Positive Interventions: Vital to HIV Prevention

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    Successful HIV Prevention Programming for PLWHA

    Edwin Ramos-Soto March 31st, 2009

    Positive Interventions:Vital to HIV Prevention

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    Dedicated to:

    The HIV-Positive Individuals

    Of Orange County, CAWho Throughout The Epidemic

    Have Taken Extraordinary Steps

    To Protect Others, thereby

    Preventing The Spread of HIV

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    Presentation Summary

    Positive Preventions

    Community Needs Assessment

    Successful prevention program with (MSM) PLWHA

    Measure of success

    Closing Thoughts

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    Objectives

    At the completion of this session Scholars will:

    Explain how the needs of PLWHA were assessed

    Describe how AIDS Services Foundation (ASF) hasconducted a successful program with PLWHA

    Discuss how the success of ASF HIV preventionprogram with PLWHA is measured

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    Positive PreventionsBackdrop

    Prevention efforts focused on HIV-negative

    Emphasis on care/support services to PLWHA

    Many factors point to the need for

    interventions designed for PLWHA

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    Positive PreventionsBackdrop - Factors

    Need for interventions for PLWHA

    Increasing number of PLWHA

    High rates of infection in communities ofcolor; resurgence of HIV in some

    populations

    The HAART impact

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    Positive PreventionsBackdrop - Factors

    Maintenance of low-risk behaviorchallenge

    HIV transmission prevention environmentis increasingly complex

    Increasing number of PLWHA are livingand coping well with disease challenges

    Occasional lapse into unsafe behaviors

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    Positive PreventionsLogic of Preventions for PLWHA

    New infections involve an HIV-infected individual

    New infection can be prevented by intensive

    efforts directed toward population capable oftransmission

    Simple truth, complicated repercussions

    Prevention efforts directed toward PLWHA needto encourage responsibility, support lifestyle, andsupport relationships.

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    Community Needs AssessmentAIDS Services Foundation PLWHA Needs Assessment

    Data collection strategies:

    Informal

    Frequent conversations with colleagues andclients

    FormalStrategic Planning meetings

    Focus Groups

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    Community Needs AssessmentAIDS Services Foundation PLWHA Needs Assessment

    Results:

    Many HIV-positive persons live with

    multiple diagnoses

    Health care adherence and HIV

    transmission prevention are not primaryconcern

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    Community Needs AssessmentAIDS Services Foundation PLWHA Needs Assessment

    High-risk behaviors are not exclusive to

    those who struggle with poverty, stigma,mental illness

    Some risk behaviors transcend class,economic status and demographic group

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    Community Needs AssessmentAIDS Services Foundation PLWHA Needs Assessment

    A comprehensive approach to preventionwith positives must include strategies

    intervene with high-risk behaviors

    Include strategies for engaging out-of-careHIV-infected persons into care

    Reality of limited resources meanscommunities can not provide entire range

    of possible interventions

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    Community Needs AssessmentAIDS Services Foundation PLWHA Needs Assessment

    Factors that place any HIV-positive personat risk for transmitting the virus are often

    highly individualized

    Beyond simply identifying risk behaviors, it

    is important to gain understanding of theplace these behaviors hold within thecontext of each individuals life

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    Successful prevention programASF Mpowerment EBI adaptation for (MSM) PLWHA

    Formative research led to the adaptation andimplementation of a Mpowerment EBI for (MSM)PLWHA

    Mpowerment is a peer-led community levelintervention

    Through Mpowerment large numbers ofPLWHA are reached in a cost-effective mannerbecause it operates on the community level

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    Successful prevention programASF Mpowerment EBI adaptation for (MSM) PLWHA

    Mpowerment is designed to be tailored tothe characteristics of every community

    Based on interrelated Core Elements thateach community can adapt

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    Successful prevention programASF Mpowerment EBI adaptation for (MSM) PLWHA

    Adapted for MSM PLWHA, the Mpowermentintervention mobilizes individuals to:

    Shape a healthy community for themselves Build positive social connections

    Support safer sex

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    Successful prevention programASF Mpowerment EBI adaptation for (MSM) PLWHA

    Two programs were implemented:

    Positive Life Force English-speaking HIV-positive MSM

    Hombres Por La Vida Spanish-speaking HIV-positive MSM

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    Successful prevention program with

