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Steven Dashiell MAI Outreach Program Coordinator Baltimore City Health Dept. STD/HIV Program

Employing Disease Intervention Techniques For the Linkage of Newly Identified HIV Positive Clients to Care. Steven Dashiell MAI Outreach Program Coordinator Baltimore City Health Dept. STD/HIV Program Johns Hopkins University. Background – The Issue.

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Steven Dashiell MAI Outreach Program Coordinator Baltimore City Health Dept. STD/HIV Program

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  1. Employing Disease Intervention Techniques For the Linkage of Newly Identified HIV Positive Clients to Care Steven Dashiell MAI Outreach Program Coordinator Baltimore City Health Dept. STD/HIV Program Johns Hopkins University RW MAI Outreach Program

  2. Background – The Issue • Baltimore has the 5th highest rate of HIV prevalence in U.S. cities (CDC Surveillance 2003) • Over 60% of the HIV cases in the state of Maryland can be found in the Baltimore Metro area (Maryland 2005 HIV/AIDS Annual Report) • Primary services (CTR/Treatment) are dispersed, and lack connection. • “The panel observed … there was no mechanism reported for collaboration or coordination between other agencies to address HIV/AIDS.” – Ralph Brisueno, Asst Director of the Ryan White office in Baltimore, commenting on a report of the City Council Commission on HIV/AIDS in Baltimore. RW MAI Outreach Program

  3. Background –RW Funding • HRSA provides Minority AIDS Initiative funds to EMAs with high prevalence among minority populations. • Baltimore EMA awarded funds for multiple categories, including Non-Traditional Outreach • BCHD/JHU applied for funds RW MAI Outreach Program

  4. The System (most providers) RW MAI Outreach Program

  5. The System (BCHD) RW MAI Outreach Program

  6. No direct connection for CTR sites w/o PMC Anonymous sites have little/no info to pass Referrals rarely practiced Little follow up on referrals Any referrals only scant due to limitations PMC sites w/o RW funds unable to serve clients Clients unfamiliar with overall system Problems with the System RW MAI Outreach Program

  7. Challenges to Construction • How to create links between clients tested and care sites • How to determine RW care sites for clients • How to reinforce compliance with care • How to encourage community trust (clients, providers) • How to track care patterns RW MAI Outreach Program

  8. Assets • BCHD HIV Testing • 2004/2005 HIV numbers • Staff • Community partners • MSM • Substance Abuse • Women/Transgender RW MAI Outreach Program

  9. BCHD MAI Outreach Program • Recruitment of Case Finders through community partners and internal staff • Hybrid outreach/ISTDI training • Connections made with all RW PMC providers • Design of Authorization form • Coordinator determines numbers through HIV database RW MAI Outreach Program

  10. The NEW System RW MAI Outreach Program

  11. Initial Results RW MAI Outreach Program

  12. Challenges • Large percentage of previous positives • Individuals already in care • U – unable to locate; bad contact info • Info collected during outreach • Appointments • Some providers 2 month wait RW MAI Outreach Program

  13. Next Steps • More cases • Evaluation system • Additional training • More provider connections • Better client-level data RW MAI Outreach Program

  14. Thanks Jonathan Ellen, MD, JHU Glen Olthoff, BCHD Barbara Glass, JHU Phyllis Burnett, BCHD Sheridan Johnson, BCHD Carlton Smith, Baltimore Black Gay Pride Kevin Coger, BCHD Sherell Jackson, BCHD RW MAI Outreach Program

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