Evaluation

THRIVE requires that health department grantees lead a collaborative that includes CBOs, behavioral health and social providers, and healthcare providers in order to develop, implement, and evaluate comprehensive HIV prevention, care, and support programs for MSM of color. Furthermore, grantees were asked to develop a set of jurisdiction-specific goals, strategies, and objectives to meet the overall goals and objectives of the funding announcement.

Each grantee developed and is implementing a Monitoring and Evaluation plan that includes:

• A logic model that delineates how program inputs, activities, and outputs are linked to short-term, intermediate, and long-term program outcomes
• Priority monitoring and evaluation questions
• Annual performance targets for each core activity

The CDC evaluation and performance measurement strategy requires that awardees use 10% of the overall budget to support local program evaluation of funded activities, including:

• Collaborate with CDC to develop evaluation plans and data collection activities as appropriate;
• Participate in data collection activities as appropriate;
• Submit progress reports;
• Conduct real-time documentation and tracking of program activities using existing health department
• and partnering agency IT applications; and
• Periodically enter and electronically submit to CDC data and other reporting information using a CDC approved system.

In collaboration with the CDC, each grantee designed an evaluation and performance measurement plan that includes both outcome and process measures consistent with their logic model. In addition, a cross-site evaluation plan was developed by CDC, in collaboration with grantees, to collect and report client-level data as indicators of program outcomes. Grantees will also be responsible for using evaluation data for continuous quality improvement of the program.

Outcomes

Key outcomes to be expected by the end of the project period for the provision of comprehensive HIV prevention and care for MSM of color are listed below.

Potential Short-term Outcomes

Collaborative increases the number of MSM of color who are:

• Screened with lab-based 4th generation HIV tests
• Screened at least annually for HIV
• Screened more often if at substantial risk for HIV (e.g., every 3-6 months)
• Prescribed PrEP or nPEP if at substantial risk for HIV acquisition
• Provided appropriate clinical management if prescribed PrEP or nPEP
• Provided medication adherence support for PrEP or nPEP
• Immediately linked to care (within 14 days) and initiated on ARV treatment (within 21 days) if diagnosed
• with acute HIV
• Expediently linked to care (within 30 days) and initiated on ARV treatment (within 60 days) if diagnosed
• with established HIV
• Provided retention interventions if living with HIV and engaged in care
• Provided Data to Care re-engagement interventions if living with HIV and lost to care
• Provided medication adherence support/interventions if living with HIV
• Routinely screened for STDs
• Provided timely partner services
• Provided behavioral risk reduction services
• Routinely screened for behavioral health and social services needs
• Linked to behavioral health and social services
• Provided navigation to access HIV prevention, care, and behavioral health and social services
• Provided navigation to enroll in a health plan

Health department trained collaborative in:

• Healthcare billing and reimbursement procedures
• Provision of culturally competent HIV prevention and care for MSM of color

Health department supported collaborative to:

• Designate/hire staff to perform billing and reimbursement activities
• Implement billing for HIV tests, STD tests and treatment, and PrEP or nPEP services
• Designate/hire navigators to assist patients to access HIV prevention, care, and social services and to enroll in a health care plan
• Develop/implement tools to facilitate patient utilization of assistance programs for PrEP or nPEP medication costs

Potential Intermediate Outcomes

Collaborative increased the number of MSM of color who are/have:

• Diagnosed with acute HIV among all HIV diagnoses
• Adherent to PrEP or nPEP medications
• Retained in HIV care
• Re-engaged in care
• Adherent to ARV treatment medications
• Received appropriate STD treatment
• Sex partners who received lab-based 4th generation HIV testing and linkage to HIV care and STD testing
• and treatment
• Received behavioral health and social services
• Enrolled in a health plan

Collaborative has:

• Expanded billing for HIV tests, STD tests and treatment, and laboratory tests required for PrEP and nPEP
• services
• Increased proportion of HIV tests that are reimbursed by a third party payer
• Increased proportion of STD tests and treatment and PrEP and nPEP clinical services that are reimbursed by a third party payer
• Developed business models for long term sustainability of HIV testing and treatment, STD testing, and PrEP or nPEP services beyond the project period
• Developed service models for provision of culturally competent HIV prevention and care for MSM of color

Potential Long-term Outcomes

Among MSM of Color:

• Increased proportion of HIV diagnosed in the acute stage of infection
• Decreased incidence of HIV and STDs
• Increased number living with HIV who are virally suppressed

Collaborative has:

• Sustainable service models for HIV testing, STD testing and treatment, and PrEP/nPEP for MSM of color at risk for HIV
• Culturally-competent service models for HIV prevention, care, and behavioral health and social services for MSM of color

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