Monday, September 25, 2023
9/25/2023
NewYork-Presbyterian (NYP) is one of the largest healthcare delivery systems in NYC, a municipality that is home to the largest HIV epidemic in the nation. An early epicenter of the HIV epidemic NYC continues to experience high rates of new HIV infections, especially in vulnerable communities, including young, black MSM, transgender/gender non-conforming individuals, and individuals who engage in sex work. In 2015 NYS launched an ambitious HIV End the HIV Epidemic (EtE) initiative that among its goals seeks to reduce new HIV infection to less than 750 cases per year by the end of 2020. Investment in HIV prevention services, including at NYP, helped the EtE initiative meet many milestones but the advent of COVID-19, its ongoing disruption of the NYC HIV prevention care delivery system, and evolving economic impact threatens to erode recent progress on EtE goals and precipitate a backslide into high rates of new HIV transmission. The proposed project would markedly extend NYP’s HIV prevention reach by the a) deployment of a mobile medical unit (MMU) to provide comprehensive HIV prevention services at venues and neighborhoods in NYP’s catchment communities that have high HIV incidence, prevalence, and individuals of unknown serostatus, b) expansion of NYP and Columbia University’s At-Home HIV Testing and Prevention Program via augmented staffing and enhanced social media outreach and marketing, and c) extension of a sophisticated, real-time HIV Alert Dashboard across the NYP care system to ensure the rapid identification, linkage, and sustained engagement for PLWH. These interventions would build upon the extensive NYP HIV prevention and care program already in existence but currently insufficiently resourced to engage every NYP clinical site, such as Methodist Hospital in Brooklyn, every at-risk community in NYP’s catchment area, and specific unengaged at-risk communities who infrequently touch the healthcare system but frequently utilize online social media venues to facilitate sexual encounters. NYP’s HIV Prevention Program is recognized as one of the largest and most effective prevention programs in NYC, serving over 7000 active clients and one of the only programs that remained open for in-person and walk-in services throughout NYC’s COVID-19 crisis. During this time the NYP HIV prevention program also piloted a successful home based, self-collected STI and HIV testing and telemedicine bundle as part of a COVID-19 mitigation strategy necessary to sustained HIV prevention activity during an epidemic and as an exploration of expanding HIV prevention services to hard to reach at-risk communities. The expected 5- year outcomes for the proposed interventions include 1. a substantial (100%) increase in HIV testing in high-risk demographic groups, 2. an increase by 50% in the annual number of new HIV diagnoses identified at NYP (60/year -> 90/year), 3. an increase of 100% in identification of PLWH who have been lost-to-follow-up (LTFU), their navigation back into care, and initiation of ART within 30 days, 4. an increase by 1000 (717->1800) of high-risk HIV-negative individuals who receive comprehensive HIV prevention services, including STI, hepatitis, Tb screening and PrEP, 5. implementation of protocols that ensure 100% of individuals newly diagnosed with HIV or PLWH who are lost-to-follow-up (LTFU) are referred for Partner Services, and 6. the distribution of condoms in unlimited quantities to all HIV-negative and PLWH served by NYP’s CHIHP program. NYP has identified HIV elimination as one of its key priorities of its recent Community Service Plan and has committed to establishing an elimination plan that includes its hospitals, EDs, ambulatory care network, and CBO partners to achieving this goal. The project would help ensure this outcome by providing critical infrastructure support, technical assistance, and help augment institutional focus on ETE through the recognition of partnership with CDC in this critical activity.
HHS’ Tracking Accountability in Government Grants System (TAGGS) website provides access to detailed descriptions of grants, loans, aggregated direct payments and other types of financial assistance awarded by the HHS Operating Divisions (OPDIVs) and the Office of the Secretary Staff Divisions (STAFFDIVs).
