High Impact HIV Prevention and Surveillance Programs for Health Departments, including programs targeting Ending the HIV Epidemic - This is Missouri’s proposal to provide HIV surveillance, prevention, testing, and linkage to care. 521 individuals were newly diagnosed with HIV in 2022, 100 in rural regions. Activities proposed to identify people with HIV and to reduce new infections include health care and non-health care HIV testing, condom distribution, risk reduction activities, increased PrEP access and social marketing. For HIV Prevention, Missouri will partner with several existing regional contractors. As part of Ending the HIV Efforts, Missouri will increase the number of tests provided by its existing health care testing program and expand the program into an additional region of the state. Missouri will also continue funding three PrEP clinics in rural PrEP deserts and add a PrEP program with a local public health organization that also provides HIV prevention and testing, Ryan White case management, and Disease Intervention partner services, completing true status neutral services in the region. Finally, the state will actively seek out partnerships with new, nontraditional partners in the Kansas City and St. Louis regions in an effort to reach populations that have historically been disproportionately impacted by HIV and underserved by prevention and testing efforts.