PROJECT IN-CAREChicago’s Positive Charge Project

Roman Buenrostro, AIDS Foundation of ChicagoSunday July 22, 2012

AGENDA

• The need we responded to• What the project looked like in Year 1?• Changes made to the project in Year 2?• What have we learned so far?

THE NEED

Of the new cases of HIV infection between 2006-2008:

• 51% are Non-Hispanic African American while comprising 18% of the EMA population

• 16% are Hispanic matching roughly their estimated EMA population size

• 64% are MSM identified

UNMET NEED ESTIMATES

Total local estimate is 52% of all PLWHIVA are not in care– 52% of MSM diagnosed are out of care– 40% of MSM/IDU are out of care– 50% of NH/African American are out of care– 49% of Hispanic are out of care

How do we (AFC and our partners) address these statistics?

Project IN-CARE: ComponentsActivities

I - Identify Pilot use of new assessment tool to measure relative risk of care interruption or non-adherence, and enroll target population into IN-CARE system

N - Navigate Provide short-term peer health navigation in community- and/or clinic-based settings

C - Connect Provide HIV case management services through our current coordinated system

A - Access Provide primary care, lab services, and medications thorough our community partners

R - Retain Group-level interventions

E - Evaluate Information gathering, data analysis, project monitoring, and continuous quality improvement

RED = New modalities incorporated into our current system.

Project IN-CARE: Our Goals

• Identify and monitor men of color living with HIV/AIDS who are at greater risk for treatment non-adherence.

• Identify the specific barriers that prevent men of color from accessing and remaining adherent to HIV care.

• Better understand the needs of project IN-CARE clients.

• Help providers across the city develop better targeted linkage-to-care and retention interventions.

Components By Site- First Year

AIDS Foundation of Chicago• Lead agency• Develop the Access/Retention-to-Care Screening

Tool for pilot testing• Develop the peer health navigation protocol and

training collaboratively• Coordinate project-wide data collection and

management activities• Develop service tracking logs and convene regular

meetings with each site

Brothers Health Collective• Identify and enroll clients through their

existing prevention outreach and testing activities

Howard Brown Health Center• Administer retention screening tool• Enroll newly diagnosed clients at STD/HIV

clinics and/or initial client visits to primary care clinics

CORE Center• Administer retention screening tool• Enroll newly diagnosed clients at STD/HIV clinics

and/or initial client visits to primary care clinics

TPAN• Administer retention screening tool• Identify and enroll clients through their existing

prevention outreach and testing activities• Treatment Education Advocacy Mobilization

(TEAM) group will be adapted and utilized for IN-CARE clients

Year 2 CHANGES

• In an effort to serve more participants, we expanded our we expanded our eligibility criteria to include non-men of color MSM

• Removed the group level education component as a requirement for IN-CARE participants

• Consolidated the Peer Health Navigation to three sites due to an underperforming partner

Lessons Learned

• Planned outreach strategies (e.g. internet outreach through social networking sites) not successful especially for “out of care” individuals

• Multiple access/retention to care intervention initiatives launched concurrently -important to participate in service provider planning meetings , and ongoing meetings

Elements needed for Peer Health Navigation services to be successful:

• Organizational structure and processes significantly impact service delivery

• Buy-in is key from:–Organization–Administration – Staff

Lessons Learned

Lessons Learned

• Peer services were meant to be a bridge into standard care, but it is proven challenging to focus on care with poverty, substance use, incarceration, and housing instability

• Our local project included several questions that were trauma-related and found that 78% of our clients reported having been exposed to a crime-related event, 42% have been victims of physical violence, and 40% have been victims of sexual abuse.

Contact information:Roman Buenrostro

Director of Special ProjectsAIDS Foundation of Chicago

200 West Jackson, Suite 2200Chicago, IL 60606

312-334-0960 (phone)312-922-2916 (fax)

rbuenrostro@aidschicago.org