In response to the existing epidemiological data, guidance from the LA County’s proposed Ending the HIV Epidemic plan, and almost a decade of experience with the transgender population, St. John’s proposes a new initiative: Community to Clinic Transgender Program (CCTP). Under the CDC PS22-2209 opportunity, St. John’s will expand its current THP/TC to its new Avalon Health Center in a different area of South LA (to meet demand and provide easier access for our transgender patients living in the southeast area of South LA). St. John’s will work with community-based organizations (CBOs) subcontractors (APAIT, Unique Women’s Coalition, and Imperial Court of Los Angeles), as well as other transgender CBOs to develop a holistic community-to-clinic service model which will provide health and wellbeing services for transgender men and women that include co-located HIV prevention and care; gender-affirming services including hormone therapy and other procedures; STI testing and treatment; hepatitis testing, treatment, and vaccination; preventive health care; behavioral health services; and chronic disease care. The CBOs will play a critical role in reaching transgender persons who are not already engaged in HIV prevention or care services for HIV education and counseling, HIV testing, and referral to the THP/TC at Avalon Health Center for PrEP, nPEP, ART, gender-affirming services, and other health care services. This area specifically – and LA County as a whole – has very limited transgender health services and HIV prevention programs that specifically target the needs of transgender persons. In short, the CCTP will fill a gap in innovative, clinic-to-community-based, peer-driven and delivered model for transgender persons in LA County that address the health disparities among the target population.
CCTP is aligned with national and local public health priorities of reducing the number of new HIV infections, increasing the proportion of people who know their serostatus, and ensuring that PLWH are linked or reengaged and retained in care to increase viral suppression, thereby reducing HIV-related health disparities. Requesting a cooperative agreement with CDC over 4 years, St. John’s project targets a key population for ending the HIV epidemic identified by its local jurisdiction (adult transgender persons, especially transgender women) and encompasses multiple high-risk populations disproportionately affected by HIV identified by the CDC (Latinos and Black/African American). CCTP will address HIV risk by developing, implementing, and evaluating a comprehensive, integrated community-to-clinic model that incorporates vetted, proven and mandatory strategies to address critical gaps in services to diagnose, treat, prevent and respond to HIV, taking into account the unique needs of the transgender individuals to be served by ensuring that the interventions be designed, deployed and assessed for their efficacy largely by transgender peers.