Yale R3EDI Hub Webinar: Tyrell Manning, Ginger McKay, and Justin Cole “I want there to be a clear path for people through the system…” – generating evidence for collaboratives as a strategy to optimize HIV testing and other evidence-based services in the St. Louis system

Missouri is one of seven states in the U.S. with a disproportionate HIV burden, making it an Ending the HIV Epidemic (EHE) Priority State. The St. Louis Region alone bears about 40% of that burden despite substantial investment. We demonstrated numerous structural and system-level barriers hindering meaningful progress toward achieving EHE goals. To overcome this, we have established the Clear Path Collaborative as a strategy that changes the structure of the HIV service system. Presented by key partners from the St. Louis City and County Departments of Health, we will walk through our application of community-based participatory systems science approach to identify structural barriers and develop the Collaborative. We will then provide preliminary evidence of collaborative effectiveness on two fronts: 1) By evaluating the collaborative’s ability to engage new organizations in sexual health services and improve coordination of services among providers. 2) By evaluating collective effort from members to promote expanded STI/HIV testing. We will then reflect on challenges and limitations of attempting strategies that address structural barriers to implementing evidence-based HIV interventions.