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

Burgess, Samuel MA, MSHCM; Beltrami, John MD, MPH&TM; Kearns, Laura MPH; Gruber, DeAnn PhD

Journal of Public Health Management and Practice: February 22, 2019 - Volume Publish Ahead of Print - Issue - p
doi: 10.1097/PHH.0000000000000959
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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.

Louisiana Department of Health, New Orleans, Louisiana (Mr Burgess and Dr Gruber); and Center for Surveillance, Epidemiology, and Laboratory Services (Dr Beltrami) and Division of HIV/AIDS Prevention (Ms Kearns), Centers for Disease Control and Prevention, Atlanta, Georgia.

Correspondence: Samuel Burgess, MA, MSHCM, Office of Public Health, STD/HIV Program, Louisiana Department of Health, 1450 Poydras St, Ste 2136, New Orleans, LA 70112 (samuel.burgess@la.gov).

The authors would like to acknowledge the work of Chris Daunis and Michael Robinson, who coordinated the Louisiana Department of Health STD/HIV Program's Wellness Center project for several years and the staff, and community advisory boards at the Wellness Centers located across the state: Crescent Care in New Orleans, Open Health Clinic in Baton Rouge, Acadiana CARES in Lafayette, Central Louisiana AIDS Support Services in Alexandria, GO CARE in Monroe, and Philadelphia Center in Shreveport, Louisiana.

Funding for the demonstration project described in the article was provided through a competitive demonstration project grant from the Centers for Disease Control and Prevention.

The findings and conclusions in this article are those of the authors and do not necessarily represent the views of the Louisiana Department of Health or the Centers for Disease Control and Prevention.

None of the authors have any conflicts or possible conflicts of interest, and no funding was given for the work of the authors other than the federal funding that the Centers for Disease Control and Prevention gave to health departments to conduct these demonstration projects.

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