Project CIRCUIT: Community-Inspired Research and Change for Ultimate Impact in the Tenderloin
2026-03-20 10:45 - 12:15 (America/New_York) | Studio C

Understanding Social Drivers of Health among People Living with HIV with Unsuppressed Viral Loads Visiting the Emergency Department
2026-03-20 10:45 - 12:15
Despite the wide availability of antiretroviral therapy (ART) as an effective treatment option for HIV, a substantial portion of people with HIV (PWH) in the United States remain out of care or inconsistently take their medications, leading to an unsuppressed viral load despite diagnosis—a critical gap that undermines both individual health outcomes and public health objectives.
The factors that contribute to sub-optimal care engagement and frequent emergency department (ED) utilization may overlap. However, little is known about ED utilization patterns and social drivers of health (SDOH) among PWH who are sub-optimally engaged. In this study we examined ED visits among PWH with an unsuppressed viral load over a two-year period from January 1, 2021, to December 31, 2023, at a large, urban, academic ED. Among 198 PWH who were not virally suppressed, we found that almost half (45%) reported unstable housing or homelessness, 41% had a psychiatric diagnosis, and 64% reported using one or more substances. The average number of ED visits per individual during the study period was 7 and the median was 4 visits. Using a multivariate linear regression model, we found that housing instability, younger age, history of schizophrenia, total number of comorbidities and substance use were positively associated with higher ED utilization.
Understanding patterns of ED utilization among sub-optimally engaged PWH and SDOH affecting them will provide a foundation to create targeted interventions to improve the linkage of these individuals to care and to achieve sustained viral suppression.

Hartford Employment Initiative: Addressing Critical Employment Gaps for Persons Living with HIV (PLWH)
2026-03-20 10:45 - 12:15
The employment landscape for PLWH in the Hartford Transitional Grant Area (TGA) presents significant challenges. According to the 2022 Statewide Needs Assessment Survey, 54.46% of PLWH were unemployed, with 59.46% unemployment within the TGA. Among respondents, 78% of individuals over 50 lacked access to career and life skills training, limiting their ability to secure stable, fulfilling employment.
Further highlighting the issue, the CDC’s 2021 Medical Monitoring Project found that 39% of adults diagnosed with HIV reported unemployment or inability to work, a substantial indicator of barriers such as stigma, health-related limitations, and systemic socioeconomic challenges.
Additionally, results from a Housing Opportunities for Persons with AIDS (HOPWA) provider survey emphasized the lack of confidence among service providers in delivering effective employment support. Many staff members expressed that:
• They lacked adequate time to focus on employment assistance.
• They require additional training to better support clients in securing jobs.

Testing and Treatment Services for HIV, STIs, and Hepatitis C at Substance Use Treatment Facilities Serving Clients in the Ending the HIV Epidemic Priority Jurisdictions of the U.S.
2026-03-19 16:00 - 17:30
Substance use and substance use disorders (SUD) are well-known risk factors for elevated incidence of HIV, sexually transmitted infections (STIs) and Hepatitis C (HCV). Regular, accessible testing for HIV, STIs, and HCV is critical to controlling spread through early identification and prompt treatment. The array of treatment options for HIV and HCV has dramatically expanded with multiple regimens for each, many of which are curative for HCV. Pre-exposure prophylaxis (PrEP) is highly-effective for HIV prevention. In 2019, the U.S. designated 50 counties and cities as priority jurisdictions for intervention within the Ending the HIV Epidemic (EHE) initiative due to their high incidence of new infections. In this study, we utilized publicly available data to investigate availability of testing for HIV, STIs, and HCV and treatment for HIV, HCV, and PrEP for HIV prevention at over 5,000 substance use treatment facilities operating in the EHE priority jurisdictions. As frequent points of healthcare system contact for people with SUD, these treatment facilities present an opportunity to make meaningful progress in ending the HIV, STI, and HCV epidemics through expansion of testing and treatment services. This session presents data from the National Substance Use and Mental Health Services Survey (2023) conducted by the Substance Abuse and Mental Health Services Administration to present the current state of availability of testing and treatment services for HIV, HCV, and STIs. Specific opportunities for seamless integration of these services leveraging the existing care provided for SUD to integrate screening and treatment for viral and infectious diseases.

