Asclm/alliance CDC PS21-2102 - new york city is home to the nation?s largest population of people living with HIV (plwh), most of whom are low-income people of color

In 2018, 119,170 new yorkers were living with HIV; approximately 9% were unaware of their status and 32% were not virally suppressed. Of the 1,953 new diagnoses in 2018, 77.2% were among blacks and hispanics; 72.0% were men who have SEX with men (MSM)?the target population for this proposal. To address this profound disparity, aids service center of lower manhattan DBA alliance for positive change (?alliance?) proposes a comprehensive, coordinated, and integrated HIV prevention service program for low-income, underserved black and latino/hispanic MSM in NYC, focusing on central harlem (manhattan) and crotona park-tremont (bronx). We will focus on 20-to-39-year-olds, the age group that makes up 80% of new HIV diagnoses in NYC. The program will be delivered in collaboration with newyork-presbyterian hospital (NYP) (subcontractor), with support from engagewell harm reduction independent practice association and community care management partners health home. Purpose: to provide coordinated, integrated high-impact HIV prevention programming to HIV+ and high-risk negative (HRN) MSM of color in NYC by implementing evidence-based behavioral interventions enhanced by extensive condom distribution; HIV/STI/HCV counseling, testing, and referral (CTR); linkage to care; service navigation and treatment adherence programs; and other supportive services. Outcomes are organized around the pillars of the comprehensive HIV prevention core program. Pillar i outcomes: diagnose: short-term: diagnose at least 15 new HIV infections/year; increased client receipt of integrated screenings. Pillar II outcomes: treat: short-term: provide linkage to care and anti-retroviral treatment (art) prescriptions within 30 days to all newly diagnosed individuals; increased receipt of HIV medical care and art among persons with previously diagnosed HIV who have fallen out of care; increased medication adherence among plwh; increased access to partner services and other essential support services among plwh. Intermediate: increased access to care for persons with diagnosed HIV; increased viral load suppression among those receiving anti-retroviral treatment and access to services (artas). Pillar III outcomes: prevent: short-term: increased access to prep; increased access to npep; increased availability of condoms; increased receipt of evidence-based risk reduction behavioral interventions; increased access to essential support services for HRN persons. Pillar IV outcomes: respond: short-term: increased health dept. And community engagement for HIV-transmission cluster detection and response. Intermediate: improved response to these clusters and outbreaks. Long-term: improved response to HIV transmission clusters/outbreaks; reduced new HIV infections; reduced new infections where the person is also diagnosed with aids when first diagnosed with HIV; reduced HIV-related health disparities; improved health outcomes for persons diagnosed with HIV; reduced number of deaths of persons diagnosed with HIV.five-year objectives: provide 4,000 HIV tests. At least 75% of testing participants will be black/latino MSM and at least 75 persons will be newly diagnosed HIV+. 90% of these newly diagnosed people will be linked to medical care within 30 days. At least 50 people who have ?fallen out of care? (and at least 30 known HIV+ people who have been retested) will be reconnected to care; 100% will be referred to partner services and prevention/essential services. 100% of HRN persons will be referred/navigated to prep and npep clinical services. More than 15,000 free condoms will be distributed across all program activities over the five-year period.