LA; 91% of newly and previously diagnosed PLWH will be linked to care within 30 days; and 100% of all PLWH will be referred to Partner Services. Seventy-five percent of HRN women will be referred to PrEP services at Via Care, and 15% will enroll; 2,700 will receive the Sister to Sister Evidence-based Intervention (EBI); and 3,200 will receive PESS at Via Care, ELAWC and other partners. At least 10,000 condoms and 10,000 female condoms will be distributed to protect women from contracting HIV. In addition to Sister to Sister, the EBIs ARTAS and Stay Connected will be implemented within the target populations.
Via Care requests $2,363,905 over five years for CHICAS, which will address HIV risk by developing, implementing, and evaluating a comprehensive, integrated navigation program that incorporates proven strategies to address critical gaps in services to diagnose, treat, prevent and respond to HIV. Ensuring that the unique social determinant-related needs of the women are met, CHICAS interventions will be designed, deployed and assessed by Latina peers.