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Introduction Introduction Introduction Nationwide Cause for - - PowerPoint PPT Presentation

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Introduction Introduction Introduction Nationwide Cause for Concern 1 https://www.cdc.gov/std/stats17/infographic.htm Introduction Epidemiology in Western Colorado CPHE Surveillance Data Report, May 2018 Chlamydia Epidemiology in Western

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Introduction

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Introduction

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Introduction

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Introduction

Nationwide Cause for Concern

1 https://www.cdc.gov/std/stats17/infographic.htm

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Chlamydia

Epidemiology in Western Colorado

CPHE Surveillance Data Report, May 2018

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Gonorrhea

Epidemiology in Western Colorado

CPHE Surveillance Data Report, May 2018

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Syphilis, All Stages

CPHE Surveillance Data Report, May 2018

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HIV, Newly Diagnosed

CPHE Surveillance Data Report, May 2018

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Introduction

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Community Partnerships

Staff Resourcefulness

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Colorado Health Network (CHN)

Western Colorado AIDS Project (WCAP), Grand Junction

  • Medical Case Management
  • Insurance Enrollment Assistance
  • Syringe Exchange
  • Walk-in HIV & HEP C Rapid Testing
  • Outreach Testing & Education

The only HIV case management agency on the Western Slope!

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AIDS Education & Training Center (AETC)

  • : University of Colorado Anschutz Medical Campus

Infectious Disease Division and Local Public Health Agencies

  • : HIV testing in collaboration with 16 sites at 22

locations in Western Colorado, 2009-Present

  • : To promote earlier identification of HIV infection,

particularly among minority individuals residing in rural areas

  • f western Colorado
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Think Global, Act Local!

  • Hospitals
  • Urgent Care
  • Private Practices
  • Family Planning Clinics
  • County Health Departments
  • FQHC’s
  • Youth Centers
  • Community Corrections
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Catering To Our Client’s Needs

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The Evolving Role of a DIS

Accessing Care

Interview Linkage/Retention To Care, SHSP Partner Elicitation Notify & Test Partners

Interview Partner Elicitation Notify & Test Partners

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The Evolving Role of a DIS

Accessing Care

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Accessing Care

Who are we serving?

61% 27% 8% 4%

RACE/ETHNICITY

White, Non-Hispanic Hispanic/LatinX African-American Other/UNK 17% 51% 32%

AGE RANGE

15-24 25-39 40-65 65% 8% 8% 19%

RISK FACTORS

MSM IDU MSM/IDU NONE

CPHE Surveillance Data Report, May 2018

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Barriers to Accessing Healthcare

Accessing Care

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Breaking Down The Barriers

Comprehensive Testing

  • HIV
  • Syphilis
  • Gonorrhea, Triple Site
  • Chlamydia, Triple Site
  • Hep C

Outreach Testing

  • STI & HIV Contacts/Partners
  • Social Contacts
  • Referrals
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Breaking Down The Barriers

Access to Insurance

  • AIDS Drug Assistance Program

(ADAP)

  • Public Health Insurance Program

(PHIP)

  • Medicaid
  • Health Marketplace
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Breaking Down The Barriers

Linkage to Care

  • HIV/STI Referrals
  • Medical Home
  • Mental Health Providers
  • Substance Use Treatment
  • Hep C Treatment
  • Risk Reduction Intervention Programs
  • Others as Needed
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Breaking Down The Barriers

Risk Reduction Interventions for PLWH

Sexual Health Service Providers (SHSP) are Licensed Professional Counselors/Clinical Social Workers (LPC/LCSW) who provide Individual Level Interventions, including:

  • Individual and Couples Counseling
  • Risk Reduction Planning
  • Disclosure Skill Building
  • LTC/PrEP/ART education/support/adherence
  • Art Therapy
  • CLEAR (Choosing Life: Empowerment, Action, Results)
  • Critical Events (CE) Program Sponsorship
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Breaking Down The Barriers

Risk Reduction Interventions for PLWH

The Critical Events (CE) Program assists clients in overcoming critical life events determined to be barriers to their care, including:

  • Homelessness
  • Substance Abuse
  • Mental Health Issues
  • Unemployment
  • Intimate Partner Violence
  • Other Factors Based in Individual Circumstance

Financial Assistance is available to those who qualify

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Barriers to Field Outreach

You may be meeting with clients at……

Conducting Field Work

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Selling the Service

Skepticism ‐ “Why doesn’t this cost anything?” Fear ‐ “You want to swab me WHERE?!?” Mistrust ‐ “Are you sure you’re from the health department?” Denial ‐ “Oh, I don’t need that kind of testing…”

Conducting Field Work

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  • Every question is an opportunity to educate!

✓ STI Trends ✓ Asymptomatic ✓ Routine testing

  • Take advantage of the intimate setting

✓ Broach sensitive topics ✓ Help build the bridge to your community

Timing Really is Everything

Conducting Field Work

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✓ Flexible scheduling ✓ Respond to transportation issues ✓ Non‐standard testing options ✓ No cost to the client or insurance required ✓ Linkage to other services (PrEP, Substance Abuse, etc.)

Benefits of Public Health Outreach

Conducting Field Work

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Results & Data Analysis

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PRISM PS Data Outcomes, Extended Services Supervisor 2018

MY1

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Slide 32 MY1

Mendez, Yesenia, 10/23/2018

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HIV Interview Outcomes

# of Partners Initiated 726 # of Partners Notified 603 (83%) # of Partners Examined 464 (77%) # of Positivity Found 21

Overall Positivity Rate 27%

PRISM Data PS Outcomes, Extended Services Supervisor 2018

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Sexual Health Services Provider (SHSP)

  • 172 Referrals received in 2017
  • 153 clients accepted services

Housing shortages, mental health services, unemployment and substance abuse treatment options continue to be a challenge.

PRISM Data 2018

SHSP

LTC PrEP DIS Regional Consultants Providers CBOs ASOs Partners Repeat Clients

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Critical Events Outcomes :

  • CE served 127 clients in 2017
  • 48 clients are still actively

participating (May 2018)

  • 53 clients were successful
  • 26 clients were unsuccessful
  • Of the 79 clients that were closed in

2017, 58 were undetectable at closure.

  • Housing shortage and substance

abuse treatment options continue to be a challenge. Qualifying Criteria: Newly diagnosed: 44 clients Lapsed in Care: 34 clients Medically Vulnerable: 53 clients Pregnant: 11 clients Homeless: 81 clients Unemployed: 82 clients Substance Use: 38 clients Mental Health: 45 clients

Critical Events Data Outcomes, Critical Events Coordinator 2018

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Colorado Care Continuum as of Dec 31, 2017

CPHE Surveillance Linkage to Care Data Report 2018

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Kacie Taylor, Colorado Department of Public Health & Environment STI/HIV/VH Branch, Western Regional Consultant Kacie.Taylor@state.co.us, 970-248-7146