California Department of Public Health California Department of Public Health Office of AIDSOffice of AIDS

Strategic Response for Strategic Response for African Americans & HIV/AIDSAfrican Americans & HIV/AIDS

Reggie Caldwell, LCSWReggie Caldwell, LCSWUnited States Conference on AIDSUnited States Conference on AIDSNovember 10, 2007November 10, 2007Palm Springs, CaliforniaPalm Springs, California

GoalGoalTo reduce the disproportionate To reduce the disproportionate HIV incidence and prevalence HIV incidence and prevalence among African Americans in among African Americans in California by providing leadership California by providing leadership through the deployment of a through the deployment of a CDPH/OA CDPH/OA African American African American Strategic Response.Strategic Response.

Strategic Response

Program & Policy

Research

LegislationTechnicalAssistance

CommunityRelations

LegislationLegislation Assembly Bill 1142-Assembly Bill 1142-Statewide African American HIV/AIDS InitiativeStatewide African American HIV/AIDS Initiative Addresses the disproportionate impact of Addresses the disproportionate impact of

HIV/AIDS on the health of African AmericansHIV/AIDS on the health of African Americans Establishes the administrative, educational, Establishes the administrative, educational,

and communication infrastructure to support and communication infrastructure to support the activities of the provider networkthe activities of the provider network

Mandates CPDH/OA provides support Mandates CPDH/OA provides support Initiative until January 1, 2008, when the Initiative until January 1, 2008, when the Initiative would become an independent non-Initiative would become an independent non-profit organizationprofit organization

The The Initiative Initiative establishes theestablishes theCalifornia African American HIV/AIDS CoalitionCalifornia African American HIV/AIDS Coalition

(CAAHAC)(CAAHAC)

Bay Area

SacramentoCentral Valley

RiversideSan Bernardino

Los Angeles

San Diego

Mission StatementMission Statement

The mission of CAAHAC is to address The mission of CAAHAC is to address the disproportionate impact of the the disproportionate impact of the HIV/AIDS epidemic in the black HIV/AIDS epidemic in the black community and communities of African community and communities of African descent among stakeholders, and descent among stakeholders, and prioritize HIV/AIDS as an urgent prioritize HIV/AIDS as an urgent healthcare issue by:healthcare issue by: impacting public policy, impacting public policy, enhancing resource development, and enhancing resource development, and promoting collaboration.promoting collaboration.

Steering Committee

Bay Area

Riverside/San Bernardino

San Diego

Sacramento/Central Valley

Los Angeles

Board of Directors

CAAHAC StructureCAAHAC Structure

The Steering Committee is comprise of 5 members from each region and 2 members from each region are member of the Board of Directors.

Continuum of RiskContinuum of Risk

HIGH RISKHIGH RISK LOW RISK LOW RISK

California DepartmentCalifornia Departmentof Public Health/of Public Health/Office of AIDSOffice of AIDS

Primary FocusPrimary Focus

Community and Natural PartnersCommunity and Natural Partners•SchoolsSchools•Community Health ClinicsCommunity Health Clinics•Community Services AgenciesCommunity Services Agencies•Faith-Based OrganizationsFaith-Based Organizations

Primary FocusPrimary Focus

Policy and ProgramPolicy and ProgramCurrentCurrent Gay men/MSMGay men/MSM WomenWomen

PerinatalPerinatal Black Infant Health Black Infant Health

CollaborativeCollaborative HIV Testing in HIV Testing in

Emergency Emergency DepartmentsDepartments

In DevelopmentIn DevelopmentYouthYouth

CHPG recommended thatCHPG recommended that

designated LHJs create an designated LHJs create an Action PlanAction Plan to adequately to adequately address the HIV prevention address the HIV prevention needs of African American gay needs of African American gay men/MSM.men/MSM.

African AmericanAfrican AmericanGay Men/MSM Gay Men/MSM

Action Plan GoalsAction Plan GoalsFor C&TFor C&T: To increase testing : To increase testing for HR AA gay men/MSM for HR AA gay men/MSM

For HERRFor HERR: To provide effective : To provide effective HIV prevention services for AA HIV prevention services for AA gay men/MSMgay men/MSM

Action Plan TenetsAction Plan Tenets Targeted funding Targeted funding Providers with a history and capacity Providers with a history and capacity Services that are accessibleServices that are accessible Address social, cultural, political and Address social, cultural, political and

economic risk factorseconomic risk factors Prevention as health and wellnessPrevention as health and wellness Counter isolation/loneliness, depression Counter isolation/loneliness, depression

and outcomes of childhood sexual abuseand outcomes of childhood sexual abuse

Perinatal Program Primary ObjectivePerinatal Program Primary Objective::Build capacity to provide rapid HIV testing in Build capacity to provide rapid HIV testing in every California Labor and Delivery Hospitalevery California Labor and Delivery Hospital

Provide rapid HIV test to pregnant women Provide rapid HIV test to pregnant women who present to L&D with an undocumented who present to L&D with an undocumented HIV status.HIV status.

