Background: The Bronx, the poorest borough in New York City, (NYC) with a median household income of $38,085, according to the 2014-2018 US census. Self-identified men who have sex with men (MSM) constituted 71.4% of new HIV diagnosis among New York City men, in 2018. The largest number within this group are 20-39 years of age . To reduce new HIV infections, increase access to health care, and reduce health disparities among Bronx residing Black and Latino MSM, our CDC-modeled High Impact HIV Prevention (HIP) Program will provide rapid HIV testing in community-settings, on-site at the Montefiore Prevention Center (MPC), at our Federally Qualified Health Centers and via self-test home kits (mailed or picked up). We will immediately link participants to medical care and, prevention and essential services (ESS) for HIV-positive and Men who have Sex with Men (MSM) and transgender and/or gender-non-conforming (TGNB), 13-49 years old and of color within the structure of the Montefiore HIV Prevention Program, (MHPP). The MHPP located in the MPC, has utilized their project space to provide innovative approaches (movie night, clothing drives, fashion shows, etc.) to engage hard to reach populations.
Our Target Populations are Black and Hispanic/Latinx MSM and TGNB, 13-49 years old, residents of Norwood, Crotona-Tremont, Fordham-Bronx Park, Highbridge, Morrisania, Morris Heights, Melrose, West Farms, and other areas of the Bronx and NYC where MSM and TGNB congregate. The Bronx neighborhoods mentioned have the highest number of HIV diagnoses, and high rates of poverty.
Bronx-based MSM and TGNB experience social, cultural, and economic barriers to prevention, treatment and care, including a lack of knowledge of HIV status; awareness of risk and risk reduction strategies; non-disclosure of positive HIV status; minimal access to health insurance and care; unstable housing; homophobia; limited educations; HIV and sexual orientation and gender identification related stigma; racism; financial hardship; and lack of family and social support. These experiences de-prioritize health and heath care and prevent MSM from seeking and accessing services.
Objectives: The Montefiore HIV Prevention Program (MHPP) proposes the delivery of high-impact HIV prevention services, governed in part by the Community Engagement Group (CEG) who will inform the program at various levels of service delivery from program promotion messaging to targeting venues for outreach and so forth. Prevention services will align with the goals of the national Ending the Epidemic (ETE) by focusing efforts on the four outlined components: Testing, to identify undiagnosed HIV + individuals; Treatment, to facilitate viral suppression; Prevention, by initiating PrEP care for those testing HIV negative and by achieving viral suppression for HIV + individuals who are immediately linked to care and ESS, provided via status-neutral navigation, in collaboration with the Bronx Community Healthcare Network’s Community Health Workers (CHW’s) to address social determinants of health ; and Respond, to collaborate with the NYC Department of Health and Mental Hygiene, (DOHMH), to collaborate on a coordinated plan for responding to identified cluster outbreaks of HIV diagnosis to rapidly deploy testing staff and immediately link those testing positive to HIV medial care and those testing negative to PrEP and nPEP within 72 hours.