Implementation of Community Health Worker-Mediated Services for Re-Engagement to Care and Outreach for Persons with HIV in Rural Communities (REACH: Rural Re-Engagement and Care using CHWs for Persons - Executive Summary: The Indiana Department of Health seeks funding for the REACH (REACH: Rural Re-Engagement and Care using CHWs for Persons with HIV) program, a comprehensive initiative aimed at improving HIV care services in rural communities. Targeting key challenges such as limited access to care, provider shortages, and transportation issues, the program specifically addresses the needs of Black/African American, People Who Inject Drugs (PWID), and Hispanic/Latino communities, which face disproportionate impacts. Indiana has a HIV prevalence of 13,560, with 67% virally suppressed, and a 25% unmet need, the REACH program focuses on enhancing care and outreach for underserved populations. Utilizing a Community Health Worker (CHW) home-based approach, the program strives to improve access, retention in care, and viral load suppression for Persons Living with HIV (PWH). The application emphasizes partnerships with HIV care providers, diverse services provided by CHWs, and a data-driven strategy to enroll 100 PWH over a year. Aligned with national objectives and CDC collaboration, REACH aims to reduce disparities, overcome barriers, and enhance outcomes in Indiana's rural communities. Background: The Indiana Department of Health is seeking funding to implement a program, REACH (REACH: Rural Re-Engagement and Care using CHWs for Persons with HIV), aimed at improving HIV care services in rural communities. The application requests $501,303 for year one. Challenges faced by rural populations include limited access to HIV care, provider shortages, and transportation issues. Certain demographics, such as Black/African American, People Who Inject Drugs (PWID), and Hispanic/Latino communities, are disproportionately affected. The prevalence of HIV in Indiana is 13,560, with 67% virally suppressed and with an unmet need at 25%. The program targets improving care and outreach, particularly in underserved populations. Approach: The program aims to address HIV disparities, focusing on Black individuals, Hispanic/Latino populations, gay, bisexual, and other men who have sex with men, and PWID. It will employ a Community Health Worker (CHW) home-based approach to enhance re-engagement in care and outreach for Persons Living with HIV (PWH). The goal is to improve access to care, increase retention, and achieve sustained viral load suppression, ultimately benefiting individual health and reducing community-level HIV transmission. Outcomes: The program uses partnerships with HIV care providers to implement a CHW-mediated approach for re-engagement in care and outreach services for PWH in rural communities. CHWs offer diverse services, including ART delivery, sample collection, transportation, telehealth scheduling, and medication adherence support. The initiative aims to enroll a minimum of 100 PWH not in care or with unsuppressed viral loads, emphasizing data-driven effectiveness. Aligned with national objectives and frameworks and in partnership with the CDC, it addresses geographic disparities, reduces unmet needs, and enhances outcomes for PWH by tackling barriers and social determinants in rural populations. The application reflects the Division's commitment to the Ending the Epidemic initiative, outlining strategies for HIV and Hepatitis elimination. Strategies, Activities and Purpose: The program addresses healthcare disparities for PWH in Indiana's rural communities, where limited access to HIV care providers and long travel distances pose significant challenges. Seeking funding, the initiative collaborates with HIV care providers, employing a CHW model for re-engagement in care and outreach services. The CHWs facilitate ART delivery, sample collection, transportation, telehealth visits, and medication adherence support. With a focus on culturally responsive services, the program aims to enroll a minimum of 100 PWH not in care or with unsuppressed viral loads.
