Neville MN, Quinones H, Cummins-Martinez P; National HIV Prevention Conference (2003 : Atlanta, Ga.).
Abstr Book 2003 Natl HIV Prev Conf July 27 30 2003 Hyatt Regency Atlanta Hotel Atlanta Ga Natl HIV Prev Conf 2003 Atlanta Ga. 2003; abstract no. T2-F1003.
Settlement Health, New York, NY
ISSUE: Approximately 95% of all HIV/AIDS cases in East Harlem are African-American or Latino a reflection of the community itself, and it is estimated that 40% are unaccounted for or are not in care. The primary modes of transmission are intravenous drug use and unprotected sex. The social ills of homelessness, substance use, mental illness and differences in culture limit their ability to navigate the health care system and pose barriers to accessing or maintaining care. SETTING: Community-Based Health Center; Homeless Shelters; outreach throughout East Harlem New York.PROJECT: HIV Prevention and Access to Care is a Community Based Model which utilizes individual, group and community level HIV prevention interventions designed at educating the target population about the risks of HIV infection or "superinfection" (re-infection) and helping persons at risk to reduce their probability of becoming infected along with using an adapted prevention case management model to facilitate access to and promote maintenance in HIV care to the target population in East Harlem who would otherwise not seek HIV care unless there is close guidance, encouragement and the necessary skills and resources provided to do so. The HIV prevention component of the model focuses on being ongoing and consistent with all educational sessions grounded in behavioral change theory aimed and to increase condom usage among the target population, raise community awareness on the impact of HIV/AIDS, reduce the incidence of HIV infection and unprotected sex, and to increase access to HIV/AIDS services. This is accomplished through street outreach, individual and group health education/risk reduction presentations and community forums. Utilizing the HIV prevention component to engage clients and connect them to the access to care program, access to care counselors conduct risk and need assessment interviews to develop a service delivery plan that includes counseling and testing services if the client HIV status is unknown, primary care and supportive services.RESULTS: Since the community-based model inception in September 2002, 6,571 participants have participated and accessed HIV prevention services at Settlement Health. Of the 6,571 participants, 57 participants are currently enrolled in the access to care program. Of the 57 participants participating in the ATC program 46 are currently receiving primary care services at Settlement Health, a 37% increase in our current primary care caseload. Of the 46 clients receiving primary care services at Settlement Health, 98% have remained consistent in achieving their service delivery plan goals while 2% have been lost to follow-up.LESSONS LEARNED: The integration of the access to care along with dedicated staff employed in our HIV program has meant a 37% increase in patient caseload in a matter of months. One major difficulty in delivering this model to the target population is socioeconomic burdens due to poverty, homelessness, and substance abuse history sometimes rendering them powerless to be consistent with following their service delivery plans and accessing primary care services. Additional prevention efforts need to be focused on reaching clients where they are at-the places where they congregate to meet their social and drug treatment needs.
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- Case Management
- Condoms
- Counseling
- HIV Infections
- HIV Seropositivity
- Health Education
- Humans
- Incidence
- New York
- Poverty
- Primary Health Care
- Substance Abuse, Intravenous
- Substance-Related Disorders
- organization & administration
Other ID:
UI: 102262028
From Meeting Abstracts