Guest Lecture - U-M Bio 118
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Guest Lecture - U-M Bio 118

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The slides describe the process of HIV testing at the HIV/AIDS Resource Center as of April 2009.

The slides describe the process of HIV testing at the HIV/AIDS Resource Center as of April 2009.

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Guest Lecture - U-M Bio 118 Presentation Transcript

  • 1. Preventing HIV in Our Community Carrie Rheingans AmeriCorps Intern, HIV/AIDS Resource Center School of Public Health
  • 2. Outline  AmeriCorps  Public Health  Local epidemiology  AIDS over the life course  Prevention overview  Outreach  HIV Testing, Counseling, and Referral  Policy Providing HIV related services to our community through compassionate direct care, prevention and outreach activities.
  • 3. AmeriCorps National service program Peace Corps Teach for America Serve 1700 hours, 11 months Living stipend, education award Team or individual Providing HIV related services to our community through compassionate direct care, prevention and outreach activities.
  • 4. What’s Public Health? Population focus Epidemiology It’s working when you Biostatistics don’t think about it Health Management Iodine in salt Health Policy Vaccinations Health Behavior Infectious diseases Health Education Chronic diseases Environmental Health Nutrition Occupational Providing HIV related services to our community through compassionate direct care, prevention and outreach activities.
  • 5. Epidemiology – United States Providing HIV related services to our community through compassionate direct care, prevention and outreach activities.
  • 6. Epidemiology – United States
  • 7. Epidemiology - Michigan 18,000 estimated living with HIV 52% of known transmission mode among men who have sex with men (MSM) 17% among injecting drug users Fastest rising rates among African-American MSM, African-American women, especially young (13-24) Providing HIV related services to our community through compassionate direct care, prevention and outreach activities.
  • 8. Epidemiology – Washtenaw County 28 new infections in 22 among men 2007 6 among women 16 among MSM 16 among African- 0 among IDU American 9 among “low-risk” 11 among Whites heterosexual 16 among youth (15-29) Providing HIV related services to our community through compassionate direct care, prevention and outreach activities.
  • 9. AIDS Over the Life Course Infants/Children Teens  Usually born with HIV  May be sexually active  Rare in US  Birthing process  May not take their meds  Breastfeeding due to schedule  Rape very rare mode of  May only take them when transmission in US they feel sick  Blood transfusion very rare mode of transmission in US  Parents assist with medications Providing HIV related services to our community through compassionate direct care, prevention and outreach activities.
  • 10. AIDS Over the Life Course Adults Seniors  Most medically adherent  Limited finances group  Low knowledge about  May live for decades current medical trends  May have children after  Overall health infection  May need assistance with their care  Low risk perception Providing HIV related services to our community through compassionate direct care, prevention and outreach activities.
  • 11. Prevention Overview Outreach HIV Testing, Counseling, Where people Referral congregate In clinics Mobile unit to high- Health departments prevalence zip codes Mobile unit Education Rapid, traditional HIV 101 presentations Anonymous, Part of HIV testing Confidential During outreach Providing HIV related services to our community through compassionate direct care, prevention and outreach activities.
  • 12. Prevention – Stigma AIDS stigma often Intersecting stigmas works against HIV include: prevention activities: Race Discrimination against Gender those living with HIV Socio-economic Status Compulsory HIV testing Sexuality (jobs, apartments) Drug use Confidentiality issues Violence Providing HIV related services to our community through compassionate direct care, prevention and outreach activities.
  • 13. Preventing Transmission HIV transmitted only via Barrier Methods five fluids: Condoms Blood Internal Condoms Semen (including pre- (“female”, “Reality”) ejaculate) Dental Dams Vaginal Secretions Risk Reduction Breast Milk Lubricants Cerebrospinal fluid Outercourse Syringe exchange Less risky behavior Providing HIV related services to our community through compassionate direct care, prevention and outreach activities.
  • 14. Outreach Mobile Unit HIV testing Hand out supplies Syringe exchange Hepatitis C testing Referrals Volunteers help a lot! Providing HIV related services to our community through compassionate direct care, prevention and outreach activities.
  • 15. Outreach Bar Outreach Hand out supplies Referrals Promote HIV Testing Volunteers help a lot! Providing HIV related services to our community through compassionate direct care, prevention and outreach activities.
