Ryan White Title III HIV Capacity Development and Planning Grants - The Los Angeles County (LAC) HIV Care Continuum data from 2023 show that only 64% of people living with HIV (PLWH) in LAC achieved viral suppression and 51% were retained in HIV care. These rates fall well below the County’s goals of 90-95% to End the HIV Epidemic, especially among underrepresented communities. Viral suppression was lowest for Blacks/African Americans (58%) and Hispanics/Latinos (63%) compared to Whites (67%) and women (61%) compared to men (64%). In LAC, the largest perinatal center for HIV care is the Maternal, Child & Adolescent/Adult (MCA) Center for Infectious Diseases and Virology at the LAC General Medical Center. Since 1988, the MCA Center has been providing wrap-around, family-centered care for pregnant and non-pregnant women, children with HIV exposure (and infection) and youth, who are primarily indigent and from minority groups. Ninety percent of the MCA Center’s patients live at or below the federal poverty level, 70% are Hispanic/Latino, and 24% are Black/African American. In 2023, retention in care at MCA was lowest among Blacks/African Americans (77%) and the 12-24 age group (66%), compared to all other racial and age groups. Viral suppression rates were lowest among Blacks/African Americans (75%) and those ages 12-24 years (69%). A prominent barrier to optimal HIV outcomes is lack of adequate social support. Social support is a critical external resource that has been shown to protect against stigma and discrimination and mental health conditions, in addition to promoting earlier HIV diagnosis, better retention and engagement in care, and improved ART adherence. Conversely, suboptimal levels of social support are associated with poorer ART adherence, unhealthy coping mechanisms, and disease denial among PLWH. Social support directed from peers living with HIV is particularly powerful for PLWH and has been linked to improved HIV Care Continuum outcomes. The purpose of this proposal is to request $150,000.00 to develop and implement a training and education workshop for PLWH at the MCA Center to become peer support advocates (members of a Peer Support Squad). The 3-day workshop will include modules on the basics of peer support, effective communication, privacy and confidentiality, HIV basics, HIV care compliance, stigma and discrimination, and resource referrals delivered by experts in the field. After the workshop trainings, we will pair each Peer Support Squad member (10 total) with one MCA Center patient to provide peer support services, followed by a debrief and evaluation of the engagement. This proposed project falls under the HIV Care Innovation Activities: Strategic Partnerships, Training and Capacity Building. The goal of the proposed program is to empower Peer Support Squad members with knowledge to develop trusting relationships with PLWH, to provide critical peer support services, to offer mentorship, and to assist with health care system navigation in an effort to promote optimal HIV outcomes. Additionally, our goal is for PLWH, particularly those experiencing challenges to HIV care compliance, to feel connected with other PLWH, to feel supported and validated in their lived experiences, and to feel understood by compassionate, knowledgeable and resourceful members of a Peer Support Squad. These feelings will then increase their enthusiasm and motivation to adhere to their ART regimen and care plan, attend scheduled visits and appointments, and reach viral suppression. The project will be implemented at the MCA Center, a RWHAP Part C and D recipient.
