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Client Based Prevention Program Highlights and Successes

Client Based Prevention Program Highlights and Successes. Yesenia Mendez Supervisor Disease Intervention Specialist Unit Colorado Department of Public Health and Environment. Introduction. Colorado has a totally integrated STD and HIV program.

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Client Based Prevention Program Highlights and Successes

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  1. Client Based Prevention Program Highlights and Successes Yesenia Mendez Supervisor Disease Intervention Specialist Unit Colorado Department of Public Health and Environment

  2. Introduction • Colorado has a totally integrated STD and HIV program. • All staff is fully trained to provide Partner Services for HIV and STD • No distinction is made between STD and HIV partner services work

  3. EDG ISTDI PCRS STDs for non-clinicians Motivational Interviewing Client Centered Counseling Test Decision Counseling Cultural Competence Mental Health and HIV Substance Use and HIV Law and Ethics Rapid Testing Positive Start GC/CT Testing Phlebotomy Field Safety Course Referral Coordination Status Disclosure MSM: Prevention Issues Community Mobilization Highly Skilled Cross Trained DIS

  4. Shared Principles • STD/HIV Partner Services operate under the very same principles • Voluntary • Confidential • Science Based • Culturally Appropriate • Comprehensive Prevention System • Diverse Partner Referral Approaches

  5. Shared Principles • Offer coordination of Referrals • Counseling and Support • Timeliness • Open to new emerging technology • Analysis and use of Partner Services Data

  6. How much funding is STD services and how much is HIV services?

  7. HIV/STD PS Work LoadNewly Diagnosed Cases2007 . STD 32% HIV 55% 13% HIV/STD

  8. Advantages of Integration • Maximizes client’s access to services • “One Stop Shop” • Eliminates duplication • Streamline Services • Consistency in Service Delivery • Enhancement in Service Delivery

  9. SUCCESS! • Package of Preventive Care • Counseling • Screening/Testing • Partner Services • Extended Services • Referrals

  10. Use of Data • Analysis of integrated data to: • Respond to changing epidemiology • Find new opportunities to intervene • Develop targeted interventions • Enhance Service Delivery

  11. Use of Data • 9 Sq Mile Project • NAAT Pool Testing • Venue Out reach Testing • Strengthened collaboration with other STD/HIV public and private providers • Acute and Early HIV cases • Heterosexual HIV cases

  12. STD/HIV Partner Services Program Functions • DIS Work Force • Conduct interviews, risk reduction counseling, partner notification, testing and coordination of referrals. • STD/HIV Tester • Goal is to achieve early disease detection. Conducts out reach testing in identified high risk venues and target testing to high risk individuals. Target testing is 160 tests a month with 10% positivity rate.

  13. STD/HIV Partner Services Program Functions • Regional Public Health Consultants • Become the STD/HIV experts in their regions. Each regional staff has a 20+ county area for which they provide a compilation of services. Duties include: • Surveillance • Client Based Prevention • Ryan White • Technical Assistance and Contract Monitoring

  14. STD/HIV Partner Services Program Functions • Linkage to Care Coordinator • Ensures that previous HIV + individuals are linked to care and treatment. Between August – December 2007- 16 clients (25%) have been successfully connected. • Comprehensive Risk Counseling Service (CRCS) Providers • Both HIV + and High risk negatives in risk of assistance in working towards individualized risk reduction behavior changes are referred to the CRCS providers. Of the 29 clients referred to CRCS, 26 (89%) successfully completed the required sessions.

  15. STD/HIV Partner Services Program Functions • Client Placement Coordinator • Assist clients in need of intensive services, such as mental health, substance abuse treatment, behavioral counseling or other social service assistance. • In 2007, 113 active referrals were made with a success rate of 65%.

  16. STD/HIV Partner Services Program Functions • Recalcitrant Exposure Review (RER) Committee • The RER committee reviews case details for individuals who are HIV+ and acquired another STD or have been identified as unsafe, non disclosing sex and/or needle sharing partner. RER determines the best intervention for assisting individuals in reducing or eliminating those risky behaviors.

  17. RER Continued Several resources are available to support an RER decision: • Warning letters • Several Levels of public Health Orders • CRCS services • Behavioral Counseling In 2007 there were 109 referrals to RER, 59 (54%) went on to receive additional services.

  18. Ultimate Goal • Continue to integrate additional cost effective client services and prevention strategies through out Colorado • Hep C testing • EPT • Support local providers’ integration efforts

  19. Questions?

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