Project Grant H79TI086831

THE CARE AND ACCESS FOR RURAL ENGAGEMENT (CARES) PROJECT - THE CARE AND ACCESS FOR RURAL ENGAGEMENT (CARES) PROJECT BUILDS ON THE ONGOING WORK AND EXISTING STRONG COMMUNITY PARTNERSHIPS BY FIVE HORIZONS HEALTH SERVICES TO EXPAND HIV AND SUBSTANCE USE PREVENTION AND CARE IN 53 COUNTIES ACROSS WEST AND SOUTH ALABAMA (37 COUNTIES) AND EAST MISSISSIPPI (16 COUNTIES). THE PROJECT AREA INCLUDES OVER 2.1 MILLION PEOPLE, REPRESENTING ABOUT 26% OF THE COMBINED POPULATION OF ALABAMA AND MISSISSIPPI AND IS MAINLY RURAL. MOST OF THE RESIDENTS IN THE TARGET AREA ARE LISTED AS BEING IN PERSISTENT POVERTY. BY THE END OF THE PROJECT, WE WILL REACH APPROXIMATELY 80,000 INDIVIDUALS AND PROVIDE HIV TESTS, SUBSTANCE USE/MENTAL HEALTH ASSESSMENT TO OVER 12,000 INDIVIDUALS. THE CARES PROJECT WILL EXPAND CARE TO MAINLY UNDERSERVED RURAL POPULATIONS IN ALABAMA AND EAST MISSISSIPPI, BY ADDRESSING THE SALIENT BARRIERS TO CARE AND PREVENTION AMONG INDIVIDUALS WITH OR AT RISK OF HIV AND ITS RELATED COMORBIDITIES INCLUDING SU/MHD. THE FOLLOWING GOALS AND OBJECTIVES WILL GUIDE THE PROJECT: GOAL 1: REDUCE NEW HIV INFECTIONS AND RELATED COMORBIDITIES BY INCREASING ACCESS TO SCREENING, TESTING, AND CARE FOR INDIVIDUALS AT RISK FOR HIV, THROUGH TARGETED OUTREACH EFFORTS AND REDUCING BARRIERS TO CARE RESULTING IN EARLY ACCESS TO TREATMENT AND PREVENTION. BY THE END OF THE PROJECT, THE CARES OUTREACH TEAM WILL CONDUCT OUTREACH EVENTS IN ALL 53 COUNTIES AND REACH AT LEAST 80,000 PEOPLE FROM MEDICALLY UNDERSERVED RACIAL AND ETHNIC COMMUNITIES DISPROPORTIONATELY AFFECTED BY HIV/AIDS AND HIV-RELATED DISPARITIES. BY THE END OF YEAR 5, THE OUTREACH TEAM WILL OFFER PRELIMINARY HIV TESTING TO ALL INDIVIDUALS ATTENDING OUTREACH EVENTS OR VISITING FHHS, RESULTING IN AT LEAST 12,000 OF INDIVIDUALS (15%) ATTENDING OUTREACH EVENTS OR VISITING FHHS CLINICS GETTING TESTED FOR HIV. BY THE END OF YEAR 5, THE CASE MANAGEMENT TEAM WILL ENSURE THAT AT LEAST 95% OF CLIENTS SCREENING POSITIVE FOR HIV AT ANY OF OUR EVENTS RECEIVE CONFIRMATORY HIV TESTING AND 95% OF THOSE CONFIRMED TO BE POSITIVE ARE LINKED TO AND MAINTAINED IN HIV CARE. GOAL 2: REDUCE SU/MHD RISK AMONG INDIVIDUALS WITH OR AT RISK OF HIV, BY IMPLEMENTING AN ONGOING STRATEGY TO REACH AND PROVIDE EVIDENCE-BASED SU/MHD SERVICES. OBJECTIVES: BY THE END OF YEAR 5, THE OUTREACH TEAM WILL OFFER SCREENING FOR SU/MHD AS INDICATED TO INDIVIDUALS WITH OR AT RISK FOR HIV ATTENDING OUTREACH EVENTS FHHS, RESULTING IN AT LEAST 15% OF ATTENDEES BEING SCREENED FOR SU/MHD. BY THE END OF YEAR 5, THE BEHAVIORAL HEALTH TEAM (BHT) WILL DIAGNOSE AND DEVELOP AN INDIVIDUALIZED TREATMENT PLAN FOR AT LEAST 80% OF INDIVIDUALS WHO SCREEN POSITIVE FOR SU/MHDS. BY THE END OF YEAR 5, THE BHT WILL CONNECT 100% OF INDIVIDUALS RECEIVING A DIAGNOSIS FOR SU/MHD TO THE IN-HOUSE TREATMENT TEAM OR PARTNER AGENCIES AND ENSURE THAT AT LEAST 80% RECEIVE EVIDENCE-BASED TREATMENT AND ARE MAINTAINED IN CARE. GOAL 3: REDUCE RISK FOR NEW INFECTIONS FOR HIV AND OTHER STIS BY INCREASING ACCESS TO PREP, POST-EXPOSURE PROPHYLAXIS (PEP), AND STI TREATMENT AND CARE TO INDIVIDUALS AT RISK FOR HIV AND /OR STI. BY THE END OF YEAR 5, INDIVIDUALS IDENTIFIED AS BEING AT RISK FOR HIV WILL BE PROVIDED WITH SUPPORTS INCLUDING EDUCATION, CASE MANAGEMENT AND REFERRAL TO IN-HOUSE PREP AND STI TREATMENT AND CARE TO ENSURE THAT AT LEAST 50% OF INDIVIDUALS AT RISK AND ELIGIBLE ARE INITIATED AND MAINTAINED IN PREP AND/OR STI TREATMENT AND CARE. BY THE END OF YEAR 5, 100% OF INDIVIDUALS REPORTING INCREASED RISK FOR HIV WILL BE PROVIDED SUPPORTS INCLUDING EDUCATION, CASE MANAGEMENT AND REFERRAL TO HIV CLINIC TO RECEIVE PEP SERVICES, INCLUDING BEING PROVIDED WITH PEP MEDICATION WITHIN 72 HOURS TO ENSURE THAT AT LEAST 95% OF IDENTIFIED INDIVIDUALS AT RISK DUE TO EXPOSURE ARE INITIATED ON PEP AND MAINTAINED IN CARE. BY THE END OF YEAR 5, 100% OF INDIVIDUALS TESTED POSITIVE FOR VIRAL HEPATITIS B AND C WILL BE REPORTED TO THE DEPARTMENT OF PUBLIC HEALTH. GOAL 4: CONDUCT PROGRAM EVALUATION TO MEASURE PERFORMANCE ON OBJECTIVES AND PROGRAM SUCCESS.