 |
CITY
AIDS AMERICAS Americas Leadership Initiative for AIDS Competence in Cities |
|||||||||||||||||||||||||
|
First Annual Workshop and Conference A Program of CIFAL Atlanta Session 3: Best Practices Sharing: Peer assist reviews Topic: Adapting Our Response Atlanta: [Need to adapt: Prevention education response in face of limited opinion leader involvement] we are good about educating people but less good about turning education into widespread policy and practice. We also have a persistent problem with gathering input and buy-in of locally important opinion leaders as well as government leaders. Common principle: Aggressive, engaged, governmental/community gatekeeper participation is needed to support the work of the ASOs Suggestion: San Juan’s mayor attended a Health Fair and had a HIV test. Atlanta: [Need to adapt: Prevention education response in face of limited capacity to foresee future trends in the epidemic] How do we, as a community, keep our finger on the pulse of where the epidemic is going (e.g. moving into crystal meth. population) and adapt our response accordingly in a timely manner? Common principle: Partnerships bring diverse strengths to address a changing epidemic in a timely manner Suggestion: Environmental Scan to spot emerging trends San Juan: [Need to adapt: Treatment response in face of limited financial resources] Adapting clinical treatment program to new trends in prevention and treatment because it brings good results from consumers but have to make cost-benefit decisions because don’t have large budget. Employees are in training all the time on the new trends. Policy is done by the state. That can be slow so we act before it is a policy, as soon as we receive notification. Health department receives funds from HRSA, state, managed care etc. Are involved in clinical trials, go to conferences, search internet. Our health department faculty meet and discuss the new protocols and present to the administration (executive director of HD), who makes decisions based on money and impact (cost / benefit). Are spending $12 million per year in medications. Need better utilization reviews. Common principle: Address Pharma-economy strategies to lessen burden on drug programs Suggestion: Approach pharmaceutical companies for patient assistance programs Honduras: [Need to adapt: Youth education response in face of limited access to target audience]. Currently offer a two day education program (funded by Global Fund and United Nations): Youth without boundaries. Purpose: Dissemination of information. Target people ages 12-24. Reach out to youth via schoolteachers, in three different regions. Use health educators to teach several seminars, for example about self esteem, discrimination, how to use a condom. Work with both infected and uninfected. For infected, emphasis on teaching about disclosure. Have limited resources to offer infected people and resources are far away from where the training is offered. Do a post-test at 6 months of a participant sample (10%) to check for changes in behavior attributable to the intervention. Use teachers (who are locally important opinion leaders) for input and as liaisons. Need way to get more directly to children and via venues other than just schools. Common principles: 1) Prevention educators need direct access to adolescents for prevention programs and 2) community participation matters Suggestion: Peer education. E.g. in San Juan -- work with three schools each year. One each: wealthy, middle, poor. Get popular kids (opinion leaders) to act as peer educators to go monthly to give seminar about different topics. At end of year they arrange for a talent show, drama, comedy on HIV prevention. Effective because of peer education. Also overcome parents’ resistance to educational programs by holding a parents meeting prior to start of school year, show them videos of what their children are exposed to in the real world (sex, drugs) and propose the program as being designed to protect their children from the effects of this. Houston: [Need to adapt: Case management response in face of inadequate/incorrect/out of date information about service availability]. Problem accessing needed information; no central database of available services. Need new strategies for case management. Common principle: Case management services are only as effective as the information is accurate and comprehensive Suggestion: Aggressive preventive case management (e.g. AID Atlanta); Houston version of Key Contacts. Denver [Need to adapt: Life planning response in face of need to transition HAART consumers back into the workplace]. Growing number of long-term survivors who are healthy enough to go back to work but are still on public assistance. Running out of money to support new people on HAART if don’t transition people into workplace Common principle: If healthy PLWHAs have programs to help them reenter the workforce it will relieve strain on public assistance programs Suggestions: Reconstruction program developed by AID Atlanta; Adult Day Care in San Juan; Project Life Road in Houston, Pathways to Success in Houston (see chart for more details) Adapting our Response
|
||||||||||||||||||||||||||
