Tcrhcc STI public health response - tcrhcc is a nonprofit, tribal 638 organization in coconino county, arizona, and is the sole health care provider in this region of over 33,000 navajo, hopi and…

Tcrhcc STI public health response - tcrhcc is a nonprofit, tribal 638 organization in coconino county, arizona, and is the sole health care provider in this region of over 33,000 navajo, hopi and SAN juan southern paiutes. Tcrhcc is proposing to use cooperative agreement funding to increase the reach and efficiency of its PHN STI case management program through development and implementation of a case management and epidemiology software platform, community outreach, and a treatment incentive initiative. The american indian communities that tcrhcc serve are disproportionately impacted by stis. Rate of stis among american indians (AI) in arizona far exceed the general population (chlamydia rate is 995 per 100,000 for AI VS state average of 601; and gonorrhea 430 for AI versus 85 for whites). Syphilis rates have climbed dramatically for american indians in arizona over the past 5 years, up to 105. This compares to a rate of just 19 for whites in arizona. Arizona has a much higher rate of congenital syphilis (137 per 100,000 live births) than the united states (49), and the rate is drastically higher among american indians in arizona (621).the tuba city service area has seen a 500% increase in new syphilis case between 2019-2021. So far in 2022, there has been an additional 80% increase in syphilis cases over 2021 in the tuba city service area. Increasingly, new STI cases are among women of childbearing age (58% of new syphilis cases) - a significant change from prior epidemics which often affected primarily men who have SEX with men. This shift requires different public health and clinical strategies-and more epidemiological data to better understand the trends and develop effective interventions. There is a critical and urgent need to improve identification and treatment of stis in this high risk population. Tcrhcc has the established PHN case management program, but desperately needs data software to better track and respond to outbreaks and target social network response. Tcrhcc's goals for this PHN STI case management program are to: develop and fully implement a STI case management software platform by the end of grant year 1 (2023); review and refine PHN STI case management policies and procedures, create an evaluation plan, and implement a patient satisfaction collection process by end of grant year 1 (2023); increase the number of syphilis tests conducted by tcrhcc annually by 200% by the end of grant year 5 (2027); track and measure baseline syphilis treatment adherence by the end of grant year 2 (2024), and improve that treatment adherence rate by the end of grant year 5 (2027) through patient incentives; and reduce the number of new syphilis cases in the tuba city service unit by at least 25% by the end of grant year 5 (2027). The anticipated benefits of our proposed activities for the american indian communities we serve include: greater awareness of STI prevention; decrease in STI infection rates; increase in STI early detection and treatment; improved quality and continuity of care using the PHN case management model; and increased patient satisfaction.