Online Program

Engaging the invisible: Locating and linking the long-term, out-of-care PLWH - a community systems approach

Wednesday, November 6, 2013 : 10:30 a.m. - 10:45 a.m.

Cynthia A. Gómez, PhD, Health Equity Institute, San Francisco State University, San Francisco, CA
Nicholas Alvarado, MPH, BANPH/Health Equity Institute, San Francisco State University, San Francisco, CA
Danielle Gordon, MS, BANPH/Health Equity Institute, San Francisco State University, San Francisco, CA
Background: The U.S. prioritizes locating over 650,000 PLWH that are not in care, and linking them to HIV services as a critical strategy in ending the pandemic. Yet little is known about local realities that keep PLWH out of care or what is needed to mobilize and coordinate a system of care providers. Methods: Bay Area Network for Positive Health (BANPH) is a consortium of 12 agencies/HIV clinics in San Francisco and Oakland that identifies individuals not in HIV care and links them. Using mixed-methodologies, we illustrate the individual-level and systems-level requirements to effectively engage the most disenfranchised. PLWH are identified through street outreach, syringe exchange, jails, prison, support groups, and review of clinic records. Individuals complete a survey to assess barriers/needs, and are linked to HIV care and auxiliary services. Network agencies share resources, lend peer-support, and problem-solve together to increase effective outreach, linkage and retention in HIV care. Results: Over 500 PLWH have been engaged by BANPH. Most are over age 40 (62%), 58% male, and primarily African American and Latino (73%). It took an average of 56 days from first contact to medical appointment. Individuals knew their status on average for 10 years. 25% reported avoiding treatment because someone might find out about their HIV. BANPH agencies increased their own capacity in outreach, data collection, and collaboration. Conclusions: Creating an urban collaborative network built with mutual respect and a common mission has proven to be an effective approach to systems change and effective engagement of disenfranchised PLWH.

Learning Areas:

Administer health education strategies, interventions and programs
Assessment of individual and community needs for health education
Diversity and culture
Provision of health care to the public
Public health administration or related administration
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Demonstrate the effectiveness of engaging a diverse set of community agencies for reaching chronicly out-of-care persons living with HIV.

Keyword(s): Community Collaboration, HIV/AIDS

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been a HIV investigator for over 20 years with a particular focus on community-based interventions. Conducted the first studies on the prevention and care needs of HIV+ MSM and IDUs. I have been a principal investigator or co-investigator on multiple federally and privately funded grants.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.