Pamela Ogata, Research & Evaluation Mike Janson, Research & Evaluation

1. 2003 Countywide Risk Assessment SurveyFindings From a Large-scale Multi-site Survey in Los Angeles County: Metro (SPA 4) Pamela Ogata, Research & Evaluation Mike Janson, Research & Evaluation Office of AIDS Programs and Policy November 20, 2003

2. West Hollywood Hollywood Downtown Los Angeles Service Planning Area (SPA) 4 Metro • 107 Square Miles • 1.1 Million Residents • Proportion of County Population: 11.9% • Proportion of LivingAIDS Cases: 37.2% • Living with AIDS: 6,685 • Population:Latino/a 54.2%White 22.1%Asian/PI 15.4%African-American 5.7%Native American 0.3% Mixed 2.3% Source: United Way of Greater Los Angeles, 2003; HIV Epidemiology Program, 2002; U.S. Census Bureau, 2000

3. Background • Centers for Disease Control and Prevention (CDC) requirements • Community Planning Process • Prevention Plan • Allocation of HIV Prevention Resources • Evaluation

4. Data Utilization An integral data source for • Priority Setting • Evaluation of the linkage between: • HIV Prevention Plan • Resource Allocation • CDC application • Local needs assessment

5. Eligibility • Inclusion • Persons receiving HIV prevention services from OAPP-funded contractors • Surveys conducted in Los Angeles County • Exclusion • Less than 12 years old • Previously surveyed in 2003

6. Instrument • Part A: Assesses Demographic Information • Race/ethnicity • Age • Gender • Sexual orientation • Part B: Examines Drug and Alcohol Usage • Injection drug use, needle sharing • Part C: Assesses Sexual Risk Behavior • Barrier use • Unsafe sex with HIV positive partners • Number of partners • Part D: Measures Service Utilization

7. Provider Trainings • 22 trainings (May 2003) • 238 staff from 50 agencies attended • Training covered • Sampling Methodology • Overview of Survey Instruments • Survey Procedures • IRB and HIPAA protocols • California Mandated Child and Elder Abuse Reporting

8. 2003 Participation Surveys • Total Expected: 2,520 • Total Received: 2,107 • Survey Return Rate: 83.6% • Total Complete: 1,847 • Proportion of Surveys Completed: 73.3% Agencies • 47 out of 50 participated (94.0%) Programs • 164 out of 175 participated (93.4%)

9. Data Collection and Analysis • Surveys were administered between May 5, and July 30, 2003 by agency staff in one-on-one interviews. • Clients were randomly selected using systematic sampling and received an item valued at $10 for compensation. • OAPP staff entered the data into a password-protected database. • Data entry error rate was <2%, no critical variables involved.

10. Weighting • Surveys were weighted to provide a representation of the average number of clients who received prevention services from OAPP-funded contractors monthly. • All analyses are weighted and based on an estimated client count of 5,147. • Estimated client count for SPA 4 is 1,818.

11. Clients Surveyed by SPA N=5147 SPAs Source: 2003 CRAS Data (weighted)

12. Clients Surveyed by Gender n=374 N=5147 SPA 4 All SPAs Source: 2003 CRAS Data (weighted)

13. Clients Surveyed by Age Percent Source: 2003 CRAS Data (weighted)

14. Clients Surveyed by Race/Ethnicity Percent Source: 2003 CRAS Data (weighted)

15. Clients Surveyed by Living Situation Source: 2003 CRAS Data (weighted)

16. Immigration (SPA 4) • 26.6% (n=484) were born in another country *includes 24 countries with proportions less than 2% Source: 2003 CRAS Data (weighted)

17. Substance Use Source: 2003 CRAS Data (weighted)

18. Substance Use (Cont.) Source: 2003 CRAS Data (weighted)

19. Needle Use Source: 2003 CRAS Data (weighted)

20. Sexual Behaviors Source: 2003 CRAS Data (weighted)

21. Drug Use and Sex Trading Source: 2003 CRAS Data (weighted)

22. Sexual Orientation vs. Behavior • Self-reported sexual orientation • Does not correspond to self-reported behavior Source: 2003 CRAS Data (weighted)

23. Behavioral Risk Groups (BRG) n=1818 n=3684 SPA 4 All SPAs Source: 2003 CRAS Data (weighted)

24. Condom/Barrier Use Source: 2003 CRAS Data (weighted)

25. HIV Counseling & Testing (HE/RR, HCT clients) Numbers may not add up to 100% due to rounding, missing answers, or refused to answer Source: 2003 CRAS Data (weighted)

26. Services Utilized Source: 2003 CRAS Data (weighted)

27. Limitations Time period 6 months May not capture all drug users May contribute to the unknown BRG category

28. Conclusions • CRAS • Provides demographic information and risk behaviors of individuals receiving services. • Reflects strong outreach efforts. • Demonstrates response to HIV/AIDS epidemic in communities of color.

29. Acknowledgements AIDS Healthcare Foundation • AIDS Project Los Angeles AIDS Service Center • AltaMed Health Services Corporation AMASSI Center of South Central Los Angeles • At the Beach Shorey, Inc. Bienestar Human Services, Inc. • California Drug Consultants, Inc. Children’s Hospital Los Angeles • Clinica Para Las Americas El Centro del Pueblo • FAME Health Corporation Greater Los Angeles Council on Deafness • JWCH Institute, Inc. Los Angeles Centers for Alcohol & Drug Abuse • LA County STD Program Los Angeles Free Clinic • Los Angeles Gay and Lesbian Center Los Angeles Shanti • Minority AIDS Project • Prototypes • Reach LA Special Services for Groups (APAIT) • The Salvation Army The Wall-Las Memorias • Traveler’s Aid Society of Los Angeles United American Indian Involvement, Inc. • Van Ness Recovery House Thank you for your participation