Project Grant P0647307

RYAN WHITE TITLE III HIV CAPACITY DEVELOPMENT AND PLANNING GRANTS - I. PROJECT ABSTRACT: WAKE COUNTY HEALTH AND HUMAN SERVICES: FY 2022 PART C CAPACITY DEVELOPMENT PROGRAM WAKE COUNTY HEALTH AND HUMAN SERVICES-CLINIC B 10 SUNNYBROOK ROAD RALEIGH, NC 27610 ROBERT DODGE, PHD, RN, ANP AND LINA ROSENGREN-HOVEE, MD OFFICE: 919-250-3078 FAX: 919-250-4429 EMAIL: ROBERT_DODGE@MED.UNC.EDU WEBSITE: WWW.WAKEGOV.COM ORGANIZATION MISSION: WAKE COUNTY HEALTH AND HUMAN SERVICES (WCHHS) IN PARTNERSHIP WITH THE COMMUNITY WILL ANTICIPATE AND RESPOND TO THE PUBLIC HEALTH, BEHAVIORAL HEALTH, AND THE ECONOMIC AND SOCIAL NEEDS OF WAKE COUNTY RESIDENTS. WE WILL COORDINATE AND SUSTAIN EFFORTS THAT ASSURE SAFETY, EQUITY, ACCESS, AND WELL-BEING FOR ALL. CURRENT HIV SERVICES: WCHHS INFECTIOUS DISEASES (ID) CLINIC IS THE SOLE HIV PRIMARY CARE PROVIDER FOR 1,500 INDIVIDUALS WHO ARE UNINSURED/UNDERINSURED/INSURED IN WAKE COUNTY. THE ID CLINIC DIRECT SERVICES ARE TO A POPULATION THAT IS 82.8% MINORITY WITH 68.9% OF THESE BEING AFRICAN AMERICANS AND 11.6% HISPANIC. THE CLINIC IS AVERAGING SEVENTEEN (17) NEW CLIENTS PER MONTH OF WHOM 81.3% ARE MINORITIES INCLUDING 65.5% AFRICAN AMERICANS AND 11.9% HISPANIC. WCHHS ID CLINIC PROVIDES A WIDE RANGE OF MEDICAL-SOCIAL SERVICES FOR ITS CLIENTS: 1) HIV PRIMARY MEDICAL CARE 5 DAYS/WEEK; WEDNESDAY EVENING CLINIC; DAILY WALK-IN CLINIC; 2) CLINICAL TRIALS AS A SUB-UNIT OF THE UNC SCHOOL OF MEDICINE CTU; 3) MENTAL HEALTH/SUBSTANCE ABUSE COUNSELING; 4) NUTRITIONAL COUNSELING; 5) HIV CASE MANAGEMENT-SHORT/LONG TERM; 6) MEDICATION ADHERENCE COUNSELING; 7) SOCIAL WORK COUNSELING/SERVICES; AND 8) BRIDGE COUNSELOR SERVICES TO RE/ENGAGE CLIENTS INTO CARE. SELECTED CATEGORY: INFRASTRUCTURE DEVELOPMENT PROPOSED ACTIVITY: YOUTH LIVING WITH HIV (YLHIV) ARE A POPULATION THAT IS NOTORIOUSLY DIFFICULT TO REACH AND ENGAGE IN CARE. ACCORDING TO THE CDC, 79% OF ALL YOUTH WITH AN HIV DIAGNOSIS RECEIVED SOME CARE, 58% WERE RETAINED IN CARE, AND ONLY 60% WERE VIRALLY SUPPRESSED. YLHIV REPORT HIGHER NUMBERS OF SKIPPED MEDICATION DOSES AND MORE MISSED MEDICAL VISITS. YOUTH AT INTERSECTING MARGINALIZED GROUPS, SPECIFICALLY YOUNG BLACK MEN WHO HAVE SEX WITH MEN (MSM), TRANSWOMEN (TW) AND NONBINARY/GENDER NONCONFORMING PATIENTS (SEXUAL AND GENDER MINORITY YOUTH; SGM YOUTH) HAVE EVEN LOWER RATES OF VIRAL SUPPRESSION AND ARE PRIORITY POPULATIONS FOR INTERVENTIONS THAT IMPROVE HEALTH ALONG THE HIV CARE CONTINUUM. THESE DATA ILLUSTRATE THE NEED FOR YOUTH-SPECIFIC PROGRAMS THAT INCREASE HIV CARE RETENTION AND MEDICATION ADHERENCE. OUR PROJECT AIMS TO INCREASE YOUTH RETENTION IN CARE BY CREATION OF A TEXTING SUPPORT PROGRAM, CALLED "TEXT-IN", SPECIFICALLY DESIGNED TO IMPROVE COMMUNICATION WITH OUR YOUTH PATIENTS. TEXT-IN WILL ALLOW US TO PERFORM "CHECK-INS" VIA TEXT TO OUR SGM YOUTH PATIENTS IN A STRUCTURED WAY TO IMPROVE HIV CARE, COMMUNICATION WITH PATIENTS, EMOTIONAL SUPPORT, MEDICATION ADHERENCE AND CARE RETENTION. IT WILL OFFER BOTH A MEANS TO INCREASE ATTENDANCE AT VISITS BEFORE THEY ARE MISSED, AND A SAFETY NETWORK OF COMMUNICATION WITH PATIENTS WHO MAY BE IN CRISIS OR AT HIGH RISK OF FALLING OUT OF CARE. FUNDING AMOUNT REQUESTED: $105,240, UNDER THE FUNDING OF INFRASTRUCTURE DEVELOPMENT FOR TELEHEALTH, FOR UNDERSERVED POPULATION, PARTICULARLY THAT OF MINORITY YOUTH LIVING WITH HIV.