The Care and Prevention in the United States (CAPUS) Demonstration Project

Overarching Framework

CAPUS is designed to increase the overall impact of prevention activities on HIV-related morbidity, mortality, and incidence by enhancing public health systems and processes that determine when in the course of their infections racial and ethnic minorities living with HIV are diagnosed; if and when racial and ethnic minorities diagnosed with HIV are linked to care; and whether HIV-positive individuals are effectively retained in care.

Funded health departments must develop a work plan that includes a set of required components; as well as supplemental/optional components or other approaches the jurisdiction selects to help achieve the overarching goals of the project. Because there is no one single approach that will work effectively to address the overarching goals of the project across all jurisdictions, a variety of approaches were proposed by grantees and designed to have the greatest public health impact. These combined activities will also have the greatest potential to address the social and structural determinants of health that are known to create the most significant barriers to testing, linkage to, retention in, and re-engagement with care and prevention in the applicant's jurisdiction.

Grantees are funding community-based organizations (e.g., AIDS service organizations, faith-based organizations, sororities, fraternities, and other non-profit organizations) within each jurisdiction using a minimum of 25% of the total award.

Required Components

1. Increase HIV testing, linkage to, retention in, and re-engagement with care, treatment, and prevention
2. Enhance navigation services
3. Use surveillance data and data systems to improve care and prevention
4. Address social and structural factors directly affecting HIV testing, linkage to, retention in, and re-engagement with care, treatment, and prevention

Supplemental/Optional Components

Grantees may select other supplemental/optional components to help achieve the overarching goals of the project. These activities differ in scope and complexity and, when combined with the required components, should have the greatest public health impact in the jurisdiction.

How Does CAPUS Complement CDC's Prevention Portfolio

CAPUS is unique in its specific focus on the treatment continuum and improving the health of racial and ethnic minorities living with HIV in disproportionately affected jurisdictions. A range of interrelated social and economic conditions contribute to HIV disparities in communities of color. For example, nearly a quarter of African-American and Latino families live in poverty, which can limit access to HIV testing and medical care. Homophobia and HIV stigma, far too common in all communities, can discourage individuals from seeking HIV testing, prevention and treatment services. Other barriers to HIV testing and care include discrimination, unstable housing and low rates of health insurance coverage.

It is expected that this innovative project and cross-agency collaboration will have synergistic effects on HIV prevention, care and treatment that will significantly reduce HIV-related morbidity and mortality among racial and ethnic minorities in the funded jurisdictions. The CAPUS demonstration projects are designed to identify practical, workable solutions to minimize the impact of these broader problems on HIV testing and care. At the end of the three-year program, best practices and lessons learned will be shared with health departments throughout the nation.