KIR February Progress Report

KEEPING IT REAL PROGRAM
MONTHLY PROGRESS REPORT
DIRECT SERVICE ACTIVITIES
Outreach:
• 701 people were outreached to via intercom announcements in the various dorms on both the
9000 (GBT+ population) floor and 5000 (cis-heterosexual population) floor to reach MSM and
intravenous drug users, respectively.
• A number of clients were informed of the program from other CHJ staff or police staff.
Classes:
• Twelve KIR health education classes were completed at Men’s Central Jail (MCJ) , six on 5000 and
six 9000 floor.
• The Risk Reduction Specialists completed the class sessions with a total of 94 participants, 46
from the 5000 floor and 48 from the 9000 unit.
• Nineteen participants completed the KIR education classes and were eligible for Milestone
Credits.
• KIR incorporate more diverse educational tools to empower individuals, emphasize community
coalition and building while incarcerated, and to encourage knowledge of syndemic issues facing
marginalization that contribute to incarceration and HIV/AIDS prevalence.
Support Groups:
• KIR implemented three concurrent support groups on 5000 and 9000 units for clients to discuss
common challenges and empower one another and themselves. Clients participated in groups
modeled after the NA/AA 12-step program. The groups targeted monolingual Spanish speaking
injection drug users, GBTQ+ injection drug users, and cis-heterosexual injection drug users,
respectively.
• Due to the disproportionately high rates of morbidity/mortality due to racism, transphobia,
misogyny, poverty etc., transwomen were targeted for a specific trans-empowerment workshop
held every week.
• The NA/AA support groups in the 9000 and 5000 units averaged 45 participants, the Spanish
monolingual NA/AA group drew in an average of 10 participants and the transwomen
empowerment group averaged 18 participants in the month of January.
• Those who participated in sessions discussed the psychosocial, socio-economic and structural
barriers to their self-care and wellness, community uplift and empowerment. The NA/AA
participants focused primarily on substance abuse, familial reconciliation, relapse prevention,
triggers, trauma, sponsorship and recovery. The trans* empowerment support group discussed
the continued challenges due to societal discrimination, familial rejection, abuse and their
adverse coping skills.
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• A local nurse was invited by the risk reduction specialists to speak with the women in the trans-
empowerment support group concerning access to hormone replacement therapy and the
benefits and potential problems with this treatment.
• The KIR team will incorporate more internal and client evaluations by operationalizing the rich
qualitative data available to determine how these support groups are influencing the behaviors
of the clients served.
One-on-One Sessions, Linkages, and Follow-Ups:
• Twelve clients continued with individual counseling sessions pre and post incarceration.
• Two were enrolled, three 1st
sessions, four 2nd
sessions, two 3rd
sessions, and one 4th
session
were completed.
• There was a correlation between abstaining from illegal substances and residential treatment
centers; all of the clients that had secure housing reported drug abstinence, while those with
insecure housing were struggling with relapsing post incarceration.
• KIR conducted a training on Project Start, the curriculum used for individual counseling sessions.
All KIR risk reduction specialists are now utilizing this model which will streamline the ability to
evaluate the progress of the clients and ultimately the program.
• Secure housing and employment were common themes throughout the motivational interviews
this month.
• Sixteen participants were linked to HIV and STI testing while incarcerated. Follow-up counseling
sessions took place at various treatment and housing centers, as well as at the Service Center.
• The risk reduction specialist linked eight clients into housing and/or substance abuse treatment.
One entered the Tarzana Transitional Housing Program and has stated that she has enjoyed her
stay.
Media Posts:
• The KIR media specialist created a draft for the interactive map and appointment card to be
disseminated to the clients.
• The KIR team will translate the Project Start material into Spanish and begin enrolling
monolingual Spanish speaker into the module.
• All evaluative measures will be translated into Spanish as well.
• A risk reduction specialist disseminated a pamphlet with a guide on how transwomen in
particular can avoid tribulations while incarcerated.
CAPACITY BUILDING ACTIVITIES
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Assessment:
• The KIR team has begun utilizing the weekly reports on direct service activities created last
month. This will allow the team to observe long-term trends, barriers and accomplishments of
the KIR program in relation to direct service activities.
• The Program Coordinator is currently on the second draft of the Community Needs Assessment
Template and will complete by the end of this month.
• The Project Coordinator recently began collecting weekly assessment reports on their activities
to streamline data collection and assess common and/or recurrent issues.
Community Advisory Board:
• The KIR team recently visited Central Juvenile Hall in Boyle Heights, CA to conduct a focus group
on the motivators of behavior change, community involvement and HIV infection prevention.
Many of those interviewed were interested in attending a CAB in the near future, and becoming
community leaders within that CAB.
Partnerships:
• This month the KIR team focused on finding resources for youth and housing insecure clients.
• A KIR risk reduction specialist was introduced to the Transgender Wellness Program at St. John’s
Medical Center, which provides HIV testing and counseling, hormone replacement therapy,
