1. AIDS Partnership Michigan
Miriam Holbrook
Douglas Manigault III
Susan Shadley
Joshua Schuyler
Kenny Sparks
The Highway to Health Initiative Grant Proposal
Cabin, SW 663
July 28, 2014

2. The Problem
In 2012, Dr. Ronald Valdiserri wrote to inform organizations like Aids Partnership
Michigan (APM) about an unfortunate trend in HIV-care. While there are over a million
Americans with HIV, only eighty percent of these people are aware of their HIV status.
Sixty two percent of those aware of their HIV status have been linked to HIV care; forty-
one percent of these stay in care1. Of those HIV positive who stay in care, only twenty-
eight percent of them are able to adhere to their treatment and sustain undetectable viral
loads2. There is a great need to address a clear local and national health disparity.
Prisoners are more than three times likely to have HIV than the general population
and men with HIV who return to their communities after incarceration are likely to return
to communities where they will not have
access to medical care. The period after
release is associated with considerably
higher HIV-related death rates than those
HIV positive who have never been to
prison. There is support for some
transitional care and getting these
individuals linked with medical care can lead to better compliance and retention of care3.
Research has demonstrated a more positive outcome for those who accept their HIV-
positive status and incorporate it as part of their identities. Volunteering in HIV related
programs and educating others about HIV may help those struggling with their HIV
positive status. It has also been shown that learning more about HIV is positively correlated
with obtaining medical intervention. Having a support network can also help those with

3. HIV move on to normalize their illnesses and deal with the stigma often associated with
being HIV-positive4.
Mission, Goals and Objectives
The Mission of APM is two-fold: the prevention of the disease and providing the
best services for those who are infected. Our organization wants everyone to be safe, and if
they cannot be safe, we want them to be
well-informed5 . The Highway to Health
Initiative (HHI) will support us as we
move forward in our mission by providing
both excellent services and education to
our participants. The mission of the HHI is
to reduce the viral loads of our participants
and decrease their likelihood of
transmitting the HIV virus to others in the
community, as well as to reduce stigma through HIV and AIDS education.
We will accomplish the mission through the following goals and objectives:
Goal 1: Increase participants’ knowledge of HIV, AIDS and the benefits of
medication compliance.
Objective 1.1: Provide six two hour training classes to be completed by
July 2015.
Objective 1.2: Assess learning of 100% of attending participants after
each training session.
Objective 1.3: Provide feedback and additional training if needed to 100%
of attending participants after each training session.

4. Goal 2: Reduce viral load and HIV transmission for HHI participants.
Objective 2.1: Provide education on medication compliance and its effect
on viral load and HIV transmission to 90% of participants by
end of second training session and throughout the program.
Objective 2.2: Monitor 100% of participants for medication compliance bi-
weekly, six and twelve months after the program.
Objective 2.3: Assess viral loads of 100% of participants through medical
testing at the end of the program, six and twelve months after
program completion.
Goal 3: Help decrease stigma related to HIV and AIDS status in the community*.
Objective 3.1: Hold three community speaking events by July 2015.
Objective 3.2: Have 20% of community members attending these
events by the end of the program.
Program Action – Logic Model
Situation
High viral
load of HIV
positive ex
prisoners
Low
medical
compliance
-
Higher
rates of
contracting
AIDS;
Higher
recidivism
rates
INPUTS OUTPUTS
Participants - Activities - Direct Products
What we
invest
$$$:
Office/class
space
Materials and
equipment
Medical
testing
supplies
Three events
(venue rental,
advertising,
media, food)
Three staff
members-
salaries
Time:
Six four-hour
training
sessions with
incentives for
participation
150.00. total
Who we
reach
Staff:
Social
Workers
(social work
intern/
community
social worker)
Trainees for
advocacy:
HIV positive
ex prisoners
(7-10
participants)
Community
members?
What we do
Training
classes
Speaking
engagements
Advocacy
talks/ events
Medical
testing
What we
create
Peer
advocates for
compliance
Medical
testing
Support and
training for
HIV positive
felons on
community
re-entry
OUTCOMES - IMPACT
Short term - Intermediate - Long-Term
Results in
terms of
Learning
Knowledge/
awareness
of the
benefits of
compliance
Positive
attitude on
re-entry
Motivation
to take
medication
and improve
quality of
life
Public
speaking
skills
Results in
terms of
changing
Action
Change in
behavior,
practice,
policy and
procedure
Increased
medication
compliance
Increased/
more
confident
speaking out/
teaching
about the
benefits of
medical
compliance
Results in
terms of
change to the
Conditions
Reduced viral
load/ rates of
HIV
transmission
Changes in
environment:
social/
political/
economic
conditions
Reduced
recidivism
Higher QoL
Priorities
Training and
empowering
HIV positive
parolees to
become peer
trainers and
advocates
to others like
them re-
entering the
community to
achieve higher
medical
compliance
Assumptions External Factors
Logic Model adapted and modified from UW Extension (2003). Program Development and Evaluation Logic Model. Available at: http://www.uwex.edu/ces/pdande/evaluation/pdf/LMfront.pdf (Retrieved 6/22/2013)

