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Bay Area Network for Positive Health

Bay Area Network for Positive Health. Cynthia A. Gómez, PhD Health Equity Institute San Francisco State University AIDS, 2012. Background. Estimated 8,000 individuals in San Francisco and Alameda County (Oakland), CA with known HIV infection not receiving adequate care.

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Bay Area Network for Positive Health

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  1. Bay Area Network for Positive Health Cynthia A. Gómez, PhDHealth Equity Institute San Francisco State University AIDS, 2012

  2. Background • Estimated 8,000 individuals in San Francisco and Alameda County (Oakland), CA with known HIV infection not receiving adequate care. • Little is known about the contextual realities that keep PLWH out of care in the resource-rich setting of the SF Bay Area.

  3. SF/OAK Bay Bridge Oakland, Alameda County City and County of San Francisco Bay Area Context

  4. SF Incidence versus Community Viral Load Maps

  5. Health Disparities Health Inequities

  6. PLWH/A Service Design Non-HIV organizations HIV/AIDS CBOs HIV Care Providers

  7. Methods: Network 12 CBOs, HIV clinics, and San Francisco and Alameda County Departments of Public Health Health. Serving: • African Americans • Women • IDUs • Incarcerated (State Prison and County Jail systems) • Immigrant Latinos • Burmese Refugees

  8. Client Identification Clients are located through: • Street outreach • Syringe exchange • Jails • Prison • Support groups • Review of internal clinic records.

  9. Survey Data Data are collected on: • Barriers to care • Experience of stigma • Quality of Life • Resource Needs • Demographics • Mixed quantitative/qualitative method, including voice recordings • Data entered directly into iPod Touch devices and uploaded automatically to centralized server

  10. Linkage to Care • Out of care individuals are offered assistance to access HIV care and other support services: • Linked to HIV Care • Linked to other medical care as needed • Linked to support services as needed • Follow-up of retention through county surveillance. • Release of Medical Records collected for potential future chart review.

  11. Hard to Reach • Known HIV+ average of 10 years • 34% reported no HS diploma or equivalent • 63% over 40 years of age • 66% reported living in someone else’s home, a treatment center, SRO, shelter, or outdoors. • 10 Attempts on average to engage • 63% linked to HIV care in 56 days (mean) after initial contact vs. 30-day national guideline goal

  12. What lessons have we learned? • Actual time taken to effectively engage and link prospective HIV+ clients • Resources and capacity needed to “set the stage” • Intra-agency “cross-pollination” has helped close gaps of client service

  13. Conclusions • Barriers to care have been persistent and difficult to remediate. • Other priority needs must be met before linking to HIV medical care. • Extra time and additional resources are imperative to reach and link these individuals critical to the containment of the pandemic.

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