    (MSM) PLWHA

    Spanish-speaking

    HIV-Positive MSM Program

    English-speaking

    HIV-Positive MSM Program

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    Successful prevention programLevels of Interventions for (MSM) PLWHA

    Individual interventions

    Allow the development of a collaborativerelationship

    Assist clients in making plans for individualbehavior change and ongoing appraisals oftheir own behavior

    Provide safe space to explore sensitive topics

    Making appropriate referrals to HIV prevention

    and other supportive services

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    Successful prevention programLevels of Interventions for (MSM) PLWHA

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    Successful prevention programLevels of Interventions for (MSM) PLWHA

    Group-level interventions

    Allow for exchange of ideas, experiences, support,resources

    Enhance communication skills and receive feedback

    Monthly Positive Voice (Core Group) Meeting wherePLWHprovide input and direction for the programdesign and implementation of workshops, social

    activities and community building events.

    Positive Voice Group members become empoweredas they take part as decision makers, help provideinput and feedback and assist the program to remain

    client-centered.

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    Successful prevention programLevels of Interventions for (MSM) PLWHA

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    Successful prevention programLevels of Interventions for (MSM) PLWHA

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    Successful prevention programLevels of Interventions for (MSM) PLWHA

    Health Communication/Public Information

    A Reality Check HIV Disclosure, Who? When? Where?

    How? Party Smart HIV Meds and Drug Interactions

    Passionate Living Become your greatest self-advocate

    Understanding your labs

    Take all your meds Building AdherenceYour new life stage Life after HIV diagnosis, what next?

    Living Well with HIV

    Living Happy Managing HIV & Depression

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    Successful prevention programLevels of Interventions for (MSM) PLWHA

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    Successful prevention programLevels of Interventions for (MSM) PLWHA

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    Successful prevention programLevels of Interventions for (MSM) PLWHA

    Community-level intervention

    Allow for community-wide events, whichserve as an effective compliment to individualand group-level interventions

    Seek to change normative communityattitudes and behaviors, providing opportunityfor the diffusion and support of lower risk

    behavior

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    Successful prevention programLevels of Interventions for (MSM) PLWHA

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    Measure of SuccessIndividual-Level Intervention Program Evaluation

    By June 30, 2009, the HIV-positive MSM programswill conduct a minimum of ninety (90) riskreduction counseling sessions, and make referrals

    when appropriate, to a minimum of thirty (30)unduplicated English-speaking individuals and aminimum of thirty (30) unduplicated Spanish-speaking individuals

    Evaluation indicator: Health Education/Risk Reductionforms, ILI Risk Assessments, Risk Reduction Plans

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    Measure of SuccessGroup-Level Intervention Program Evaluation

    After participating in core group meetings,eighty-percent (80%) of individuals will

    report a decrease in social isolation due toHIV disease

    Evaluation indicator:

    meeting evaluation reports

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    Measure of SuccessHealth Communication Public Info Program Evaluation

    By June 30, 2009, the HIV-positive MSMprograms will conduct fourteen (14)workshops to increase prevention behavior,

    improve personal attitudes toward HIV andprevention and increase a sense ofpersonal responsibility.

    Evaluation indicator: Sign-in sheets,curriculum, prevention materials,pre/post assessment scores

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    Measure of SuccessHealth Communication Public Info Program Evaluation

    After participating in the workshop, eighty-percent (80%) of individuals willdemonstrate competency in utilizing items

    in safe sex kits.

    Evaluation indicator: safer sexcompetency check sheets

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    Measure of SuccessCommunity-Level Intervention Program Evaluation

    By June 30, 2009, the HIV-positive MSMprograms will conduct two (2) communityevents, one in English and one in Spanish,

    to empower a minimum of thirty (30) HIV-positive MSM individuals per event, and toincrease their awareness of HIV supportservices and related health issues

    Evaluation indicator: meetingevaluation reports and sign-in sheets

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    Closing Thoughts

    ...in one last plea, let me drive home the point that reducing not eliminating transmission is truly our only hope at this

    stage of the epidemic. To realize this feat is no smallendeavor and would be the noblest of accomplishments. Butit requires the pragmatic and steadfast efforts of individuals,communities, professionals, and governmental agencies...

    - Dwayne C. Turner