Professional Documents
Culture Documents
Edwin Ramos-Soto
Dedicated to:
The HIV-Positive Individuals Of Orange County, CA Who Throughout The Epidemic Have Taken Extraordinary Steps To Protect Others, thereby Preventing The Spread of HIV
Presentation Summary
Positive Preventions Backdrop The Logic of Prevention with PLWHA Community Needs Assessment OCHCA Community Needs Assessment ASF-PLWHA Community Needs Assessment Successful prevention program with (MSM) PLWHA Mpowerment EBI adaptation for (MSM) PLWHA Varying Levels of Prevention Interventions Conducted Measure of success Process/Outcome Evaluation Systematic Steps, Best Measure of Success Closing Thoughts
Objectives
At the completion of this session scholars will: Explain how the needs of PLWHA were assessed Describe how AIDS Services Foundation (ASF) has conducted a successful program with PLWHA Discuss how the success of ASF HIV prevention program with PLWHA is measured
Need for interventions for PLWHA Increasing number of PLWHA High rates of infection in communities of color; resurgence of HIV in some populations The HAART impact
challenge HIV transmission prevention environment is increasingly complex Increasing number of PLWHA are living and coping well with disease challenges Occasional lapse into unsafe behaviors
of low-risk behavior
burnout Depressive symptoms and increased rates of unprotected sex correlation HIV treatment optimism Reinfection/Superinfection confusion Viral undetectability = reduced infectivity confusion
infections involve an HIV-infected individual New infection can be prevented by intensive efforts directed toward population capable of transmission
need to:
Encourage
healthy sense of responsibility without assigning blame Support a lifestyle that includes a fulfilling sex life Support the enhance of interpersonal and community relationships
Objectives: Describe the risk and/or protective behaviors of individuals not receiving HIV preventions services
Describe
knowledge and perceptions regarding HIV and HIV risk HIV prevention needs, met/unmet
Determine
Needs Assessment Outcomes Focus: Demographics HIV knowledge Drug risk behaviors Sexual risk behaviors Perceptions about HIV Barriers to service utilization
Continued
prevalence contributing to increased high-risk behaviors risks differences depending on acculturation levels
Perceived
Prevention efforts for PLWHA need be tailored specifically to their needs: HIV treatment education workshops
Community-building General
Greater
Peer-led
and/or group counseling focused on contextual factors that influence risk that focus on relationship dynamics
Interventions Peer
Identify
Establish
Establish
staff
partners
Community OCHCA
(local DOH)
Additional data as resource: Socioeconomic and demographic status; Current statistics and trends involving HIV/STD
Existing Social
Identification
clients
Formal
Strategic
care adherence and HIV transmission prevention are not primary concern
Results: High-risk behaviors are not exclusive to those who struggle with poverty, stigma, mental illness
Some
comprehensive approach to prevention with positives must include strategies intervene with high-risk behaviors strategies for engaging out-of-care HIVinfected persons into care of limited resources means communities can not provide entire range of possible interventions
Include
Reality
that place any HIV-positive person at risk for transmitting the virus are often highly individualized
simply identifying risk behaviors, it is important to gain understanding of the place these behaviors hold within the context of each individuals life
Beyond
Emphasizing
Providing
interventions to provide both individual and small-group work harm reduction based approaches
Using
Maintaining
on client-defined motivators as a basis for creating change behavioral objectives that are specific and achievable effects of multiple diagnoses on motivation and behavior change relapse prevention
Using
Factor
Include
Formative research led to the adaptation and implementation of a Mpowerment EBI for (MSM) PLWHA
Mpowerment
intervention
Through
Mpowerment large numbers of PLWHA are reached in a cost-effective manner because it operates on the community level
is designed to be tailored to the characteristics of every community on interrelated Core Elements that each community can adapt
Based
Positive
Hombres
Por La Vida
English-speaking
provide different opportunities for working with positives and their communities
They
interventions
the development of a collaborative relationship clients in making plans for individual behavior change and ongoing appraisals of their own behavior
Assist
Enhancing clients self awareness of HIV risk behavior Discussing options for risk and harm reduction Demonstrating and practicing techniques for risk reduction (e.g. barrier demonstration, cleaning needles) Role playing for condom negotiation
Making
interventions
for exchange of ideas, experiences, support, resources Enhance communication skills and receive feedback Monthly Positive Voice (Core Group) Meeting where PLWH provide input and direction for the program design and implementation of workshops, social activities and community building events. Positive Voice Group members become empowered as they take part as decision makers, help provide input and feedback and assist the program to remain clientcentered.
