CRUSH - Connecting Resources for Urban Sexual Health
PI: Jeffrey Burack
East Bay AIDS Center/Alta Bates Summit Medical Center
Epidemic Interventions Demonstration Research Project
Thirty years after AIDS was discovered, HIV (the virus that causes AIDS) continues to spread in the United States, primarily through sex and injection drug use, but we have come a long way. We now have a coordinated plan to combat AIDS, the National HIV/AIDS Strategy. There are other important signs of progress, such as recent studies showing that HIV infection can be prevented by taking medicines BEFORE being exposed to the virus, as a traveler to Africa takes anti-malarial medications to prevent malaria. Other studies have proven that people living with HIV who are taking medicines are much less likely to spread the virus to others, and that if everyone who was infected got tested, got into care, and stayed on medicines, the spread of HIV would slow dramatically.
Despite these successes, HIV continues to take an enormous toll in some communities. The number of new infections is still rising in young African American and Latino men who have sex with men (MSM), even as numbers level off in other groups. Racism, poverty, stigma, lack of health insurance, and lack of welcoming places to receive health care are important contributors to this problem.
The East Bay AIDS Center (EBAC) and the UCSF Center for AIDS Prevention Studies (CAPS) will work together to fight the HIV epidemic in California by meeting the need for high quality health care for young MSM of color in the eastern San Francisco Bay Area. The CRUSH (Connecting Resources for Urban Sexual Health) project will improve access to state-of-the art health care by combining cutting-edge research at CAPS and compassionate and welcoming services at EBAC.
The CRUSH pilot project has three goals in the first year – (1) to pilot test better HIV testing options for young MSM of color in the East Bay, (2) to plan and pilot the provision of sexual health services including medicines that prevent HIV to clients that test negative for HIV, and (3) to plan and pilot studies to understand which elements of health care for HIV positive patients lead to better results and stronger connections between clinics and patients. We will make it easier to get tested for HIV by piloting a program to ask our patients to tell their friends about us and bring them in for a test, a strategy that works well across the country and in the East Bay. We will also offer self-testing for HIV to a small number of young MSM of color through our clinic to better understand how self-testing may become part of a more patient-centered approach to HIV testing in the future. All of our sexual health services will be planned and designed side-by-side with young MSM of color to make sure that they are respectful and welcoming, and we will become one of only a few places in the area to prescribe medicines to prevent HIV. We will also improve our current primary care services for HIV positive patients by interviewing patients and providers to better understand what elements of primary are most important to achieve the best results. We will track our progress using electronic health records, and share everything we learn with local community partners, the network of AIDS Education Training Centers, and the broader scientific community.