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SAMHSA –
HIV CBI
Lawrence E. Lewis, LCSW
Youth Services Coordinator
Presented at 4/14/16 RPAG Mtg.
HIV CBI Purpose:
• Support an array of activities to assist grantees
in building a solid foundation for delivering and
sustaining quality and accessible state of the
science substance abuse and HIV prevention
services.
• Funding Opportunity Number SP-15-005
• Five Year Funding Opportunity
• Annual Funding: $283, 875
HIV CBI Strategies:
• Combine education and awareness programs,
social marketing campaigns, and HIV and viral
hepatitis (VH) testing services in non-traditional
settings with substance abuse and HIV
prevention programming for the population of
focus.
HIV CBI MAI:
• The HIV CBI is one of CSAP’s Minority AIDS
Initiative (MAI) programs. The purpose of the
MAI is to provide substance abuse and
HIV/VH prevention services to at-risk minority
populations in communities disproportionately
affected by HIV/AIDS.
HIV CBI MAI Targets:
• African American Youth(18-24)
• African American YMSM
• Seek to serve over 1500 youth over 5 years
Strategies/Interventions:
• Intensive and evidence-based HIV and substance abuse direct prevention services;
• Integrated substance abuse, mental health, and health serviced offered in a YMSM-dedicated setting;
• Early STD diagnoses, treatment and intervention among YMSM with access to extragenital (aka triple site) screening;
• Enhanced repeat testing engagement and ongoing intervention with YMSM identified with elevated risk for HIV infection;
• Provision of PrEP Education and Counseling (including Hepatitis Screening and vaccination); and
• Environmental strategies designed to address stigma and trauma by using a trauma informed approach to care.
Evidence Based Interventions:
• MPOWERSTL Center
– (Think YMSM specific mini-The SPOT)
• Evidence Based Interventions– Mpowerment
– Screening, Brief Intervention, and Referral to Treatment (SBIRT)
– Motivational Interviewing (MI)
– HIV/STI Testing
– PrEP Education & Counseling (including VH screening)
– Mobile Outreach Testing
Project TeamRole Staff FTE
• Medical Director Kathryn Plax, MD .05 FTE
• Project Coordinator/Mental Health Specialist Lawrence Lewis, LCSW .95 FTE
• Prevention Specialist Will Bogan 1.0 FTE
• Mental Health/Substance Abuse Specialist TBN .20 FTE
• Nurse Practitioner Teri Lindsey, NP .30 FTE
• Prevention Specialist William Smith In-kind
• Substance Abuse Specialist (NCADA) Nicole Browning, LPC In-kind
• Case Management Jessika Triplett, MSW In-kind
• Nurse Nicole Carr, BSN In-kind
• Pediatric Infectious Disease Nurse Phyllis Ballard, RN In-kind
• Evaluator Jeffrey Glotfelty, MPH .10 FTE
• Data Manager Gaurav Kaushik, MPH .25 FTE
• Program Director Kim Donica, LCSW .05 FTE
3
Strategic Prevention Framework
SPF Explained
Strategic
Prevention
Framework
Step Defined
Assessment Profile population needs, resources, & readiness to address needs/gaps
Capacity Mobilize and/or build capacity to address needs.
Planning Develop a Comprehensive Strategic Plan.
Implementation Implement evidence based prevention programs and activities.
Evaluation Monitor, evaluate, sustain, and improve or replace those that fail.
Sustainability Build stakeholder support for program, showing and sharing results,
and obtaining steady funding.
Cultural
Competency
The ability to interact effectively with people of different cultures.
Being respectful and responsive to the health beliefs and practices of
diverse population groups.
Needs Assessment Highlights
• Using CDC estimate (3.9%), black YMSM in the
STL region have a 14% prevalence of HIV
compared to 1.9% among black males.
• 27.1% incidence increase between 2011-2013.
• 17.5% MO youth have problem with alcohol or
illicit drugs
• Miller et al, 2013 – 75% of black YMSM
experienced 2-3 forms of trauma
Target Risk & Protective FactorsSocio-ecological
LevelRisk & Protective Factors
Community
(Protective
Factors)
Access to PrEP Social & medical services to address
broad psychosocial needs
Community
(Risk Factors)
Community norms favorable to substance
use Poor access to sexual health clinics
Relationship
(Protective
Factors)
Connectedness to the gay community Safer Sex Norms
Relationship
(Risk Factors)
Homelessness
Older Partners (5+ years)
Unknown HIV status of Primary
Partner
Broken Negotiated Safety Agreements
Individual
(Protective
Factors)
Ability to have self-control & emotional
mgmt.
Access to mental health services
Optimism & Health as a Value
Self-efficacy & Refusal assertiveness
Self-monitoring
Social competencies & Social
Creativity
Individual
(Risk Factors)
Drug Use
Loneliness & Idleness
Access to HIV prevention services
Low perception of risk
Frequency of HIV/STI screening
Sensation-seeking
Community Capacity
• Advisory Groups to promote cultural competency & sustainability
– St. Louis Regional Prevention Advisory Group
– Youth Advocacy Committee
(Looking for committed youth leaders)
• The SPOT
• SAMHSA
• SPNS
• Condom Distribution
– St. Louis Mental Health Board (Poss. Advisory Group)
Community Capacity
• Community Partners
– St. Louis Effort for AIDS
– National Council on Alcoholism and Drug Abuse
– Ranken Technical College
– STLCC @ Forest Park (In progress)
– MDHSS (Rapid Hep C. Kits)
• Additional community partners can be added at any time
by Memorandum of Understanding
Community Capacity
• Advisory Group to aid implementation, policy development, and evaluation
– Interested in seeing PrEP access expanded?
– Interested in seeing mobile testing in specific parts of the community?
– Interested in social marketing?
– Interested in substance abuse/mental health concerns among African American youth?
• You might be who we are looking for!
Wrap - Up
• This project will be as successful as our
community partnership and collaborations can
be.
• This is not competition for clients but making
sure we best coordinate a response to the needs
of the community.
• We TRULY DESIRE feedback and support, this
capacity building
More Information
Lawrence E. Lewis, LCSW
Youth Services Coordinator
314-535-7275 x 206
