Twenty-eight percent of new HIV infections in Chicago occurred in youth ages 13 to 24, and many of the neighborhoods most affected were on the South Side, according to the Chicago Department of Public Health’s 2016 HIV/STI report. That’s why Care2Prevent (C2P), the University of Chicago’s pediatric/adolescent comprehensive HIV/STI prevention and treatment program, goes directly into the community to test, treat, and identify young adults vulnerable to acquiring HIV.
Once a week, C2P staff, led by Mallory Edgar, manager of community health, operate a drop-in program for homeless and unstably housed LGBTQ youth and their network contacts and friends in Washington Park on the South Side of Chicago. Youth are offered HIV/STI testing, referrals to a UChicago Medicine provider for HIV and pre-exposure prophylaxis (PrEP) care, case management, assistance with basic needs such as hygiene supplies and food vouchers, and space for recreational activities.
Another evening each week, the mobile medical unit visits different communities on the South Side, taking C2P’s testing, care linkage, and resource advocacy services into areas of need. “To increase HIV/STI awareness and service uptake among our priority populations, we need to make our presence known in the highest-risk communities by meeting youth where they are and opening up access points in these relative clinical-service deserts,” says Julia Rosebush, DO, medical director for C2P.
C2P takes a novel social networking testing approach to increase the number of vulnerable youth it reaches. During their testing session, eligible youth can enroll as “network recruiters” and are asked to mobilize members of their social networks to engage in testing and other supportive services. Recruiters are compensated with a gift card for their own enrollment and for each eligible member of their networks who successfully tests. The recruits are also eligible to become network recruiters.
“We are mobilizing members of a patient’s network to come to us, which shifts the focus on minimizing transmission from educating individuals about their own risk factors to targeting a larger population of peers exposed to untreated HIV,” says Matthew Richards, LCSW, director of programs for C2P.
“Research consistently shows that social network approaches to HIV testing identify undiagnosed HIV infections at significantly higher rates than targeted, routine, or non-clinical facility-based approaches," adds Richards.
And for highly vulnerable youth who test negative for HIV, Rosebush and her team have collaborated with other UChicago researchers to submit an NIH R01 proposal that explores the impact of same-day PrEP on medication adherence and retention in care, which is a novel intervention.
In FY 2017, C2P performed 373 HIV screening tests, of which 16 were positive for HIV. C2P also performed 112 STI tests. The average time individuals received care after testing was 7 days. C2P placed 178 individuals from its drop-in center in Chicago’s centralized housing database, with 21 percent placed in permanent housing, 17 percent referred to shelters, and 8 percent referred to market-rate housing.