Outreach to Outcomes: Advancing HIV Care in Priority Populations

The US HIV epidemic disproportionately affects historically marginalised groups, particularly Black individuals in the Southern states. The national "Ending the HIV Epidemic" (EHE) initiative was established in 2019 to reduce HIV infections in priority populations. Systemic barriers such as social stigma, economic hardship, and limited healthcare access contribute to higher HIV incidence and worse outcomes, requiring a multidimensional response beyond clinician education alone. To address this, we developed and implemented five community-engaged programmes in priority jurisdictions, leveraging culturally safe and familiar community venues, such as Black-owned barbershops and Black faith-based organisations. Our programmes used a multidimensional educational strategy: first, for clinicians, focusing on critical gaps such as HIV and PrEP disparities, cultural humility, and rapid ART initiation; second, for trusted community partners, including barbers, peer counsellors, and clergy; and third, for clients, providing educational materials and fostering conversations in multiple languages. A central and vital component of the initiative was providing onsite health education, client incentives, and screenings for HIV alongside other conditions (e.g., hypertension and diabetes) at community events, with an approach designed to mitigate stigma and access barriers by bringing services directly where people live and gather. Across five programmes, 804 HIV screenings were conducted. Over 1,650 clinicians were educated, with demonstrated improvements in knowledge, competence, and confidence regarding HIV and PrEP disparities, cultural humility, and HIV management. The investment of partners (e.g., clergy and barbers) was instrumental in recruiting and educating communities, bridging persistent gaps, and addressing systemic mistrust towards the medical establishment. In conclusion, programmes that incorporate client, clinician, and trusted partner education along with client incentives are valuable strategies to promote HIV testing and treatment in priority populations in priority jurisdictions.