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Peer Ambassadors
To reach certain population subsets, LIAAC counselors must use special strategies. Men who have sex with men, for example, often express a feeling of “AIDS fatigue,” which comes from having heard so much about the problem that they don’t want to think about it any more.
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| A SAMHSA HIV minority outreach grantee explains to a client the simple procedure for a rapid HIV test that gives results in approximately 20 minutes. |
By working through a “peer ambassador” who carries the message, counselors have succeeded in convincing many of these resistant individuals to reconsider their earlier opposition to testing. Some gay men of color proved especially resistant, despite suffering an increasing rate of HIV infection, because of traditional disapproval of homosexuality prevalent in many black churches.
Project Safety Net staff learned to work with church leaders on long-term efforts to lessen the stigma attached to HIV. They worked to solve the problem of lack of health insurance by developing memoranda of understanding with certain agencies able to provide services to uninsured clients.
LIAAC also learned that Project Safety Net needs staffers who have a passion for service rather than merely a desire for a job to earn money. The knowledge that her work is “really helping the community,” for example, motivates Ms. Cabral. Also essential to counselors’ success are direct experience with or membership in the affected ethnic communities, “street smarts,” and the ability to fit in with the target populations. Also important are thoroughness in collecting and handling data, doing HIV testing to exacting standards, providing accurate and appropriate counseling, and safely managing the van.
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LIAAC outreach worker Charles Jones steps off the van. |
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These qualities all come into play as counselors work with clients both on the street and in the van, which provides a private, personal, and non-threatening setting for education and counseling.
Awaiting test results with a client, Ms. Cabral said, “I use the time to educate the people and ask questions about their substance abuse history. I let them know about services and how to protect themselves and how to reduce their risk.” She also talks about the need for re-testing for those in the “window period” of several months between the time a person first acquires the infection and the test is able to detect its presence. Any positive result on the rapid test requires confirmation by the more sensitive 48-hour test, which is done in a lab.
In that case, the counselors collect the necessary sample of oral fluid and arrange an appointment with the person to present the results.
Hundreds of individuals each year also receive referrals to substance abuse treatment and other needed medical and social services as well as risk reduction and safer-sex materials; free bags of nutritious, shelf-stable foods; and free personal care kits containing soap, a wash cloth and other necessities.
Based on what LIAAC learned under the first TCE/HIV grant, furthermore, “we are incorporating a preventative case management model,” said Chief Program Officer Karen Ross, M.A.
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LIAAC's HIV/AIDS outreach team includes (left to right) Charles Jones, Juanita Cabral, Robert O'Donnell, and Ayesha Ramsey. |
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Many who test positive cannot make effective use of referrals on their own because HIV is “just one more” in an overwhelming long list of problems. “Sometimes we hear someone say, ‘I have X, Y, and Z going on in my life, plus I don’t have money for food on the table.’ Then we work on a regular basis with that individual. We follow up on referrals and help them get connected with services,” Ms. Ross said.
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Results
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| LIAAC's HIV/AIDS outreach van is ready for another day at various locations in Long Island, NY. |
No matter what issue first brings a person into contact with LIAAC, its “no wrong door” policy assures that the full range of services is made available.
“We fast-track people into our case management system and ensure that they get the benefits that they’re entitled to, primary health care, and any other ancillary services that they need,” Mr. Friedman said. A 6-month followup of clients shows self-reported drops in drug use that exceed 50 percent.
Because of the lessons learned during the first 5-year SAMHSA grant, LIAAC received a second 5-year grant from the Agency that will keep the van on the streets of Long Island making its lifesaving rounds. 
« See Part 1: Outreach, Testing for At-Risk Individuals
See Also—Expanding HIV Assistance
Two SAMHSA HIV/AIDS Programs Reach Those in Need »
Resources on HIV/AIDS »
HIV/AIDS Consumer Guide
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