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North Carolina Positive Charge Initiative

North Carolina Positive Charge Initiative . Access to Care. Who is out of Care? In North Carolina generally and the NC Positive Charge Initiative . In North Carolina, an estimated 23.4% of those who know they are HIV+ are not receiving HIV medical care.

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North Carolina Positive Charge Initiative

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  1. North Carolina Positive Charge Initiative Access to Care

  2. Who is out of Care?In North Carolina generally and the NC Positive Charge Initiative • In North Carolina, an estimated 23.4% of those who know they are HIV+ are not receiving HIV medical care. NC Epidemiologic Profile for HIV/STD Prevention and Care Planning (12/11)

  3. A quick introduction to NC What impacted our program design • NC has unique geographies • Mountains and sea • Urban and rural • Resources are concentrated in certain areas • I-95 and I-40 corridors run through the state • HIV service system is splintered • prevention/education/care • Stigma is strong throughout the state • History of peer training programs but not of agencies hiring peers • Gaps in funding often prevent continuum of services • Clients must be in medical care to get most services • No one is looking for people outside of the HIV system • Belief that PLWH can relate to other PLWH in a unique way

  4. Program OutlineAccess to care for those living with HIV • Access Coordinators (HIV+ peers) are the core of the program • Access Coordinators (ACs) work in teams of 2 or 3 in each agency • ACs receive special training when they start and monthly conference calls • ACs split their time between their agency and the community • Short-term relationship 3-9 months • Identifying • Community outreach • Testing events • Referrals • Agency in-reach • Connecting to Care • Medical appointments • Support services • Thriving in Care • Communication skills • Empowerment

  5. NC PCI Partners Across the State • Three areas representative of the state • Rural (11 counties) • Suburban (6 counties) • Urban (1 county) • Different types of agencies • Health Department • Community-based Organization • Faith-based Organization

  6. Why are people out of Care?Barriers to Care and Meeting Basic Daily NeedsNC Positive Charge Initiative clients

  7. Program Outcomes • Improved health outcomes • Increased CD4 • Decreased viral load • Increased number of undetectable clients • Number of self-identified barriers to care decreased • Improved referral systems • Decreased no-show rates • New partners • HIV testing, prevention and education • Skills-based curriculum for Access Coordinators • Tools for thriving in care

  8. Challenges and Lessons Learned • Street and community outreach is difficult • Basic HIV education is still needed • Training Access Coordinators has to be done right • Transportation remain a barrier • Access Coordinators need to be fully integrated in their agency • Some of our greatest opposition has come from the HIV service system • There’s a reason people have been out of care, but they can thrive in care with the right support and skills

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