Karla Johnson, MSPH Executive Director Development Systems, Inc. Region VII RTC

OPA/OFP HIV Prevention ProjectAnnual Technical Support ConferenceReport from Breakout Sessions – Day 1 Karla Johnson, MSPH Executive Director Development Systems, Inc. Region VII RTC June 13, 2007

Topics Discussed Significant impact stories: • More staff and client acceptance of testing as a result of increased training and integration • CDC HIV integration toolkit available through Regional Training Centers • Changed how HIV test was tracked in charts to clarify whether a test had been performed

Topics Discussed (cont’d) • No longer see clients in terms of “high risk” • High proportion of clients who tested positive as part of screening were not “high risk” • Increased staff awareness of and screening for substance abuse • All staff trained to deliver results • Negative results available by telephone using password protected dial-in system

Topics Discussed (cont’d) • Able to implement HIV rapid testing in more sites, which increased test volume • Some clinics have been able to obtain HIV grants funds to cover cost of testing, which means those clinics can offer free HIV testing

Issues Raised • Cost of rapid testing and increased demand • Financial/legal implications of opt-out testing • Resistance to CDC recommendations from AIDS community and CBOs • Lack of definition for “integration” • Continued limited access to client HIV charts • Lack of treatment resources available for clients who test positive • Declining availability of federal funding

Issues Raised (cont’d) • Need for staff and client surveys to assess training and service needs • Staff concerns related to delivering test results (times, resources, support) • Moving away from paradigm of HIV “counselingandtesting” is very challenging • HIV still viewed by staff as “death sentence” • Need for public education about stigma

Issues Raised (cont’d) • Resources needed to focus on ABC, evaluation (e.g. staff) at odds with resources needed to implement CDC recommendations (i.e. increased testing) • ABC is very difficult to evaluate • Some states still require multi-day HIV training before staff can offer test • Limited resources to provide staff training; interrupts clinic operations

Suggested Solutions (cont’d) • Make HIV testing routine and opt-out • Need to lower cost of rapid tests • Develop a strategy for making rapid testing sustainable • Streamline counseling and shift more resources toward expanding testing • Integrate HIV staff into general clinic staffing • Identify most effective integration strategies (e.g. HIV test with Pap or STD screening)

Suggested Solutions (cont’d) • Education… education… education • Reframe HIV as a chronic disease • OPA/CDC websites should include best practices, and disseminate sooner than later • Keep Annual Technical Support Conference • Make “Integrating HIV Prevention in FP” available from OPA website • TV, radio commercials and Mobilization Campaign should address stigma

Suggested Solutions (cont’d) • Partner with HIV/STD, AETC and ATTC training centers for HIV training • Train nurses/staff who may not be skilled in providing services to male users • Train staff on new CDC recommendations and new HIVPP requirements • Train all staff on HIV basics, including stigma, transmission, prevention

Karla Johnson, MSPH Executive Director Development Systems, Inc. Region VII RTC