ENLACES por LA Salud

1. ENLACES por LA Salud UNC Chapel Hill

2. HIV Cascade of care, Nc

3. HIV among Latino MSM and Transgender women in NC • With population increase of 394%, NC had the fastest-growing Latino population among all US states from 1990-2000. • 58% of new HIV cases among Latino men in NC in 2008 were attributed to male-to-male sex. • Latino men in NC are over 2x more likely to present with a late diagnosis than non-Latinos • Our teams preliminary research and insights from our community partners indicate an urgent need to enhance HIV prevention and care efforts for both MSM and TW.

4. AIM 1: Increase # Mexican MSM/TW who are aware of HIV status (target=70) • Develop and execute innovative outreach and testing strategies in concert with our community partners • Social/sexual network based testing • New venues • Healthcare settings – FQHCs, urgent care, community/mental health clinics) • Social venues—new presence within Latino clubs • Use of internet sitesand geospatial ‘apps’ • One-on-One testing or testing “potlucks” • Mobile van

5. Community Partners

6. AIM #2: Increase “early” linKage to care among HIV+ Mexican MSM/TW • Health care navigation: • engagement of client, assessment of issues, creation of action plan, help with implementation and following up on progress toward stated goals • Two Personal Health Navigators (PHN) will be hired for project • One serving Triangle Region (housed at Lincoln) • One serving Mecklenburg (housed at RAIN)

7. AIM #2: Increase “early” linKage to care among HIV+ Mexican MSM/TW • Statewide partnerships • NC ONE CALL • Statewide toll-free number to nurses trained in assisting HIV+ patients and non-HIV providers with referral to an HIV primary care provider • State and local Bridge counselors and regional Disease Intervention Specialists

8. AIM #3: Enhance retention in care for HIV+ Mexican MSM/TW • Expand and enhance service provision to HIV+ Mexican MSM/TW • Expanded hours and translation services • Cultural competency training via developed materials, webinars with clinical partners and statewide • Review of all clinic based materials • Development of clinic protocols to provide needed healthcare services for TW within clinics including hormonal therapies.

9. Medical Partners

10. Formative research • Qualitative in-depth interviews with MSM and TW living with HIV to (n=20): • Understand their processes of getting linked to care • Identify barriers to retention and adherence and strategies for overcoming them • Obtain suggestions for effective strategies to engage with the populations

11. Evaluation Plan • Sources of data • Socio-behavioral survey including site-specific and cross-site measures (baseline and q6 months) • NC state epidemiological data • Qualitative interviews with MSM/TW from observational study (N=20) • 2-3 interviews with each

12. Evaluation Plan (END of Study) • Focus groups with MSM/TW from observational study (2-3 total) • Assess the overall experience with program strategies • Obtain suggestions for improvement • Key informant interviews with providers (n=10) • Identify the provider perspective on working with PHN, the care collaborative and other program strategies

13. Stigma Reduction Plan • Engagement with MSM and TW support groups at El Centro • Formation of Latino MSM/TW Care Collaborative • Develop a referral network to address all facets of health that affects this population thus ensuring the availability of a continuum of community based care. • Education statewide (use of NCAETC)

14. Year 1 TIMELINE Dec-Feb June-Aug Sept-Nov Mar-May • Hiring PC • Hiring PHNs • Logo development • Marketing materials • Infrastructure building • Development of data collection tools • IRB submission • Planning and kickoff meeting • Training PHNS • Resource mapping • Continue building infrastructure • Outreach activities • Intervention begins

15. Contact info Lisa Hightow-Weidman, MD, MPH Lisa_hightow@med.unc.edu 919-843-0033 130 Mason Farm Road Chapel Hill, NC 27312