FY 2021 ending the HIV epidemic - primary care HIV prevention - the primary care HIV prevention (PCHP) grant provides an opportunity to focus on another type of pandemic-like illness, HIV and aids

Since the coronavirus pandemic has been at the forefront of our medical fight, other diseases such as HIV/aids have not received much attention. The mandatory lockdowns, along with the decline of unemployment leaves many at home and vulnerable to behaviors which lead to contracting HIV. In 2019, at the start of the pandemic, there was decline in HIV new diagnoses within dallas county of 797 in 2018, to 735 in 2019. Yet the population of dallas country grew from 2.629 million in 2018, to 2.636 million in 2019. African americans make up 35.6% of the county's HIV population, and hispanic/latinx make up 40.4%. Of that entire HIV makeup, 47.2% were between 25-34 years of age. Foremost serves part of this community. 39% of our patients are uninsured, and 36% of our patients have public insurance (medicaid, chip, etc.) there are many entities within dallas county, that provide free HIV testing, but foremost family health centers wants to provide other elements with testing and screening, treatment, education and increasing enabling services for those affected with HIV. With our patient centered medical home designation, we want to integrate HIV treatment and prevention into our current primary care workflows. We will identify a provider champion, nurse care manager, a community health worker and utilize our current behavioral health staff to create a team and utilizing bilingual staff member when possible. Our target population are our current patients and individuals in our community that fall within the UDS HIV screening measure population of 15-65 years of age. We want to focus on 4 areas: testing, education, outreach/screening, and increasing capacity. 1. Increase our outreach and screening- using the community health worker to attend events and promote our services, give small talks about testing and prevention, and be advocates within our community. We also want to create a robust sexual history screener in which all patients are comfortable completing knowing their provider is capable keeping their information safe and protecting their health as well. 2. Increase HIV testing with the targeted population, using an "OPT out" model. All patients between 15-65 years of age that see a primary care provider will be tested for HIV. In 2020, we tested 1457 patients for HIV between the ages of 15-65 years old. However, a total of 4066 eligible to be tested, with only 36% of patients were tested. We know that dallas county is second only to harris county with individuals living with HIV, around 18,739 as of 2019. With our 2 years of funding, our goals would be to test at least 3000 patients for HIV, reaching at least 70% of our patients between 15-65 years of age. 3. Increasing education amongst our providers and clinical staff our community. We want to train and thoroughly equip of providers to act on the testing results, and prescribing preep and PEP, when indicated, based on their sexual history screening, and education of patients. We also want to go a step further with treating HIV through virtual and in person clinic visits. They will have a team of the nurse care manager that will be able to ensure patients are keeping up with appointments, getting their medications from our 340B pharmacies, transportation. Our community health workers, and behavioral health staff to create a supportive network that allows patient to thrive. 4. Increase capacity within our clinic. Building on our HIV knowledge, we will be able to utilize our community health worker to educate the community, connect with local HIV testing partners, funneling patients to our centers, to be seen, tested and treated for a foremost provider.