The Houston Health Department (HHD) submits this application in response to the Centers for Disease Control and Prevention (CDC) notice of funding opportunity (NOFO) announcement number CDC-RFA-PS22-2211 to conduct “Enhanced Surveillance of Persons with early and late HIV Diagnosis (ELHD) to Understand System and Individual Factors Associated with New Infection and Delayed Testing”. Houston/Harris County, Texas has the highest number of people living with HIV/AIDS in Texas and is considered a hot spot for HIV, with incalculable public health and social consequences. Rates of new HIV diagnoses and prevalence in Houston/Harris County continues to exceed rates both for Texas and the U.S, with estimated 6,825 of people living with HIV remaining undiagnosed. In a recent HIV surveillance report, 10.9% and 19.7% of the cases from Houston/Harris County were classified as stage 0 and stage 3 infection, respectively. Persons with stage 3 infection at the time of their initial HIV diagnosis (i.e., late diagnosis) did not benefit from timely receipt of testing or HIV prevention interventions and were likely unaware of their infection for a substantial length of time. In line with the CDC project descriptions, the HHD has summarized in this application the proposed approach that includes the strategies and activities, evaluation and performance measurement, process measures and the work plans associated and the expected outcomes. The goals of these strategies and activities are among others, to improve the identification and recruitment of people recently diagnosed at stage 0 or stage 3 in Houston/Harris County, Texas and to increase their access to HIV care linkage, retention services, and ancillary services. These efforts will help to decrease the number of new HIV infections, HIV-associated morbidity and mortality, late diagnoses, and disparities in health outcomes during the performance period. The HHD has successfully executed numerous CDC HIV surveilla
nce projects and has the experience, human resources and administrative capacity to effectively implement the strategies and activities outlined in the current NOFO (CDC-RFA-PS22-2211).