name and gender change services, case management, comprehensive primary, mental and
dental healthcare to transwomen residing in LA County. The risk reduction specialist has invited
Diana Oliva, the program’s coordinator, as a guest speaker at the transwomen’s group and to
provide linkages for the women upon release.
• The KIR program coordinator was introduced to Allen of Safe Refuge, the housing coordinator
for this organization.
• The KIR program coordinator was introduced to the Director of services at the Transitional
Resource Center in Long Beach.
Trainings:
Chris’ training
• Chris completed his orientation at the Central Juvenile Hall and will begin conducting classes
and support groups next month.
Community Organizing and Dissemination:
• The
EVALUATION
Case Conference and Quality Assurance
• The KIR Team met weekly at CHJ offices to share program challenges and successes, and
develop collaborative strategies to improve the effectiveness of the KIR Program.
•
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Accomplishments
Newly Diagnosed Clients
• Two clients disclosed their HIV status to a risk reduction specialist after participating in the
program and requesting testing. Their education through this program raised the clients’
perceived severity and susceptibility, thus prompting them to be tested and subsequently
diagnosed with HIV.
• and of those determined to be positive, their demographic information follows:
o 37 year-old white man, non-veteran, non-homeless
o 32 year-old white male non-veteran, non-homeless
• Overall, 30 KIR participants were linked to testing during the month of January.
• The newly diagnosed KIR clients were connected to a transitional care manager while
incarcerated to initiate treatment and stabilized care post-incarceration.
Linkages to Care
• Clients continued to utilize the Service Center without major incidence. Clients were referred to
a number of services, with one client being linked to a Native American advocacy agency to
gain access to health insurance and HIV treatment.
Evaluation of Direct Service Activities
Classes
• Clients participating in health education classes continued to improve on the measurements
collected from pre-and post-testing. These clients engaged significantly in topics including
health insurance access, HIV testing intention, condom usage, substance abuse and recovery,
and protective and perilous behaviors pertinent to HIV infection. The participants who
finished the intervention this month scored significantly higher than participants who
completed the pre-test but did not complete the class module.
• There was a 13% increase in knowledge pertaining to HIV, associated risks, and access to
treatment according to pre and post surveys disseminated in the health education classes in
the general population.
• 94% of MSM who participated in the KIR education class answered the HIV knowledge
assessment correctly, indicating a high knowledge of the factors influencing HIV risk, the
concept of treatment as prevention, and access to treatment for HIV positive individuals.
Support Groups
• The risk reduction specialist also indicated that more men from the general population (men
who identified as heterosexual) were more vocal about their sexual experiences with other
men, transwomen, people with non-identified genders and other people who did not identify
as cis-women.
• The NA/AA style support group exclusively for monolingual Spanish Speakers commenced this
month to high reviews and participation. The KIR team was able to acquire NA/AA books in
Spanish through donations from a local organization.
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Individual Counseling Sessions
• Three clients participating in individual counseling completed intakes for single resident
occupancy housing post-incarceration.
• Six clients that had previously participated in KIR have achieved sobriety and/or adherence to
HIV treatment for six months, achieving the ultimate objective for this program.
Short Term Challenges:
• A risk reduction specialist has stated the difficulty in counseling her clients in the designated
office because of the lack of privacy. Other people are constantly entering and exiting the
room, creating a difficult environment to divulge the sensitive client information needed for a
successful session. A possible solution is to have everyone sign a confidentiality sign-in sheet
ensuring the confidentiality of the conversations in the room.
• Issues concerning the implementation of private counseling in particular and support
groups/classes in general have created barriers to care for clients. CAs (deputy assistants) are
no longer available to retrieve the clients for appointments, clients are no longer allowed to
wait on the benches outside of the social services office thus increasing the time to obtain and
begin servicing the clients.
• The interactive materials are not current and do not address the particular needs of this
population. The videos shown should address the particular motivations, systemic barriers to
care, and personal abuses that many of our clients have traversed.
Systemic/Long-term Challenges:
• There is a shortage of emergency, transitional and permanent housing for indigent people in
general and people with a history of incarceration in particular. This has compelled CHJ to
focus networking efforts on housing providers There is a shortage of sober housing in Los
Angeles, which significantly increases the risk of recidivism and/or resumption of activities
that put clients at risk for HIV.
• The Team will create a survey to better document housing challenges KIR participants face and
subsequently use it to strategize solutions to serve participants more effectively. The KIR
Team believes that a possible solution includes expanding networks with competent housing
