bay area network for positive health
DESCRIPTION
Bay Area Network for Positive Health. Cynthia A. Gómez, PhD Health Equity Institute San Francisco State University AIDS, 2012. Background. Estimated 8,000 individuals in San Francisco and Alameda County (Oakland), CA with known HIV infection not receiving adequate care. - PowerPoint PPT PresentationTRANSCRIPT
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Bay Area Network for Positive Health
Cynthia A. Gómez, PhDHealth Equity Institute
San Francisco State UniversityAIDS, 2012
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Background
• Estimated 8,000 individuals in San Francisco and Alameda County (Oakland), CA with known HIV infection not receiving adequate care.
• Little is known about the contextual realities that keep PLWH out of care in the resource-rich setting of the SF Bay Area.
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City and County of San Francisco
Oakland,
Alameda County
SF/OAK Bay Bridge
Bay Area Context
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SF Incidence versus Community Viral Load Maps
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Health Disparities
Health Inequities
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Service Design
PLWH/A
Non-HIV organizations
HIV/AIDS CBOs
HIV Care Providers
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Methods: Network12 CBOs, HIV clinics, and San Francisco and Alameda County Departments of Public Health Health. Serving:• African Americans• Women• IDUs• Incarcerated (State Prison and County Jail systems)• Immigrant Latinos• Burmese Refugees
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Client IdentificationClients are located through: • Street outreach• Syringe exchange• Jails• Prison• Support groups• Review of internal clinic records.
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Survey DataData are collected on:
• Barriers to care• Experience of stigma• Quality of Life• Resource Needs• Demographics
• Mixed quantitative/qualitative method, including voice recordings
• Data entered directly into iPod Touch devices and uploaded automatically to centralized server
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Linkage to Care• Out of care individuals are offered assistance to access HIV care and other support services:
• Linked to HIV Care• Linked to other medical care as needed• Linked to support services as needed
• Follow-up of retention through county surveillance.• Release of Medical Records collected for potential
future chart review.
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Hard to Reach• Known HIV+ average of 10 years• 34% reported no HS diploma or equivalent• 63% over 40 years of age• 66% reported living in someone else’s home, a
treatment center, SRO, shelter, or outdoors.• 10 Attempts on average to engage• 63% linked to HIV care in 56 days (mean) after
initial contact vs. 30-day national guideline goal
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What lessons have we learned?
• Actual time taken to effectively engage and link prospective HIV+ clients
• Resources and capacity needed to “set the stage”
• Intra-agency “cross-pollination” has helped close gaps of client service
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Conclusions• Barriers to care have been persistent and difficult to
remediate. • Other priority needs must be met before linking to HIV
medical care. • Extra time and additional resources are imperative to
reach and link these individuals critical to the containment of the pandemic.