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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