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Objectives: We evaluated 2 innovative approaches that supported COVID-19 case investigation and contact tracing (CI/CT) in Chicago communities: (1) early engagement of people diagnosed with COVID-19 by leveraging the existing Healthcare Alert Network to send automated telephone calls and text messages and (2) establishment of a network of on-site case investigators and contact tracers within partner health care facilities (HCFs) and community-based organizations (CBOs). Methods: The Chicago Department of Public Health used Healthcare Alert Network data to calculate the proportion of people with confirmed COVID-19 who successfully received an automated telephone call or text message during December 27, 2020–April 24, 2021. The department also used CI/CT data to calculate the proportion of cases successfully interviewed and named contacts successfully notified, as well as the time to successful case interview and to successful contact notification. Results: Of 67 882 people with COVID-19, 94.3% (n = 64 011) received an automated telephone call and 91.7% (n = 62 239) received a text message. Of the 65 470 COVID-19 cases pulled from CI/CT data, 24 450 (37.3%) interviews were completed, including 6212 (61.3%) of the 10 126 cases diagnosed in HCFs. The median time from testing to successful case interview was 3 days for Chicago Department of Public Health investigators and 4 days for HCF investigators. Overall, 34 083 contacts were named; 13 117 (38.5%) were successfully notified, including 9068 (36.6%) of the 24 761 contacts assigned to CBOs. The median time from contact elicitation to completed notification by CBOs was Conclusions: Partnerships with HCFs and CBOs helped deliver timely CI/CT during the COVID-19 pandemic, suggesting a potential benefit of engaging non–public health institutions in CI/CT for existing and emerging diseases.

The ongoing COVID-19 pandemic has had widespread social, psychological, and economic impacts. However, these impacts are not distributed equally: already marginalized populations, specifically racial/ethnic minority groups and sexual and gender minority populations, may be more likely to suffer the effects of COVID-19. The COVID-19 Resiliency Survey was conducted by the city of Chicago to assess the impact of COVID-19 on city residents in the wake of Chicago’s initial lockdown, with particular focus on the experiences of minority populations. Chi-square tests of independence were performed to compare COVID-19-related outcomes and impacts on heterosexual vs. sexual minority populations, cisgender vs. gender minority populations, and White vs. racial/ethnic minority subgroups. Marginalized populations experienced significant disparities in COVID-19 exposure, susceptibility, and treatment access, as well as in psychosocial effects of the pandemic. Notably, Black and Latinx populations reported significant difficulties accessing food and supplies (p = 0.002). Healthcare access disparities were also visible, with Black and Latinx respondents reporting significantly lower levels of access to a provider to see if COVID-19 testing would be appropriate (p = 0.013), medical services (p = 0.001), and use of telehealth for mental health services (p = 0.001). Sexual minority respondents reported significantly lower rates of using telehealth for mental health services (p = 0.011), and gender minority respondents reported significantly lower levels of primary care provider access (p = 0.016). There are evident COVID-19 disparities experienced in Chicago especially for Black, Latinx, sexual minority, and gender minority groups. A greater focus must be paid to health equity, including providing increased resources and supplies for affected groups, adapting to inequities in the built environment, and ensuring adequate access to healthcare services to ameliorate the burden of COVID-19 on these marginalized populations. Supplementary Information The online version contains supplementary material available at 10.1007/s11524-020-00497-9.

Patient navigation is a primary element in linkage to HIV pre-exposure prophylaxis (PrEP) care and linkage to or re-engagement in HIV care, depending on the HIV status of the individual. However, there is a dearth of literature describing navigation services in these areas. In the context of Chicago Project PrIDE, this project conducted process and implementation evaluations with eight agencies leading demonstration projects to address these gaps. The evaluation team conducted semi-structured, individual interviews with agency staff (N = 20) assessing navigation implementation and fit, as well as project successes and challenges. Additionally, agency staff collected patient surveys (N = 300) assessing services provided, service quality, and satisfaction. The interview transcripts were coded and analyzed thematically and descriptive analyses were performed on the survey data. Analyses indicated that screening for social determinants of health, providing healthcare engagement guidance, and providing service referrals were frequently cited navigation activities. Most staff members indicated that navigation fits well within their agencies, and that limited staff and clinic capacity were often barriers to navigation. Patient navigation to support engagement in HIV prevention and care services is critical due to the extensive support provided by navigators to address social determinants of health impacting HIV disparity populations.