Communication/Public Information
peer education, support, skills training and reinforce safer behaviors
Provide
Promote
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 Adherence Your new life stage Life after HIV diagnosis, what next? Living Well with HIV Living Happy Managing HIV & Depression
intervention
for community-wide events, which serve as an effective compliment to individual and group-level interventions to change normative community attitudes and behaviors, providing opportunity for the diffusion and support of lower risk behavior
Seek
Measure of Success
June 30, 2009, the HIV-positive MSM programs will conduct a minimum of ninety (90) risk reduction counseling sessions, and make referrals when appropriate, to a minimum of thirty (30) unduplicated English-speaking individuals and a minimum of thirty (30) unduplicated Spanish-speaking individuals
Evaluation
Measure of Success
June 30, 2009, the HIV-positive MSM programs will conduct ten (10) English Core Group meetings and ten (10) Spanish Core Group meetings, will recruit five (5) English speaking and five (5) Spanish speaking members for the core group to obtain input and direction for the program design and implementation of community building activities
Evaluation indicator: Meeting Logs, Sign-in sheets and core group meeting agendas
After
participating in core group meetings, eighty-percent (80%) of individuals will report a decrease in social isolation due to HIV disease
Measure of Success
June 30, 2009, the HIV-positive MSM programs will conduct fourteen (14) workshops to increase prevention behavior, improve personal attitudes toward HIV and prevention and increase a sense of personal responsibility.
After
participating in the workshop, eighty-percent (80%) of individuals will demonstrate competency in utilizing items in safe sex kits
Evaluation indicator: Sign-in sheets, curriculum, prevention materials, pre/post assessment scores
After
participating in the workshop, eighty-percent (80%) of individuals will identify risk factors for HIV transmission and appropriate risk reduction techniques
Measure of Success
June 30, 2009, the HIV-positive MSM programs will conduct ten (10) English Core Group meetings and ten (10) Spanish Core Group meetings, will recruit five (5) English speaking and five (5) Spanish speaking members for the core group to obtain input and direction for the program design and implementation of community building activities
Evaluation indicator: Meeting Logs, Sign-in sheets and core group meeting agendas
After
participating in core group meetings, eighty-percent (80%) of individuals will report a decrease in social isolation due to HIV disease
Measure of Success
June 30, 2009, the HIV-positive MSM programs will conduct two (2) community events, one in English and one in Spanish, to empower a a minimum of thirty (30) HIV-positive MSM individuals per event, and to increase their awareness of HIV support services and related health issues
After
participating in core group meetings, eighty-percent (80%) of individuals will report a decrease in social isolation due to HIV disease
Measure of Success
PLWHA Programs Evaluation Describing
the process of behavior change is more than counting units of services delivered
whether or not an HIVpositive individual ultimately uses a condom may represent endpoint of an intervention; Such documentation does not fully represent an interventions effectiveness
Documenting
Measure of Success
PLWHA Programs Evaluation
The
path to behavior change is complex and often elusive single evaluation strategy can capture the elements involved focused on producing behavior change require a wide range of evaluation strategies, embracing both quantitative/qualitative methods of evaluation
No
Programs
Measure of Success
PLWHA Programs Evaluation It
is important to have an evaluation plan in place as prevention with positives are designed and implemented
evaluating prevention with positives programs will be very challenging.
Effectively
Measure of Success
PLWHA Programs Evaluation Carefully
evaluating a program affords opportunities to improve, redesign, or even eliminate, aspects of the program
of a program can be determined by an effective, objective evaluation combined with a willingness to modify and improve based on community need, participant feedback, and scientific merit.
Success
Measure of Success
PLWHA Programs Evaluation
To best measure the success or our programs we have developed program evaluations that require systematic steps:
1.
To what extent did the program achieve its goals and objectives? Were the activities implemented as planned? Which features were most/least effective
Measure of Success
PLWHA Programs Evaluation 2.
ii.
Deciding on info needed to provide convincing evidence of a programs effectiveness Must be purposeful, Realistic and Measurable How many/when measurements should be made? How many groups or persons should be included in the evaluation?
3.
Measure of Success
PLWHA Programs Evaluation 4. 5.
Collecting data
Analyzing data Reporting the results
6.
Closing Thoughts
Focus on the HIV-positive community as a crucial player in the prevention of HIV is key.
Without programming for PLWHA HIV prevention would be incomplete.