U1S46532

Special Projects of National Significance - Minority HIV/AIDS Fund - Address: Columbia University/Aaron Diamond AIDS Research Center 701 W. 168th Street, HHSC 1102 New York, NY 10032

Project Director: Kathrine Meyers, DrPH, MS, MPP
Phone Number: (212) 304-6110
Email: kam2157@cumc.columbia.edu

FDA approval of the first long-acting injectable (LAI) antiretroviral (ARV) medication formulation heralds a new era of HIV treatment. LAI ARV formulations have the potential to dramatically transform HIV care delivery by providing a treatment option that is discrete, long-acting, does not require adherence to a daily oral medication, and can reduce stigma.

However, introducing LAI ARV to new settings and delivering it to people with HIV (PWH) at scale in a way that advances health equity requires significant investment to overcome logistical, financial, clinical, and psychosocial barriers. Without targeted interventions designed specifically to help clinics implement and sustain LAI ARV programs among priority populations, only the most resourced clinics and the most resourced patients will have access to this important discovery, thereby exacerbating rather than ameliorating health disparities.

The proposed project – "Accelerating Implementation of Multilevel-Strategies to Advance Long-Acting Injectables for Underserved Populations" (the ALAI UP project) – will address the goals of the cooperative agreement by supporting the implementation and delivery of LAI ARV at 10 demonstration sites in EHE jurisdictions in New York City (NYC) and the Southeast (SE) region of the US providing care to underserved populations and communities of color. The ultimate goal of ALAI UP is to increase access to and uptake of LAI ARV in areas most impacted by the HIV epidemic.

Expanding access to LAI ARV at these sites will help reduce HIV-related health inequities in achieving and maintaining viral suppression among priority populations. This goal will be achieved through the formation of a multidisciplinary Coordination and Evaluation Provider (CEP) drawn from ADARC, Division of Infectious Diseases, and Psychiatry at Columbia University Irving Medical Center, the NYC Department of Health and Mental Hygiene's Bureau of Hepatitis, HIV, and Sexually Transmitted Infections, the Southeast Regional AIDS Education and Training Center housed at Vanderbilt, and Hunter Alliance for Research and Translation at Hunter College of the City University of New York.

With expertise in clinical, behavioral, and implementation science and extensive training, capacity building, and evaluation experience – and with critical input from the ALAI UP Advisory Board which includes people with diverse lived experiences and local community members – the CEP will support demonstration sites to implement, deliver, and ultimately sustain provision of LAI ARV through:

1) The co-development of protocols and implementation resources,
2) The delivery of technical assistance (TA) on how to use these resources,
3) Provider capacity building to increase provider and patient demand for LAI ARV, and
4) A rigorous monitoring and evaluation plan to inform continuous quality improvement.

ALAI UP will use the evidence-based Stages of Implementation Completion (SIC) – a standardized measure of implementation process and milestones that documents "what it takes" to implement new interventions into practice – as a planning roadmap to guide how we support sites to complete key implementation activities and move from pre-implementation to competency and sustainment. We will also use the SIC to monitor implementation progress and inform the intensity and content of the TA that the CEP delivers to the sites as they move through the stages of implementation.

Cumulatively, ALAI UP's activities will help reduce HIV-related health inequities among priority populations, with a primary goal of ensuring all persons with HIV have access to high-quality treatment and care that is non-stigmatizing, culturally appropriate, and effective.

The Trustees Of Columbia University In The City Of New York

NOT APPLICABLE

93.928 - Special Projects of National Significance

HRSA Office of Federal Assistance Management (OFAM) [HHS - HRSA]

New York, New York United States

City-Wide

Increasing Uptake of Long-Acting Injectable Antiretrovirals Among People with HIV (HRSA-22-155)

Amendment Since initial award the total obligations have increased 297% from $1,500,000 to $5,950,000.