CHARLOTTE, N.C. — New access for HIV prevention medication and case management for HIV-negative clients will be among new services offered by RAIN, a Charlotte HIV/AIDS service organization. The new services — slated to begin in July — are supported by a grant from the United Way of Central Carolinas.
The newly funded efforts will dramatically expand RAIN’s current PrEP services, says Chelsea Gulden, the organization’s vice president of operations. RAIN has had a limited service offering PrEP — or pre-exposure prophylaxis — to HIV-negative persons, but a lack of funds has prevented the group from increasing focus on prevention efforts. With PrEP, HIV-negative persons take a once-daily pill that has proven to reduce the chance of an HIV diagnosis by as much as 90 percent or more.
In addition to being able to provide increased PrEP access, RAIN will also begin to offer case management services for those clients needing PrEP. Case managers will work with HIV-negative clients to ensure they are staying on their regular drug regimen and consistently following through on the four physician appointments required for PrEP patients.
So far, the missing case management services has meant some clients on PrEP fall through the cracks and eventually stop taking the preventative drug.
“We see the same vulnerabilities in people who have tested positive who come in seeking case management as we see among people who are negative and have a huge need for PrEP,” Gulden says.
Those challenges often include unemployment or underemployment, housing instability, food insecurity and a lack of transportation — all critical issues which present challenges for a person expected to adhere to a strict drug regimen and doctor visit schedule.
“This opportunity allows us to provide support on the front end and make sure we’re doing everything we can to stop the spread of HIV,” Gulden says.
RAIN already has an intense focus on case management and treatment for HIV-positive persons. Those services — often called “Treatment as Prevention” — aims to ensure an HIV-positive client achieves full viral suppression. HIV is untransmittable to a partner if a positive client is has an undetectable HIV viral load.
New clients will be identified through RAIN’s existing community outreach and testing events.
The program will be supported with a United Way grant of $100,000 — $20,000 more than they initially requested — in order to offer the new and expanded services. A portion of the grant will be set aside for the group’s existing mental health services, but $60,000 of the total will be devoted to the new prevention efforts.
RAIN will also partner with county health officials and an expanding network of community health clinics participating in the county’s PrEP pilot. County health officials also recently announced a plan to continue and expand their PrEP and other supportive services, including partnerships with clinics for the quarterly doctor visits necessary for a PrEP prescription.