Using Community Health Workers to Overcome Obstacles to Care Engagement as a Southern CBO
2026-03-19 16:00 - 17:30
HIV care engagement is disproportionately impacted in southern rural states, yet due to a multitude of social and structural factors there are low rates of engagement across the HIV care continuum. There is an immense need for culturally responsive HIV prevention, care, treatment, and supportive services that are “people centered” and culturally responsive for those living and aging with HIV (LWH). In this workshop, participants will learn about the core elements of a community -based syndemic approach to HIV care engagement [prevention, care, treatment, and supportive services] to enhance capacity to support PLWH throughout the HIV care continuum.
Historically community-based organizations navigate many obstacles to engaging PWH in the care continuum. Care engagement in southern rural states is impacted by the same factors as urban but are compounded by specific factors like transportation, isolation, and smaller funding streams. HIV cannot be viewed as a medical condition alone, but one impacted by multiple social determinants of health such as poverty, isolation, co-morbidities, and lack of accessible mental health services, as well as racism and sexism. These can complicate HIV service delivery and hinder successful movement through the HIV care continuum.
In this session, participants will learn about the core elements of a community -based syndemic approach to HIV care engagement [prevention, care, treatment, and supportive services] to enhance capacity to support PLWH throughout the HIV care continuum. This workshop will demonstrate how community health workers improve involvement in comprehensive prevention services.

Understanding the Sociocultural Context of HIV Outcomes for Transgender Women of Color Age 50+: A Secondary Analysis of the Transgender Women of Color Initiative Evaluation and Technical Assistance Center (TETAC) Dataset
2026-03-19 16:00 - 17:30
Recent data from the U.S estimated that over half (57%) of transgender women (TW), aged 50+, are living with HIV. Findings lacked analysis by age, gender, and race/ethnicity, but found 62% HIV prevalence among Black trans women, suggesting potential HIV disparities for older TW of color.
We conducted multi-variable analysis of baseline TETAC survey data to assess if HIV health outcomes differ for TW aged 50+ and TW aged 49 and younger and looked at variation by social determinants of health (e.g. education and income) and service utilization (e.g. mental health services, food assistance). We conducted thematic analysis with a sub-set of interviews to provide context for results.
Participants aged 50+ were more likely to be engaged in care than younger participants, with older Black TW slightly less likely to be engaged in care than Latina TW. Importantly, service use attenuated the relationship between age and engagement in care. Analysis of interviews identified ways that greater community connection, supportive relationships, and use of services were solidified over time, resulting in greater stability among older participants as compared to younger participants.
This study focused on HIV outcomes and health services access for TW aged 50 and older, making important contributions to the context of care for this population sub-group, who shoulder disproportionately high HIV prevalence. Findings highlight the critical role of support services in HIV care engagement and the potential for expanded access and intergenerational peer support programs to ameliorate HIV-related disparities based on age and race.

Expanding Access, Building Trust: The Syndemic Approach to HIV, HCV, and STI Testing in Marginalized Communities in the Mid-South
2026-03-19 16:00 - 17:30
In the Memphis Transitional Grant Area (TGA), structural inequities and stigma contribute to persistent disparities in HIV and STI outcomes, particularly among BIPOC, immigrants, people who inject drugs (PWID), and those experiencing homelessness. Friends For All (FFA), a Memphis-based nonprofit, has implemented a multi-access, community-driven strategy to expand HIV, HCV, and syphilis testing while enhancing linkage to care. Between October 2024 and April 2025, FFA tested over 850 individuals—86% BIPOC—through mobile units, community outreach, and consular partnerships. This resulted in 8 new HIV diagnoses (100% linked to care), 41 syphilis cases, 5 HCV positives, and 52 PrEP initiations. The success of this approach lies in culturally competent staffing, trusted community partnerships, and multiple service entry points—including mobile clinics, faith-based settings, and campus health centers. These strategies support syndemic-aware, patient-centered engagement that reduces stigma, facilitates early diagnosis, and improves health outcomes. This presentation explores replicable models of syndemic prevention in underserved Southern communities.

