This notice announces the opportunity to apply for funding under the Enhancing Linkage of STI and HIV Surveillance Data in The Ryan White HIV/AIDS Program (RWHAP) cooperative agreement. The purpose of this health information technology (HIT) capacity-building demonstration project is to improve linkage, re-engagement in care, and health outcomes for people living with HIV (PLWH) in the RWHAP. HRSA will fund a Technical Assistance Provider (TAP) to identify jurisdictions (state, city, and/or local health departments) and provide programmatic technical assistance (TA) to enable them to create or improve data sharing across their sexually transmitted infection (STI) and HIV surveillance systems. The TAP will assess jurisdictional barriers to data sharing across STI and HIV surveillance departments and develop tools to address these barriers. This matched STI (chlamydia, gonorrhea, and/or syphilis cases) and HIV surveillance data will be used to improve the capacity of RWHAP clinics to prioritize resources for linking and re-engaging PLWH into care.
Co-infection of STIs in PLWH has been associated with decreased CD4 cell counts and increased HIV viral load, which can lead to worse health outcomes for PLWH and a greater risk of transmitting HIV to a negative partner.1 Improving data sharing across jurisdictional STI and HIV surveillance systems is critical for improving the capacity to prevent, diagnose, and treat STIs in response to the rising incidence of STIs among PLWH, as well as identifying PLWH who are in need of additional resources to improve their health outcomes.
1 Jarzebowski W, Caumes E, Dupin N, et al. Effect of early syphilis infection on plasma viral load and CD4 cell count in human immunodeficiency virus- infected men: results from the FHDH-ANRS CO4 cohort. Arch Intern Med 2012; 172(16):1237–1243.
The TAP will fund participating states, cities, and/or local health departments (referred to as jurisdictions). To qualify, the jurisdictions:
• must have high rates of reported STIs (specifically, chlamydia, gonorrhea, and/or syphilis cases) per the CDC 2017 Sexually Transmitted Diseases (STD) Surveillance Report in areas with high HIV prevalence or high rates of new HIV diagnosis per the 2016 CDC HIV Surveillance Report.
• must be willing to work to improve their STI and HIV surveillance data sharing to accomplish the goals of this project.
• electronically match person-level STI and HIV surveillance data less frequently than once per month or not at all
• do not have a mechanism in place to conduct additional follow-up activities such as linkage to care or reengagement in care.
Improving the frequency of this data sharing will inform RWHAP clinics’ decision- making around allocation of resources and services to improve health outcomes of PLWH.
The TAP will also work collaboratively with a contractor (funded separately by HRSA) who will evaluate the overall effectiveness and impact of this project. This demonstration project aligns with the HRSA clinical priority of "transforming the workforce" by enhancing the linkage of STI and HIV surveillance data so provider resources can be tailored and targeted to address the needs of PLWH with a current STI and ensure they are linked or re-engaged in HIV care in the RWHAP.
Eligible applicants include entities eligible for funding under RWHAP Parts A, B, C and D of Title XXVI of the Public Health Service Act as amended by the Ryan White HIV/AIDS Treatment Extension Act of 2009. These include, but are not limited to: health centers receiving support under Section 330 of the Public Health Service Act; Federally Qualified Health Centers as described in Title XIX, Section 1905 of the Social Security Act; public and nonprofit private entities involved in addressing HIV/AIDS/STI related issues at the regional or national level; state and local governments; academic institutions; local health departments; nonprofit hospitals and outpatient clinics; faith-based and community-based organizations; and Indian Tribes or tribal organizations with or without federal recognition.