AIDS Survival Project recognized this challenge and in 2004 was awarded a Centers for Disease Control and Prevention (CDC) grant to begin a Prevention Services department. Adding Prevention Services to the ASP structure has resulted in a lot of growth, including six new staff positions and additional office space. This new department first implemented an HIV counseling, testing and referral program, then a "Healthy Relationships" intervention.
Taking on the project of Prevention Services while focusing primarily on African-American women and African-American MSM (men who have sex with men) was challenging. It meant we had to find creative ways of informing the community that ASP, primarily known for its programs directed to people living with HIV, was now offering free HIV counseling and testing. ASP had been, for the most part of its history, an organization that focused its services primarily on empowering people who were affected by HIV with resources on HIV and how to manage living with the virus, as well as obtaining healthcare needs. Making the change into prevention had its ups and downs.
Among many issues, one that we considered as essential was managing a person's comfort level when entering the ASP office and having to ask for an HIV test. It was important to us to maintain a person's confidentiality and comfort upon entering our agency. We knew it would be challenging enough for a person to get the courage to make up their mind to take an HIV test, but since our agency's name alone indicated that our work is HIV/AIDS-specific, we knew that this would be a barrier to testing for some people.
So we put careful thought into someone's first few minutes in our agency. We also decided that we would make our waiting area comfortable so that it wouldn't seem so clinical. Much time was taken in selecting the furnishings and the décor to help individuals feel relaxed. We even thought to select a soothing paint color for the walls and music playing on the radio. At times, juice, water and coffee are offered.
In keeping with the ASP philosophy, many résumés were reviewed and interviews conducted to ensure a culturally diverse counseling and testing team. In March of 2005, we began to provide surveys to our clients to see how they felt about the quality of service that they received during the counseling and testing process. Over 240 surveys were collected and reviewed over a three-month period. All of the counselors -- Clay, Joe, Tracy, our Director, Greg Smith, as well as myself -- have received excellent comments: "Kevin English was an excellent counselor, impeccable!" said one client. "The counselor, Clay, was wonderful! He made me feel very comfortable and at ease." "Great initial counseling session, Greg!" "Joe Greenwood listens well!" "Nice compassionate counselor. Tracy was very sweet!"
|Prevention Counseling Manager Kevin English (right) worked with ASP volunteer Carolyn Morgan (left) on counseling techniques in the early days of ASP's Prevention Services Department.|
Not only were comments made about the staff, but also many people were glad to see that we provide OraSure's OraQuick Rapid Test, which provides results within the same visit versus having to wait five days for results. This change in testing has made it much easier, not only to the client, but to the organizations providing the testing. We no longer have to make telephone calls to clients to convince or remind them to return for their results. Also, no longer do we have a large number of clients who have tested anonymously and may have tested positive for HIV without a way of contacting them to return for their results and get them into care. All of our clients are counseled prior to taking an HIV test and then again after receiving their results.
The Prevention Services department is an ever-evolving program. We strive to ensure ASP has the capacity to serve anyone who enters our doors. When a client is newly diagnosed with HIV, they are immediately referred to Pamela Morse, our Linkage to Care Coordinator, who helps newly diagnosed individuals get linked to a primary care provider within three to six months of their diagnosis. Here, clients are educated about basic facts of HIV. The Linkage to Care Coordinator supports the client in overcoming barriers that might prevent them from accessing medical care.
Another program that the Prevention Services department offers is the "Healthy Relationships" intervention, funded by the CDC. This intervention is a five-session, small-group intervention with men and women living with HIV/AIDS. In this intervention, participants work on developing coping skills needed to make decisions regarding whether, when and how to disclose to family and friends, disclose to sexual partners, and to help build healthier, safer sexual relationships. In the intervention, participants focus on identifying stressors and developing coping skills when deciding to divulge to sexual partners, family and friends. Participants engage in roleplays; they are taught decision-making skills and view movie clips from popular movies that set up scenarios around disclosure and risk reduction to stimulate discussion among the participants.
During the month of June, two "Healthy Relationship" interventions were done simultaneously. One group was with African-American women and the other was with a group of African-American MSM. Both groups maintained at least 50% participation during the completion of all five sessions. At the end of each session, participants were given incentives for their participation, and after the fifth session, participants were given a certificate of completion. Look on our Web site for future dates of upcoming "Healthy Relationships" workshops.
From November 2004 until the end of the contract year in June 2005, the Prevention Services department served over 600 people. We have had a 6% positive rate, which is above the requirements of CDC.
Going into our second year of the Prevention grant, the Prevention Services department expects to double the number of people that we tested in the previous year. We have updated and tailored our forms and plan to increase our outreach efforts.
As the days of HIV counseling and testing continue for AIDS Survival Project, the Prevention Services department will continue to adapt and tailor itself to accommodate the needs of the individuals that enter through our doors. We are looking forward to increasing our outreach services to the communities where we see the need.
In closing, I would like to thank all of you for assisting and supporting the Prevention Services department, especially during the early months. Let us all continue to strive for the greater good in the work that we do.