  • 16. HIV Counseling, Testing and Referral Counseling = discuss client’s risk behavior, set safer behavior goals Testing = obtain consent, collect sample Referral = give info about other services of interest Providing HIV related services to our community through compassionate direct care, prevention and outreach activities.
  • 17. Counseling C = client intro to session I = identify risk & circumstances G = set safer behavior goals A = action steps R = suggest referrals to client S = summarize & close Acquire client consent Collect test sample Providing HIV related services to our community through compassionate direct care, prevention and outreach activities.
  • 18. Client Introduction Introduce self, ask for client “name” Describe agency Describe how testing works Testing device Anonymous, Confidential Timeline of results Providing HIV related services to our community through compassionate direct care, prevention and outreach activities.
  • 19. Identify Risk & Circumstances Open-ended questions Sexual risks Needle-sharing risk Circumstances of risk behaviors Frequency of risk behaviors Providing HIV related services to our community through compassionate direct care, prevention and outreach activities.
  • 20. Safer Behavior Goals, Action Steps Client-centered Non-judgmental Realistic Risk reduction Harm reduction Reduce barriers Providing HIV related services to our community through compassionate direct care, prevention and outreach activities.
  • 21. Referrals Sexually transmitted infection testing Pregnancy/birth control Drug treatment Mental health Housing/shelters Community resources (LGBT, youth, cultural) Providing HIV related services to our community through compassionate direct care, prevention and outreach activities.
  • 22. Summarize & Close Review risk behaviors Review safer behavior goal(s) and action steps Review referrals given Obtain client consent Collect test sample Providing HIV related services to our community through compassionate direct care, prevention and outreach activities.
  • 23. Oral Swab Test Providing HIV related services to our community through compassionate direct care, prevention and outreach activities.
  • 24. Rapid Test Providing HIV related services to our community through compassionate direct care, prevention and outreach activities.
  • 25. Rapid Test Providing HIV related services to our community through compassionate direct care, prevention and outreach activities.
  • 26. Rapid Test Providing HIV related services to our community through compassionate direct care, prevention and outreach activities.
  • 27. Giving Results Check readiness, show result promptly to client 3 possible results: Reactive: infected with HIV Non-reactive: no evidence of HIV antibodies at time sample was taken Indeterminate: need to get retested Pregnancy Other immune disease Recently infected and not enough antibodies Providing HIV related services to our community through compassionate direct care, prevention and outreach activities.
  • 28. Giving Results Nonreactive Reactive  Review safer behavior goal  Focus on client’s emotions  Review referrals  Allow time for client to decide if s/he wants info  Check social support  Get client’s contact info to check in with client  Go over information about care services  Set up case management appointment  Discuss disclosure law, partner services Providing HIV related services to our community through compassionate direct care, prevention and outreach activities.
  • 29. U.S. Policy US Visas/Entry PEPFAR: President’s Difficulty of getting visas Emergency Plan for AIDS US one of 12 countries Relief with very strict policies Initiated 2003, renewed Syringe Exchange 2008 Programs 15 focus countries, sub- Saharan African and Ban on federal funding Caribbean Must get exemption from Treatment available to drug paraphernalia laws for many programs Largest bilateral agreement in world Focuses on ABC model Providing HIV related services to our community through compassionate direct care, prevention and outreach activities.
  • 30. Michigan Laws Partner Services Disclosure Law One is not required to HIV infected persons participate, but it is are required to disclose encouraged that those status to future partners living with HIV notify their before sexual past partners. County can penetration do it anonymously. Cannot disclose Discrimination Law someone else’s status, + No one can discriminate or – against a person infected Consent with HIV Clients must consent to be tested for HIV Providing HIV related services to our community through compassionate direct care, prevention and outreach activities.
  • 31. Carrie Rheingans crheinga@umich.edu www.umichsph.wordpress.com www.nafblogger.blogspot.com www.hivaidsresource.org www.americorps.gov www.sph.umich.edu Providing HIV related services to our community through compassionate direct care, prevention and outreach activities.