Special Projects of National Significance - Minority HIV/AIDS Fund - Project Abstract Title: System-Level Systemic Approaches to Improve HIV Care and Treatment for People from Racial and Ethnic Minority Groups Applicant: AIDS Care Group, 2304 Edgmont Avenue, Chester, Pennsylvania 19013 Contact: Rahab Goodwin, MPH. Phone: 404-735-9290; Fax: 610-534-2504 Email: mogoodwin@aidscaregroup.org Web: www.aidscaregroup.org Summary of Project AIDS Care Group, a Ryan White provider since July 1999, will design and administer a Special Projects of National Significance demonstration project to help improve case finding, linkages to care, and retention in care for people from racial and ethnic minority groups. Three evidence-informed interventions will be bundled: 1. Outreach and enhanced patient navigation; 2. “Red-carpet care experiences” composed of multiple supportive enhancements, such as food, legal services, housing counseling, and transportation; and 3. Rapid and sustained access into primary care and supportive services. The program will be conducted in Southeastern Pennsylvania, with emphasis in the following counties: Delaware, Berks, Chester, Montgomery, and Bucks. The project will be staffed by personnel of AIDS Care Group within their four clinical locations; and supported by local health, judicial, and social service agencies. Target Population The targeted populations live among the have-nots in a mix of extremes: rich and poor; durably housed and marginally housed; well-nourished and under-nourished; well-educated and under-educated; securely employed and unemployed. The five targeted counties are in the top eleven in Pennsylvania for both incidence and prevalence of HIV/AIDS. The principal targeted community, city of Chester, is the third poorest city of its size in the United States; has the highest crime rate per 100,000 population in Pennsylvania; and has an HIV disease prevalence rate of over 3% of the city’s population. Chester’s population is 70% Black; 14% Latino; and 16% White. The entire community is one defined to have significant unmet medical and social-service needs. Other communities within the five counties that have similar socio-economic markers include: Reading in Berks County; and Coatesville in Chester County. Goals and Objectives for each of the four years of the project period Goal: Improve clinical outcomes of HIV linkage and retention in care with measurable increases in suppressed viral loads for 120 individuals who identify as minority. Objectives: 1. Provide comprehensive patient navigation by community health workers to 120 individuals who identify as minority over a four-year period. Provide bundled services built on a foundation of currently accepted evidence-informed interventions. 2. Meet all Office of Human Research Potential obligations to conduct approved models of outreach, education, counseling, and referral services. 3. Work collaboratively with an Evaluation and Technical Assistance Provider and HRSA for the collection of research data, assessments, and published reports. 4. Create Replication and Dissemination Plans and define a sound fiscal approach to sustainability of the project beyond the four years of the project’s funding period. Summary of funding: Request is made for $500,000 in year one; and $700,000 in years 2, 3, and 4. System-Level Systemic Approaches to Improve HIV Care and Treatment for People from Racial and Ethnic Minority Groups AIDS Care Group HRSA-24-107