Grant: Fellowship - PA: Health Services/Population Health HIV/AIDS Research

There are an estimated 1 million people living in the USA with HIV, 21 percent of whom are unaware of their diagnosis. A major issue today relates to decreasing transmission of HIV infection to uninfected individuals, particularly amongst those who are infected but unaware of their diagnosis that are unwittingly transmitting the virus to others. Several populations are disproportionately affected by HIV, including African Americans, Hispanics, injection drug users, and men who have sex with men. Many patients are exposed to HIV and seek care in local Emergency Departments. These HIV-exposures are primarily sexual or from needles. HIV transmission can be prevented in close to 100% of these patients if they seek care early (within 72 hours), and if patients adhere to a 28-day medication regimen. Unfortunately, up to 20% of those who seek care in the Emergency Department after an HIV exposure do not follow up for subsequent care in specialized clinics. This is of major concern as these patients are known to the healthcare system and are at high risk of HIV acquisition. HIV acquisition can be easily prevented in these individuals with appropriate care and follow up. The purpose of this study is to determine who these individuals are in terms of age, sex, race, socioeconomic status, language, and type of exposure. In addition, we aim to seek the utility of an age, sex, language, and culturally appropriate telephone call intervention to enable access to care. A better understanding of who fails to show up to HIV Post-Exposure Prophylaxis clinic will guide medical providers to create more accessible health care. The ultimate goal is to reduce HIV transmission in individuals with high-risk exposure and ultimately prevent further HIV transmission in the community.