My Steps To Care: Adaptation and Pilot-Testing of STC (Steps To Care) Intervention to Improve HIV Health Outcomes among Black Sexual Minority Men, Black Cisgender Women, and Trans Women Living With HIV in Washington DC
2026-03-19 14:15 - 15:45
The United States will not meet the targets of the Ending the HIV Epidemic (EHE) plan without an intentional focus on improving HIV outcomes among key populations living with HIV (LWH). Studies have shown that only 54% of Black sexual minority men (SMM) living with HIV are retained in care, 55% maintain daily treatment adherence, and 62% are virally suppressed. In 2021, one-third of Black SMM (out of 5,964), Black cisgender (out of 3,079), and transgender (out of 271) women LWH in Washington DC (a priority EHE jurisdiction) had a detectable viral load (i.e., having more than 200 copies of HIV per milliliter of blood). These viral suppression rates are suboptimal, despite a range of healthcare organizations and services in the region, contributing to the further transmission of HIV in the region and highlighting a major public health failure. The purpose of this study is to address the health inequities among key populations living with HIV through a community-based participatory research (CBPR) mixed-methods study designed to adapt and pilot-test STEPS to Care (StC), a CDC-endorsed evidence-based intervention. This intervention consists of three person-centered, evidence-informed strategies to improve retention in HIV care, adherence to antiretroviral therapies, and reduce viral load, which include: Patient Navigation, Care Team Coordination, and HIV Self-Management.

Language Justice and Accessibility: Navigating Services for Deaf, Hard of Hearing, Deafblind People Living with HIV
2026-03-19 14:15 - 15:45
This session will provide an overview of how Deaf Community Advocacy Network (Deaf C.A.N.!) Deaf HIV Program addresses the unique challenges of PWLH who are Deaf, Deafblind, and Hard of Hearing navigating Ryan White Services. Through provider assessments and cultural competency training, client assessments and workshops to improve health literacy on HIV prevention and HIV treatment, and workshops for interpreters to increase their understanding of ever growing HIV terminology such as viral load suppression and U=U, Deaf C.A.N.! has expanded their case management services from 7 counties in the Detroit Metropolitan Area to the entire state of Michigan, increased partnerships, and improved client satisfaction

Community Mental Health Project
2026-03-19 14:15 - 15:45
In collaboration with Columbia Psychiatry and New York Public Library, the community mental health project was created to address the impact of mental health on the Black and Afro-Latino communities in NYC, especially during and right after the COVID-19 pandemic. The intervention aims to engage the community in discussion around mental health and thus minimize stigma and advocate for innovative strategies to increase the utilization of mental health services within the community.

Supporting Syndemic Approaches to Care in a Hostile Political Environment
2026-03-19 14:15 - 15:45
This session focuses on the way forward with syndemic approaches to eliminate HIV, viral hepatitis, and related epidemics in a political environment characterized by significantly diminished federal investment in infectious disease prevention and treatment, and in overdose crisis response. The goal is to explore the impact of Reductions in Force at HHS, reduced funding to academic institutions, and other funding and workforce changes on our capacity to end HIV, viral hepatitis, and overdose mortality, with a particular focus on how these changes will impact adults over the age of 50; as well as exploring how syndemic approaches may provide opportunities to engage the expertise and resources of the remaining public health workforce to respond to these ongoing public health crises through innovative collaboration.