5. Evaluation Plan
To determine the effectiveness of our program, we intend to evaluate the outcomes
to ensure proper implementation and goal achievement. We will first need to evaluate any
outlying factors that could make obtaining goals more difficult for certain participants, such
as whether they have secured housing and transportation, for example. In order to evaluate
the effectiveness of our training, we will assess each participant’s learning after each
training session and follow up with any retraining as necessary.
The objectives of our program are to
increase education of HIV/AIDS and the
benefits of medical compliance, to reduce
viral load and transmission and decrease
stigma in the community. Our model would
require all participants to be pre-tested
(medically and by self-report) for compliance and current knowledge. Stigma among
community members would be evaluated through self-report surveys for stigma/feelings of
those infected with HIV/AIDS. All participants and community members would then be
post-tested after completion of the program.
As the program progresses and participants graduate from the training, we will
monitor all for medication compliance bi-weekly for the first three months after the
program and then at six and twelve months after completion. The self report likert scale
questionnaire will consist of five questions measuring their daily compliance and
feelings/attitudes about compliance. Viral load will be medically tested at three months, six

6. months and twelve months after completion through a blood test administered at our test
location.
Though there is likely no accurate method to determine the impact our initiative
will have on community stigma, our hope for the community is that through speaking
events, we can help to establish a connection through common concerns and understanding
between those without the disease, those who are affected by it, and those living with the
disease. When the community understands the benefits for all involved, we can work
together to help reduce the transmission of HIV and improve the lives of those living with
it.
Training/Education.
(During.Program)
Medical.Compliance Viral.Load
Before.Program.
Implementation
Pre$test'knowledge
Pre$test'self'report''
(likert'scale)
Pre$test'T'cell/CD4'
viral'load'in'blood
Bi>Weekly,.During.12>
Week.Program
Tests'after'each'
training'session'(6)
During.the.Three.
Months.After.
Completion.
Bi$weekly,'self'report'
(likert'scale)
At.Three.Months.After.
Completion
Self'report'(likert'
scale)
T$cell/CD4'and'viral'
load'(blood'test)
At.Six.Months.After.
Completion
Self'report'(likert'
scale)
T$cell/CD4'and'viral'
load'(blood'test)
At.12.Months.After.
Completion
Self'report'(likert'
scale)
T$cell/CD4'and'viral'
load'(blood'test)

7. Budget

8. 1 http://www.michigan.gov/documents/mdch/DET_YMSM_06292010_326598_7.pdf
2 Valdiserri, R. “HIV/AIDS Treatment Cascade Helps Identify Gaps in Care, Retention”
3 Christopoulos, K.A., Massey, A.D., Lopez, A.M., Geng, E.H., Johnson, M.O.,Pilcher, C.D.,
Fielding, H., Dawson-Rose, C.. (2013). “Taking a half day at a time:” Patient perspective and the
HIV engagement in care continuum. AIDS Patient Care and STDs. Vol 27:4
4 Baumgartner, L.M., David, K.N.. (2009). Accepting being poz: The incorporation of the HIV
identity to the self. Qualitative Health Research.
5 AIDS Partnership Michigan. http://www.aidspartnership.org/index.php/history-and-mission/
* the community is defined as the area within a one mile radius of the AIDS Partnership for
Michigan building. We do not plan to evaluate community stigma at this time, though our hope is to
desensitize the community and help those with HIV to bring it to the forefront for education and
discussion.