Northeast Los Angeles and the San Gabriel Valley Get PreP'd and PEP'd!!

East LA

San Gabriel Valley

N/A

This proposal will make LA the best place to LIVE because we envision a place where honest and proud sexuality is the norm and health equity is a reality—no matter who you are or where you live or who you love. PPPSGV was founded over 80 years ago to provide all women with broad public access to family planning, thus empowering them to seize control of their futures. With PrEP now proven as a highly effective medical prophylactic against HIV, PPPSGV now has the opportunity to offer men who have sex with men (MSM) and other HIV at-risk patients with the compassion, security, and freedom we have given women for nearly a century.

But for many Angelenos, PrEP is a drug of privilege: it can cost at least $1,500/year and can be hard to access beyond metro LA. Last month, the California HIV/AIDS Research Program published a study showing PrEP awareness and usage is lower among Black, Hispanic, and young MSM, and although the majority of MSM are interested in taking PrEP, they don’t know where or how to access it and have fears about side effects, efficacy, and cost, with nearly 60% indicating they don’t think they can afford it. This is alarming because, although metro LA continues to shoulder the greatest HIV disease burden, the Department of Public Health has said “strategies to stem the epidemic in this region are working” while other regions, like the San Gabriel Valley, are exhibiting signs of emerging epidemics, with MSM, the young, and communities of color disproportionately impacted. PPPSGV’s HIV-positive results from the past three years underscore these trends: 81% of our HIV cases were MSM; 57% were MSM of color; and 70% were under the age of 29.

PPPSGV possesses unique capabilities to reach and serve these populations. Last year, 75% (23,387) of our patients were under the age of 29 and 81% (25,052) were people of color. In the past three years, we performed 32,409 HIV tests, and in 2015, we distributed 516,926 condoms. Our patients know our staff will speak their language, will listen to fears and dispel myths and misinformation, will be sensitive to their sexual preferences and gender identities, will offer sliding scale or no-cost services, and will help them navigate the all-too-often costly and labyrinthine healthcare system beyond our doors. As one of six Planned Parenthood affiliates in California, we also have successful models of PrEP provision that we can draw upon to replicate laterally. Furthermore, our health centers are sexual-orientation neutral, meaning: no signage inadvertently “outs” clients entering our buildings for care. This is important since stigma, shame, and homophobia continue to be key barriers inhibiting HIV at-risk people from accessing the recommended care.

Our long-term goal is to offer sliding-scale PrEP to nearly 960 patients/year, and at the close of the grant, we will have rolled out nPEP/PReP services at all of our health centers and will be seeing at least 40 patients/month or 480/year.

Success means offering nPEP/PrEP services at our four health centers in a manner that is sustainable, efficient, culturally competent, and serves and educates the most patients, especially those who are out of the healthcare system, especially difficult to reach, and/or HIV at-risk.

We will measure this success as follows:

At PPPSGV, every department tracks and reviews indicators in each area of our strategic plan. This is done quarterly and then shared with the Board of Directors. Additionally, each month, our Leadership Team reviews 51 metrics pertaining to: Health Center Access; Revenue; Service and Quality; Compliance; Outreach and Marketing; and Finance. Every month, we track whether we are on-target or within 5% of our goal, and if we are not, we respond intelligently. Health center managers undergo a similar monthly performance evaluation on 40 metrics pertaining to: appointment access, quality indicators, patient satisfaction, and financial performance.

At the start of the grant, PPPSGV will generate additional metrics pertaining to PrEP patient services and outreach and integrate these into our existing performance measurement plan, so that the program’s quarterly and monthly results are not reviewed in a vacuum. This will be especially important since the activities of this project will be undertaken by staff in both our Patient Services and External Affairs Departments and implemented at all our health centers as well as in the community at large.

Money

Volunteers

Advisors/board members

Staff

Publicity/awareness

Education/training

Community outreach

Network/relationship support

Advocacy to elected officials