Harm Reduction: Getting It Right
2026-03-19 10:45 - 12:15
What is harm reduction, really? Is it voting? Is it seat belts? Is it naloxone? While public health often treats harm reduction as a list of tools or strategies, this session invites us to dig deeper, into the philosophy, politics, and contradictions of harm itself. We’ll ask: Is harm inherent, or is it produced? What are the social, structural, and emotional conditions that create or intensify harm? Who decides what harm is, and who is forced to experience it?
This conversation centers harm reduction not as a checklist, but as a justice-rooted framework, a commitment to dignity, autonomy, and survival in a world that often withholds those things. We’ll explore how harm is exacerbated by systems of criminalization, medical neglect, stigma, and control, especially for people who use drugs, sell sex, live with chronic illness, or navigate poverty, racism, and ableism. We’ll interrogate how harm reduction gets watered down, co-opted, or professionalized into meaninglessness, and what it means to reclaim it as a radical, liberatory practice.
Through discussion, storytelling, and collective inquiry, we’ll challenge dominant narratives and get to the root: not just how to reduce harm, but how to understand where it comes from, who it impacts, and what it would take to truly transform the conditions that produce it.
This session is for public health workers, care providers, organizers, and community members who want to get real about harm, and get it right.

Participant Perspectives on Contingency Management for Stimulant Use Treatment
2026-03-19 10:45 - 12:15
Contingency Management (CM) is a behavioral intervention option for stimulant use that involves immediate, tangible rewards to individuals to reinforce positive self-identified behavior change. In 2023, in response to rising rates of stimulant overdose deaths, California became the first state in the U.S. to offer CM as a benefit through public insurance. Having already embraced CM over two decades prior through the Positive Reinforcement Opportunity Project (PROP)—originally designed for men who have sex with men to reduce sexually transmitted infections through reducing methamphetamine use—San Francisco was well positioned to expand this model, and over the last two years expanded CM to more than a dozen programs throughout the city benefitting diverse populations.
The San Francisco Department of Public Health (SFDPH) partnered with Facente Consulting to engage in focus groups and interviews with over 50 participants currently engaged in CM programs in San Francisco to assess impact and identify recommendations for programmatic expansion.

An Indictment of US Public Health Policy on Pain and Addiction Management
2026-03-19 10:45 - 12:15
This presentation addresses the intersection of issues in health equity and justice, versus health advocacy and policy, to identify and contradict the significant misdirection and fatal errors of science in recent opioid prescribing guidelines of the US CDC and Veterans Administration with a critical review of published clinical and demographic data on safety and effectiveness of prescription opioid analgesic pain relievers.

Research to Practice to Capacity Building: Implementing Partner Treatment for Bacterial Vaginosis (BV) in a Public Sexual Health Clinic
2026-03-18 16:00 - 17:30
Bacterial vaginosis (BV) is the most common cause of vaginal discharge worldwide and is associated with significant stigma, health care utilization and antibiotic use. Recurrence rates exceed 50% within 6 months in most studies. Until recently data supporting partner treatment to prevent BV recurrence were lacking; however, a recent clinical trial showed a clear preventive benefit from the concomitant treatment of cis-gender male partners (with oral plus topical antibiotics) of individuals with BV, with a more than 60% reduction in BV recurrences. This presentation will outline the current understanding of BV as a dysbiosis, the role of sexual transmission in pathogenesis, and the recent findings of the Australian StepUp* Trial. Practical suggestions will be offered regarding designing and implementing a policy to provide partner therapy for BV in clinical settings in the United States based on the experience at a walk in public Sexual Health Clinic. Essential components include the need for clinician and staff education given the major change in health messaging regarding the role of sexual transmission in the pathogenesis of BV, and the practical difficulties related largely asynchronous visits of patients and partners who seek health care in different places, difficulties with pharmacy instructions, and the myriad of clinical scenarios that arise which were not addressed in the StepUp trial given strict inclusion/exclusion criteria.

