Penn Mental Health AIDS Research Center

点击翻译按钮获取中文摘要

Project Summary/Abstract People incidence who inject drugs (PWID) are disproportionately affected by HIV incidence in Philadelphia. The HIV in Philadelphia is growing and returning to pre-COVID pandemic levels.At present, the city health department's Department of HIV Health funds many community and clinical health providers for HIV testing and counseling services, including HIV Service Organizations (HSOs), substance use treatment centers, and emergency departments, which have facilitated the detection of many new cases among PWID in Philadelphia. Despite these successes, increasing infection rates in PWID suggest a need for scaled-up detection and linkage strategies. Reliance on traditional HIV prevention providers may yield missed opportunities for HIV diagnoses, timely linkage-to-care, and cluster detection and response. Leveraging providers in healthcare and social service environments outside of traditional HIV prevention settings in neighborhoods with high rates of IDU may maximize opportunities for expanding efforts for HIV cluster detection and response. The extent to which nonclinical HSO-alternative service providers in these areas understand IDU as a significant contributor to the HIV epidemic, routinely conduct or refer PWID high-quality HIV testing services, and are willing and capable to integrate or scale-up HIV testing services within current clinical operations at their agency is poorly understood. To address these gaps, we propose a 2-year study to conduct the following aims: (Aim 1) Employ persons with lived experiences/histories of IDU to conduct secret shopper methodologies toward understanding the current HIV testing/referral practices in nonclinical HSO-alternative outpatient service facilities (N = 15) in Philadelphia neighborhoods with high IDU; (Aim 2) Deploy surveys with N = 100 PWID living without HIV to evaluate environmental preferences for HIV prevention services in nonclinical HSO-alternative outpatient service facilities in Philadelphia; and (Aim 3) Engage with representatives from secret shopper-evaluated facilities through stakeholder meetings to discuss secret shopper feedback, their perceptions of the HIV epidemic among PWID in their service area, and their capacity for HIV prevention services. The proposed study will facilitate local priorities pertaining to the Diagnose pillar of the Ending the HIV Epidemic Initiative and support the city health department's HIV cluster detection and response strategies. Leveraging HSO-alternative providers' capacities to conduct, refer, and coordinate HIV testing will maximize equitable access to HIV prevention for PWID and opportunities to identify new HIV cases and unidentified clusters missed via traditional HIV testing environments, like HSOs.