services, as anecdotal evidence suggests this preference among the communities targeted by
KIR’s services.
• Although most clients have the behavioral intention to test for their HIV status, there are still
considerable barriers that inhibit individuals from seeking testing.
o The location of testing during classes (at the back of the classroom) and the manner in
which the clinician discloses statuses (he will “lean in” for negative and show them their
status on the computer if positive) is not conducive to privacy or confidentiality. Many
clients state their hesitation to test because they fear their status will spread throughout
the unit.
• As discussed last month, decreasing the social cost of testing (if a participant requests a test
and someone is aware, rumors concerning that participant’s sexual orientation may arise, for
example) by incentivizing testing through a combination of certificates, commissary benefits,
or anonymity and privacy, testing could be greatly increased. This will continue to a be a
structural challenge for this population until testing protocols are revised.
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• One of the most challenging obstacles to reduction in contracting HIV and substance abuse for
KIR clients released from custody continues to be adherence to treatment post-incarceration.
Post release, it is estimated that 80% of CHJ clients do not reach their predetermined
destination (treatment center, housing assignment, medical appointment, etc.), thus
substantially limiting their ability to continue on with prescribed treatment and KIR’s ability to
monitor their progress.
• The remaining 20% of the clients rarely remain in treatment beyond a few weeks to one
month. We have maintained continuous communication with less than 5% of our clients one
month post incarceration.
• KIR intends to address this challenge by creating a needs assessment that surveys participant
opinions on their greatest barriers to care upon release.
• A hypothetical solution is an intervention in which individuals are escorted to their
appointments by a peer navigator from that specific provider, but this requires more financial
resources to be allocated. Many KIR participants qualify for Access, a subsidized public
transportation service in LAC. We have provided instructions at the Service Center to enable
clients to enroll in Access.
• A concern coexisting with transportation is the unpredictable release times from LAC Jails.
Clients released between 1AM and 5AM are predisposed to contacting previous social
networks due to the lack of available options during this period. This leaves them vulnerable
to reengagement in the behaviors that caused their recent incarceration.
• A response team tasked with receiving these individuals and placing them in temporary shelters
may alleviate this issue; however, shelters often are filled to capacity during these hours as
well. This will continue to serve as a major institutional barrier until meaningful changes are
made to the release protocol.
PLANNING AND SUSTAINABILITY
• The KIR team will continue to create services to address the needs of our clients. These
include: support group evaluation forms, post-incarceration resource needs assessment, and
assessment, and continued focus groups for target populations on the efficacy of our
programs, behavior change, reduced recidivism and wellness.
• The surveys will capture self-efficacy, assess how access to certain types of resources
facilitates or prevents recidivism, and what methodologies reach the participants most
effectively (i.e., news media outlets vs. Facebook feeds).
• The Team will further explore strategies to utilize Facebook to reach our clients, as we have
observed the high usage of the website for our target population.
• The KIR Coordinator will continue to increase site visits to sober living sites due to the success
KIR has observed from linking to their services.
•
• The program coordinator and risk reduction specialist will collaborate to retrieve videos that
are culturally competent for our target population.
• The Communications Specialist will create an illustrated map to show KIR participants the
locations of CHJ’s Reentry Center, social services, treatment centers, and housing programs
are located; this will be designed and laid out according to the information collected in the
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needs assessment. These maps will be distributed to KIR participants in addition to other
information and resource linkages based on zip code information and individual consultation
with each Participant.
• Lastly, the Team has collaborated with the Evaluation Consultant to assist with the
development of a more comprehensive evaluation system for KIR. We have already submitted
the Health Disparity Impact Statement to SAMHSA with assistance from the Evaluation
Consultant, and will continue to work with him as we implement the comprehensive needs
assessment, capacity building and implementation of the program.
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Page 8 of 14
DSA Objectives OCT NOV DEC JAN FEB MAR APR MAY JUN JUL AUG SEP TOTAL
People Who Hear
About KIR Program in
Locked Settings and
in Treatment Facilities
401 390 523
# Support Group
session held
8 8 8
#4-session classes
completed
1 1 1
Number of
participants who
attended one KIR
class module
53 52
# of participants who
attended at least one
DSA (Class, Support
Group, One-on-One)
76 111 106
Participants who
completed KIR 4-
session class
13 13 33
Participants who
attended at least one
support group
25 48 33
Participants who
attended 4 Support
Groups
11 12 18
New Project Start
Enrollees
14 3 1
Participants who
completed Follow-Up
Sessions at 21 Days
1 4 5
Participants who
completed Follow-Up
Sessions at 45 Days
4 0 3
Participants who
completed Follow-Up
Sessions at 60 Days
0 0 1
Clients Who
Complete 6 PS
Sessions
0 0 0

