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 Colorado CPHE Surveillance Data Report, May 2018 Gonorrhea
CPHE Surveillance Data Report, May 2018 Syphilis, All Stages
CPHE Surveillance Data Report, May 2018 HIV, Newly Diagnosed
Introduction
Staff Resourcefulness Community Partnerships
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!
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 of western Colorado
Think Global, Act Local! • Hospitals • Urgent Care • Private Practices • Family Planning Clinics • County Health Departments • FQHC’s • Youth Centers • Community Corrections
Catering To Our Client’s Needs
The Evolving Role of a DIS Notify & Partner Interview Test Elicitation Partners Linkage/Retention Notify & Test Interview Partner Elicitation To Care, SHSP Partners Accessing Care
The Evolving Role of a DIS Accessing Care
Who are we serving? AGE RANGE 15-24 25-39 40-65 RACE/ETHNICITY 17% White, Non-Hispanic Hispanic/LatinX 32% African-American Other/UNK RISK FACTORS 4% MSM IDU MSM/IDU NONE 8% 51% 19% 27% 61% 8% 8% 65% CPHE Surveillance Data Report, May 2018 Accessing Care
Barriers to Accessing Healthcare Accessing Care
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
Breaking Down The Barriers Access to Insurance • AIDS Drug Assistance Program (ADAP) • Public Health Insurance Program (PHIP) • Medicaid • Health Marketplace
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
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 ( C hoosing L ife: E mpowerment, A ction, R esults) • Critical Events (CE) Program Sponsorship
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
Barriers to Field Outreach You may be meeting with clients at…… Conducting Field Work
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
Timing Really is Everything • 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 Conducting Field Work
Benefits of Public Health Outreach ✓ 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.) Conducting Field Work
Results & Data Analysis
MY1 PRISM PS Data Outcomes, Extended Services Supervisor 2018
Slide 32 MY1 Mendez, Yesenia, 10/23/2018
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
Sexual Health Services Provider (SHSP) LTC • 172 Referrals received in 2017 Repeat PrEP Clients • 153 clients accepted services Partners DIS Housing shortages, mental health SHSP services, unemployment and substance abuse treatment options continue to Regional ASOs be a challenge. Consultants CBOs Providers PRISM Data 2018
Critical Events Outcomes : Qualifying Criteria : • CE served 127 clients in 2017 - 48 clients are still actively Newly diagnosed: 44 clients participating (May 2018) Lapsed in Care: 34 clients - 53 clients were successful Medically Vulnerable: 53 clients - 26 clients were unsuccessful Pregnant: 11 clients • Of the 79 clients that were closed in Homeless: 81 clients 2017, 58 were undetectable at Unemployed: 82 clients closure. Substance Use: 38 clients • Housing shortage and substance Mental Health: 45 clients abuse treatment options continue to be a challenge. Critical Events Data Outcomes, Critical Events Coordinator 2018
Colorado Care Continuum as of Dec 31, 2017 CPHE Surveillance Linkage to Care Data Report 2018
Kacie Taylor, Colorado Department of Public Health & Environment STI/HIV/VH Branch, Western Regional Consultant Kacie.Taylor@state.co.us, 970-248-7146
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