As the need for rigorous evidence of program efficacy increases, integrating evaluation activities into program implementation is becoming crucial. As a result, external evaluators are placing increased focus on evaluation capacity building as a practice. However, empirical evidence of how to foster evaluation capacity in different contexts remains limited. This study presents findings from an evaluation capacity survey conducted within a multisite Empowerment Evaluation initiative, in which an external evaluator worked with 20 project teams at diverse community agencies implementing HIV prevention projects. Survey results revealed representatives from project teams (n = 33) reported significantly higher overall evaluation capacity after engaging with the external evaluator on planning and implementing their evaluation. Improvements differed across organization type, intervention type, staff position, and reported engagement on various activities throughout the course of the evaluation. Results indicated empowerment evaluation and other stakeholder-focused evaluation approaches are broadly applicable when evaluation capacity building is a desired outcome, particularly when able to engage project staff in the planning of the evaluation and in delivering technical assistance services. Accordingly, efforts should be made by program funders, staff, and evaluators to encourage active engagement starting in the early stages of program and evaluation planning.

Background Women account for 25 % of HIV infections nationally, and African American (AA) women are disproportionately affected. We report important gender differences observed in an expanded HIV testing and linkage to care (X-TLC) program conducted on the South and West Sides of Chicago. Methods X-TLC is funded by CDPH with CDC prevention B funds. X-TLC has expanded from 3 sites to 14 sites, including acute care hospitals (academic, community), community health centers (CHCs), and family planning clinics. We report descriptive stats, group comparisons by Chi-square, and multivariate analyses adjusted for demographics. Results Since 2011, X-TLC has conducted 308,038 HIV screens, and 63.7 % of those tested were women. Overall seroprevalence for HIV was 0.56 %, and 30.5 % of HIV patients identified were cis-gender women (seroprevalence 0.15 %). The seroprevalence for women testing in EDs was higher (0.44 %). Similar to men, only 52.9 % of HIV positive women were new diagnoses. Women accounted for 28.5 % of all new diagnoses, compared with 15.4 % for Chicago overall. In 2016 X-TLC screened 91,865 persons for HIV, and 65.2 % of those tested were women. There were 193 new diagnosis and 32.1 % (62) were women, 85.7 % AA. In comparison, in 2015 there were 139 women with a new HIV diagnosis for all of Chicago. Women newly diagnosed were less likely to be linked to care (adjusted odds ratio, aOR, 0.54, 0.35–0.85). Linkage was lower for women diagnosed at CHCs (84.6 % vs. 76.3 %, P = 0.02). Most CHCs did not have on site HIV providers. At our site, however, women linked to care were more likely to be retained in care (aOR 0.58, 0.43–0.78). We also conduct targeted outreach testing, partner services (PS) testing, and social network strategy (SNS) testing, but women are not identified by these programs (16/171 tested women, 8 new diagnoses were men for PS; 507 tested, 471 men and 36 trans-gender women, 38 new positives, 0 cis-gender women for SNS). Conclusion More women than men were offered and/or accept HIV screening in healthcare settings. The proportion of seropositive women identified was higher than the national average. X-TLC is reaching a large proportional of AA women with HIV unaware of their status. Other testing strategies will rarely identify cis-gender women with HIV infection. Gender differences in linkage to and retention in care will require strategies targeted at women. Disclosures J. P. Ridgway, Gilead FOCUS: Grant Investigator, Grant recipient; N. Glick, Gilead FOCUS: Grant Investigator, Grant recipient; D. Pitrak, Gilead Sciences FOCUS: Grant Investigator, Grant recipient