I Have Put This Off for Decades; You Remembered Me – Improving Hepatitis C Linkage to Care Across a Health System
2026-03-18 16:00 - 17:30
Hepatitis C (HCV) is a curable disease, yet many patients remain untreated due to lack of awareness, outdated perceptions, and barriers to care. This project aimed to identify and link untreated HCV RNA-positive individuals to care within a large, not-for-profit health system in Virginia. A retrospective chart review identified 4,367 adults with no documented HCV treatment between 2016 and 2024. After thorough chart review, external lab verification, and use of public records, 3,221 (73.8%) were excluded due to prior treatment, age, relocation, death, or incarceration.
Of the remaining 1,147 patients, 503 (43.9%) had unreachable or invalid contact information, and 336 (29.3%) did not respond to messages. Ultimately, 111 individuals (9.7%) were successfully linked to care, and 43 (3.8%) declined. Patient feedback revealed both skepticism and gratitude. Some viewed the outreach as a scam, while others were deeply moved, expressing appreciation that someone “remembered” them. Many were unaware treatment was available or believed they were not sick enough to qualify.
This project underscores the challenges of delayed HCV care, the limitations of EHR documentation, and the need for dedicated, person-centered outreach. Future directions include using artificial intelligence to enhance identification and documentation of HCV status, and encouraging more timely, trusted referrals through known providers. Despite obstacles, this proactive approach demonstrated that personal outreach can successfully re-engage patients and reduce the long-term burden of untreated HCV.

Doxycycline vs. Benzathine Penicillin G for Treatment of Syphilis: A Retrospective Analysis from a Large Sexual Health Organization
2026-03-18 16:00 - 17:30
Limited evidence suggests that doxycycline may be comparable to penicillin for the treatment of syphilis, but perhaps less so for latent stages. A total of 655 individuals were included, 539 who were treated with benzathine PCN G (BPG) and 116 treated with doxycycline. For our primary analysis, we included all RPR titers up to 24 months after treatment for all stages of syphilis treated from April 2022 through September 2023. The slope of RPR decline was compared between BPG and doxycycline groups. Demographics were similar between the groups. A linear mixed effects model, accounting for repeated measurements from the same patient over time, showed no statistically significant difference in the rate of decline between the two treatment groups. These findings suggest that doxycycline dispensed directly to patients, despite its need for daily dosing and adherence for 14-28 days, has treatment outcomes comparable to BPG.

Leveraging Quality Improvement to Improve HIV Outcomes
2026-03-18 16:00 - 17:30
In recent years, sexually transmitted infections (STI) rates in the United States have risen dramatically, with more than 2.4 million STIs reported in the United States alone (CDC, 2024). STIs can have a profound impact on health, including infertility, neurological and cardiovascular disease, stillbirths, and increased risk of Human Immunodeficiency Virus (HIV). This growing epidemic demands urgent action to enhance the prevention, diagnosis, and treatment of STIs. One strategy to address this issue is the application of quality improvement (QI) methodologies. QI is a structured, data-driven, organizational approach to improve the quality of care within healthcare systems. By focusing on quality improvement, healthcare organizations can streamline processes, increase efficiency, enhance patient satisfaction, and expand access to care. QI tools can empower teams to evaluate current systems, pinpoint areas that need improvement, and implement improvements where necessary. Through sustained QI efforts using tools and data-driven practices, we can move closer to ending the epidemic, achieve better health outcomes, and save lives.

Responding to Rapid PrEP Need: Integrating Teams, Streamlining Workflows, and Equipping Clinicians
2026-03-18 13:30 - 15:30
HIV Prevention Institute
As demand for rapid-start PrEP continues to grow, healthcare teams need practical, scalable models that support timely access while fitting real clinical workflows. This live, in-person institute will focus on the real-world implementation of rapid-start PrEP across clinical and pharmacy settings, with an emphasis on team-based care and operational readiness. Through an interprofessional lens, faculty will explore how clinicians, pharmacists, and care teams can work together to integrate rapid-start PrEP using streamlined workflows, standing orders, lab reflex panels, and clinician-facing tools that support consistent, efficient delivery of care.
Key Focus Areas:

Status-neutral workflow design to support rapid-start PrEP
Leveraging interprofessional HIV prevention teams to improve PrEP routinization
Preparing clinicians and systems for the potential of rapid-start injectable PrEP
Applying practical tools such as algorithms, flowcharts, and quick-reference guides across diverse care settings