For chart, use the highlighted chart
Page 9 of 14

Page 10 of 14
Ethnicity/Race of Those
Who Participated in
DSAs
Hispanic/Latino
Black/African
American
Native American
White (Non-
Hispanic)
East Asian/Pacific
Islander
South Asian/Middle
Eastern/North African
Other/Mixed/Choose
Not to Identify
Average Age of Client 29 31 - 34 - - 0
# Veteran Clients 0 0 - 0 - 0 0
# Homeless Clients 2 4 - 3 - - 0
# Transwomen Served 6 7 - 2 - - 0
# Men Served 48 35 - 23 - - 7
#Ciswomen Served 0 0 0 0 0 0 0

Page 11 of 14
Capacity Building
Activities
OCT NOV DEC JAN FEB MAR APR MAY JUN JUL AUG SEP
Participants
linked to housing
7 4 6
Participants
enrolled in ACA
23 15 17
# Partnerships
added and/or
strengthened
4 1 2
#Linkages From
New Networks
TBD 3 1
#Clients
Receiving
Materials In
Locked Settings
N/A 390 512
# print media
posts created
1 1 0
# digital media
posts generated
2 0 0
#Online
Impressions
From Media
12 12 21
CAB Meetings 0 0 1

Page 12 of 14

Page 13 of 14
Ethnicity/Race of
Those Who
Participated in
CBAs
Hispanic/Latino
Black/African
American
Native
American
White (Non-
Hispanic)
East
Asian/Pacific
Islander
South
Asian/Middle
Eastern/North
African
Other/Mixed/Choose
Not to Identify
Average Age of
Client
29 32 N/A 34 N/A N/A
N/A
# Veteran Clients 0 0 0 0 0 0 0
# Homeless Clients 2 1 N/A 1 N/A N/A N/A
# Transwomen
Served
N/A N/A N/A N/A N/A N/A
N/A
# Men Served N/A N/A N/A N/A N/A N/A N/A
#Ciswomen
Served
1 N/A N/A N/A N/A N/A
N/A
Linkage Objectives OCT NOV DEC JAN FEB MAR APR MAY JUN JUL AUG SEP
Participants referred to
HIV/STI Testing In
custody
21 96 520
Clients linked to in-
custody HIV/STI Testing
5 12 30
Participants disclosed
living with HIV/AIDS
3 1 2
Newly diagnosed
participants from linked
HIV Tests
3 1 2
Participants linked to
HIV and/or HCV
Treatment
3 1 2
Substance Abuse
Treatment
5 6 8
other resources
(Housing, SNAP, etc.)*
7 27 23

Page 14 of 14
Ethnicity/Race of
Those Who
Participated in
Linkages
Hispanic/Latino
Black/African
American
Native
American
White (Non-
Hispanic)
East Asian/Pacific
Islander
South
Asian/Middle
Eastern/North
African
Other/Mixed/Choose
Not to Identify
Average Age of
Client
32 29 N/A 33 N/A N/A
N/A
# Veteran Clients 0 0 0 0 0 0 0
# Homeless Clients 2 1 1 3 0 0 0
# Transwomen
Served
1 1 1 0 0 0
0
# Men Served 34 30 0 12 0 0 0
#Ciswomen Served 0 0 0 0 0 0 0

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