Policy implications for HIV prevention efforts and HIV care in the high prevalence communities – a South Bronx community health center perspective

The South Bronx Health Center for Children and Families [SBHCCF] is a community health center [CHC] providing comprehensive primary care to an underserved poor community of color. The community prevalence rate of people living with HIV/AIDS [PLWHA] is at least triple the national and double the NYC average. Furthermore women of color and men of color who have sex with men [MSM] continue to have escalating rates of HIV infection. The South Bronx remains an epicenter of HIV/AIDS.

Environmental factors have encouraged the development of an HIV program within the SBHCCF. These include community prevalence & dissemination, stigma, barriers to healthcare access and co-morbid diagnoses of those PLWHA. The HIV Specialist/Primary Care Provider working in a CHC is ideally trained to address these factors and develop:

1 HIV prevention efforts directed at HIV- patients and PLWHA

2 Testing and identification of PLWHA unaware of their diagnosis

3 Treatment

4 Support Services

At the SBHCCF, 1-2 HIV specific QI projects are completed and 8-10 QI measures are collected annually. These measures show that high quality HIV care is provided (e.g. 64% patients taking anti-retrovirals have undetectable viral load and 93% have adherence quantitatively assessed). This supports the theory that CHCs should play a key role in planning HIV prevention strategies and providing comprehensive, quality HIV care especially in such epicenters.