Hospital must be able to turn around HIV Hospital must be able to turn around HIV test in 1 hour (either by lab or at point-of-test in 1 hour (either by lab or at point-of-care). care).

Hospital must have oral and IV anti Hospital must have oral and IV anti retrovirals available for women who have a retrovirals available for women who have a preliminary positive result.preliminary positive result.

Primary ActivitiesPrimary Activities

Pacific AIDS Education and Training Pacific AIDS Education and Training Center provides training to labor and Center provides training to labor and delivery hospitals using the CDC modeldelivery hospitals using the CDC model Over 20 hospitals have been trainedOver 20 hospitals have been trained

Office of AIDS Women and Transgender Office of AIDS Women and Transgender Program and Policy Coordinator provides Program and Policy Coordinator provides technical assistance technical assistance

Stanford University conducts the program Stanford University conducts the program evaluationevaluation

Perinatal HIV Hotline Perinatal HIV Hotline 888-448-8765888-448-8765

National Perinatal HIV Consultation National Perinatal HIV Consultation and Referral Serviceand Referral Service

Advice on the HIV management in pregnant women Advice on the HIV management in pregnant women and infants and HIV testing in pregnancy.and infants and HIV testing in pregnancy.

Black Infant Health Black Infant Health

CollaborativeCollaborative

Program Goals:Program Goals:1.1. To To increase awarenessincrease awareness

and understanding of and understanding of HIV/AIDS basic HIV/AIDS basic science and prenatal science and prenatal transmissiontransmission

2.2. To To increase capacityincrease capacity of of BIH service providers BIH service providers to effectively discuss to effectively discuss HIV related issues HIV related issues (including risk (including risk assessments, risk assessments, risk reduction counseling reduction counseling strategies) with their strategies) with their clientsclients

Primary ActivitiesPrimary Activities

Surveyed BIH program on training Surveyed BIH program on training needsneeds

Conducting literature review of Conducting literature review of current materials on women, HIV and current materials on women, HIV and maternal child transmissionmaternal child transmission

Develop a curriculumDevelop a curriculum Conduct training sessions and Conduct training sessions and

evaluate the training programevaluate the training program

HIV Testing in HIV Testing in Emergency DepartmentsEmergency Departments

The goalsThe goals To provide rapid HIV testing within emergency To provide rapid HIV testing within emergency

departments, specifically targeting African departments, specifically targeting African Americans, and Americans, and

To link those who test HIV positive to HIV services. To link those who test HIV positive to HIV services. CDC funded demonstration projectCDC funded demonstration project Hospitals:Hospitals:

Alameda County Health Center/HighlandAlameda County Health Center/Highland Alta Bates Summit Medical Center, and Alta Bates Summit Medical Center, and San Francisco General HospitalSan Francisco General Hospital

Program ActivitiesProgram Activities1.1. ScreeningScreening

HIV testingHIV testing

2.2. Notification of ResultsNotification of Results3.3. Post Test ServicesPost Test Services

HIV PositiveHIV Positive• Linkage to careLinkage to care• Partner counseling and referral servicesPartner counseling and referral services• Comprehensive medical and psycho-social assessment Comprehensive medical and psycho-social assessment • Risk reduction counselingRisk reduction counseling• Linkages to ancillary servicesLinkages to ancillary services• Incentivized social networking strategy Incentivized social networking strategy

HIV NegativeHIV Negative• Referral to HIV prevention servicesReferral to HIV prevention services

Social Network OutreachSocial Network Outreach

““Social Networks is all Social Networks is all about breaking from about breaking from the old model of just the old model of just doing outreach. A main doing outreach. A main goal of socialgoal of socialnetworking is to networking is to prevent HIV. What is prevent HIV. What is put into the community put into the community in terms of knowledge in terms of knowledge and awareness isand awareness isbetter than just random better than just random testing of people.”testing of people.”

Youth Initiative ConceptYouth Initiative Concept Holistic approach addressing physical, Holistic approach addressing physical,

mental and spiritual healthmental and spiritual health Community mobilization/community Community mobilization/community

empowerment modelempowerment model Create a model that is “trauma informed”Create a model that is “trauma informed” Focus on education and reducing Focus on education and reducing

possible riskpossible risk Peer involvement Peer involvement

Stages of Stages of DevelopmentDevelopment Pre-adolescencePre-adolescence AdolescenceAdolescence Young adulthoodYoung adulthood

Build on resiliencies Build on resiliencies and strengthsand strengths

Media/advertisingMedia/advertising

Access factorsAccess factors SocialSocial EconomicEconomic CulturalCultural

Service VenuesService Venues SchoolsSchools HomeHome Extra-curricula Extra-curricula

environmentsenvironments

Youth Initiative ConceptYouth Initiative Concept

Contact InformationContact Information

Reggie Caldwell, LCSWReggie Caldwell, LCSWAfrican American Policy and Program CoordinatorAfrican American Policy and Program Coordinator

California Department of Public HealthCalifornia Department of Public HealthOffice of AIDSOffice of AIDS

Reggie.caldwell@cdph.ca.govReggie.caldwell@cdph.ca.gov916-449-5811916-449-5811