The Louisiana Wellness Centers Program for HIV/STD Prevention Among Gay and Bisexual Men and Transgender Persons.

CONTEXT: During the conduct of the described demonstration project (2012-2015), the Centers for Disease Control and Prevention funding standard for HIV testing was 1.0% newly diagnosed positivity in non-health care settings. For linkage to HIV medical care, the National HIV/AIDS Strategy goal was 85%, and the funding standard was 80% (the Centers for Disease Control and Prevention and National HIV/AIDS Strategy had no other quantified goals/standards relevant to the project). OBJECTIVE: To determine aggregate quantitative results of HIV/STD testing and engagement in HIV care. DESIGN: Information sources used for this case study analysis included the Louisiana Department of Health funding application, progress and final reports submitted to the Centers for Disease Control and Prevention, and records of communications between these agencies. SETTING: Six community-based Wellness Centers throughout Louisiana. PARTICIPANTS: Gay and bisexual men and transgender persons. MAIN OUTCOME MEASURES: New HIV/STD diagnoses from testing, linkage to HIV care, and reengagement in HIV medical care. RESULTS: The percentage of persons who were newly diagnosed with HIV was 1.4% (44/3214). Of the newly diagnosed persons, 91% (40/44) were linked to HIV medical care. Of persons who were identified as out of care, 83% (5/6) were reengaged in HIV medical care. STD testing results showed that 9.0% (294/3251) of the syphilis tests were positive, and 8.3% (803/9719) of the chlamydia/gonorrhea tests were positive. The pharyngeal chlamydia/gonorrhea positivity was 7.6% (256/3375); the rectal chlamydia/gonorrhea positivity was 13% (374/2948); and the urine chlamydia/gonorrhea positivity was 5.1% (173/3396). CONCLUSIONS: The demonstration project was successful. The results were used to discontinue funding for a less effective HIV screening program, continue demonstration project activities with other funds, and make policy changes so that extragenital screening for chlamydia/gonorrhea is now the standard at Louisiana clinics that serve gay and bisexual men and transgender persons.

Using HIV Surveillance Data to Link People to HIV Medical Care, 5 US States, 2012-2015.

INTRODUCTION: From 2012 through 2015, the Centers for Disease Control and Prevention (CDC) provided funding to 5 health departments for demonstration projects using HIV surveillance data to link people with newly diagnosed HIV to care. We assessed how well these health departments established linkage to care, how the demonstration projects helped them with this work, and if they sustained these activities after CDC funding ended. MATERIALS AND METHODS: We obtained quantitative and qualitative data on linkage-to-care activities from health department communications and progress reports submitted to CDC. We calculated and combined linkage-to-care results for the 5 health departments, and we compared these results with the combined linkage-to-care results for 61 health departments that received CDC funding for routine HIV prevention activities (eg, HIV testing, linkage to and reengagement in HIV care, HIV partner services) and for the same 5 health departments when they used only routine HIV prevention activities for linkage to care. RESULTS: Of 1269 people with a new HIV diagnosis at the 5 health departments, 1124 (89%) were linked to care, a result that exceeded the 2010-2015 National HIV/AIDS Strategy goal (85%), the CDC Funding Opportunity Announcement performance standard (80%), and combined results for the 61 health departments (63%) and the same 5 health departments (66%) using routine HIV prevention activities. Benefits of the projects were improved collaboration and coordination and more accurate, up-to-date surveillance data. All health departments continued linkage-to-care activities after funding ended. PRACTICE IMPLICATIONS: Using HIV surveillance data to link people with HIV to care resulted in substantial clinical and public health benefits. Our observations underscore the importance of collaboration among medical providers, public health staff members, community-based organizations, and people with HIV to ensure the best possible clinical and public health outcomes.