Campaign Webinar Transgender Experience and Retention in+care November 20, 2013

1. Campaign Webinar Transgender Experience and Retention in+care November 20, 2013 1

2. Actively participate and write your questions into the chat area during the presentation(s) Do not put us on hold Mute your line if you are not speaking (press *6, to unmute your line press #6) Slides and other resources are available on our website at incareCampaign.org All webinars are being recorded Ground Rules for Webinar Participation 2

3. Agenda • Welcome & Introductions, 5min • Campaign Update, 10min • HIPS Presentation, 40min • Announcements, 5min In the chat room, Enter your: 1. name, 2. agency, 3. city/state, and 4. professional role at agency Michael Hager, MPH MA NQC Manager, in+care Campaign Manager New York, NY 3

4. Campaign Update 4

5. in+care Campaign in 2014 • Campaign database running through 2018! • Campaign website running through 2018! • Partners in+care Facebook maintained indefinitely • Campaign Newsletter moves to quarterly • Campaign Webinars move to quarterly • Partners in+care Webinars move to quarterly • Campaign Coaching integrates into NQC Continuous TA Portfolios • Local Retention Groups that wish to continue meeting should do so – NQC will support where possible 5

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7. Submit Improvement Updates! 7

8. Disseminating Improvement Work Lightning Rounds! • 1 or 2 slides that contain the most salient points of your retention projects • Include information on patient target, rationale for target selection and baseline data from your measures (including the date) • Include information on each improvement cycle (what was tried, what was the result per the data) – for early cycles short measures of change are not necessary, but add value! • What are your conclusions? How are you sustaining improvement • Simplicity and clarity are the idea! 8

9. Disseminating Improvement Work Case Studies • Help us tell your story! • Campaign coaches are seeking longer, written stories about various groups’ journey through the in+care Campaign • Contact your Campaign quality coach if you are interested in sharing your story! • We are collecting 12 stories in total for publication 9

10. Gap Measure Results (12/11 – 10/13)

11. Visit Frequency Measure Results (12/11 – 10/13)

12. New Patients Measure Results (12/11 – 10/13)

13. Viral Load Suppression Measure Results (12/11 – 10/13)

14. The Transgender Experience and Retention in HIV Care Cyndee Clay, Executive Director HIPS Washington D.C.

15. International Transgender Day of Remembrance 11/20/13

16. Who are You? Improving Retention in Care involves a community. Let’s see who’s on board today… Poll: • Medical Provider • Community Member • Transgender • Cisgender • HIV Prevention worker • Community Health worker • Government • Policy • Advocate • Activist

17. HIPS • Full Service harm reduction organization in Washington DC • HIV Prevention and Crisis Intervention Services to the trans* community since 1993 • Other programs include Syringe Access & Education, Diversion Programs, Advocacy, Peer Educator Program • 3,000 clients a year, approximately 35% trans* • Implemented Testing, Linkage and Retention in Care Pilot for HIV & HCV in 2012

18. Pop Quiz Percentage of respondents to the 2011-2012 DC Transgender Needs Assessment Survey who reported being HIV+ • 5% • 12% • 33% Source: DCTC Trans Needs Assessment, 2012

19. Pop Quiz True or False: Discrimination decreases in a medical setting when the client feels comfortable enough to disclose his/her/their transgender status

20. Pop Quiz Percentage of transgender individuals who reported being verbally harassed in a medical setting • 28% • 57% • 81% Source: National Transgender Discrimination Survey, 2011

21. Trans* + ? • High Rates of HIV • Stigma • Access to Care • Retention in Care

22. Why Now? • National HIV/AIDS Strategy • High Impact Prevention • New Strategies

23. Barriers to Care What could be some reasons that trans* people have challenges to gaining access and retention in care?

24. Common Barriers • Stigma • Discrimination • Previous Poor Experience • Actual Discrimination • Perceived Discrimination

25. Other Common Barriers • Street Harassment • Housing Discrimination • Poverty • Involvement in Underground Economies • Lack of Health Knowledge • Prioritization of Gender Related Care • Provider Knowledge

26. Facilitating Care • Staff • Incentives • Collaboration • Transportation • Hormone Services • Advocacy • Follow-up

27. Community Health Workers? • Pro’s • Peer-led • Peer-Support • Community Norms

28. Community Health Workers? • Challenges • Stigma • Small Communities • HIV Focused • Prioritization

29. Getting There • Collaboration • Training • Patience • Perseverance

30. Resources • www.HIPS.org • www.transequality.org • Amsa.org

31. Thank You! Questions?

32. Announcements 32

33. Upcoming Events and Deadlines • Upcoming Webinars: • in+care Campaign Webinar | State-Level Efforts to Retain New Patients in HIV CareWednesday, December 4, 2013 | 2pm ET. • Partners in+care Webinar | SPNS Projects Examine Retention in+care for HIV-Infected Transgender IndividualsThursday, December 10, 2013 | 2pm ET • Data Collection Submission Deadline: December 2, 2013 • Improvement Update Submission Deadline: December 16, 2013 • December, 2013 Campaign TopicDigital Health and Retention in+care

34. Campaign Headquarters:National Quality Center (NQC)90 Church Street, 13th floor New York, NY 10007Phone 212-417-4730 incare@NationalQualityCenter.orgincareCampaign.org youtube.com/incareCampaign 34