Overview

The rate of new HIV infections in the United States has remained largely unchanged at approximately 55,000 new cases per year for the last 20 years in which an estimated 20% of persons infected with HIV do not know their HIV status. Most patients are diagnosed late in the course of disease when treatment is less effective and mortality and costs are higher. Twenty percent of individuals with unknown HIV status are responsible for an estimated 60% of new infections annually. HIV incidence rates and late entry to care are exceptionally high in states described as the Deep South (e.g., Alabama, Mississippi), which are characterized by a concentration of HIV-related morbidities and mortality in African Americans, male, and rural populations. However, significant under-screening, testing, and linkage to care dominates the Deep South. Similar challenges have been described for universal Hepatitis C testing, indicating that 45-85% of chronically infected people remain unaware of their infection despite recommendations for universal screening. Therefore to increase testing and linkage to care for HIV- and Hepatitis C infections among African American men, the long-term goal of this proposal is to integrate universal HIV and Hepatitis C screening into the existing infrastructure of the Deep South Network for Cancer Control.