July 12, 2010
The Bronx Knows, a borough-wide testing program launched in 2008, is one of the largest, most ambitious efforts of its kind. The goal of this collaborative work of 75 religious groups, community organizations, health-care providers and the Bronx hospital system is simple: Test as many adults for HIV as possible. New York City has one of the nation's highest HIV rates, with Bronx residents, who are primarily Black and Latino, hit especially hard (pdf).
So far the plan is working better than the New York City Department of Health and Mental Hygiene, which oversees the project, expected. In just two years the collective has administered more than 375,000 HIV tests at more than 100 sites, far surpassing its original three-year goal of 250,000.
For Nurah Amatullah, founder of the Muslim Women's Institute for Research and Development (MWIFRD), whose organization has been actively involved in the effort, the key is to send volunteers out into the community who look and think like the people they are testing.
"My staff reflects the diversity of the community we're based in," she says of the heavily Dominican, Puerto Rican and West African neighborhood of Highbridge where MWIFRD is based. "Some of our volunteers speak Spanish or are Muslim, so they're able to engage linguistically with the people they test, as well as be sensitive to their faith backgrounds. Cultural sensitivity is very important. In Puerto Rican culture, for instance, there is a respectful sort of language kids use with their elders, so you would never send an 18-year-old in to test a 50-year-old. When people see that you understand and respect their way of life, they open up more."
What is also helpful, says Lynette Ford with the Gay Men's Health Crisis (GMHC), is working with counselors that use a gentle approach -- encouraging folks to get tested without being pushy about it. "Our outreach workers talk to residents about HIV prevention in a manner that is friendly and nonjudgmental," she says of GMHC's work at subway stations and in areas well known for prostitution. "If residents aren't interested in talking to us on the street, we leave business cards so they can contact us at their convenience. Our staff understands that we have to meet people where they're at -- providing them with a safe environment to ask questions, receive information and hopefully get tested."
"Providing overall quality-of-life treatments for residents -- including HIV-preventive care -- also sends a message to residents that you care about them individually and are not just concerned with the overall welfare of the community. Our success in large measure derives from the outreach skills of the members of our health-education team, and their willingness to go the extra mile in engaging clients, educating them and empowering them to know their HIV status," says Lizanne Fontaine with Care for the Homeless. Her 70-member organization provides health and social services to folks living in homeless shelters and other temporary-housing sites around New York City. "Our people go door to door at residential facilities, or engage people in conversation in the hallways of shelters when they are sitting and waiting for an appointment. Sure, we provide rapid testing for HIV, but we also prepare fliers and conduct group sessions on various health topics -- such as information sessions about Pap smears, hepatitis and other health challenges."
Indeed, says Amatullah, HIV prevention is generally only part of an overall need for the residents who are being serviced. "Smoking cessation is a big effort we're involved in, so we provide free nicotine patches," she says of her staff's daily work on the street. "People know they can come to us to get their blood pressure checked. Plus we operate two food pantries in Highbridge and Parkchester. And when we're dealing with HIV, we don't just get people tested ... we wait with them to find out the results. If they're scared, we stay with them. If it turns out they are positive, we support them in making their next move. In the end, people just want to know that you care."
Tomika Anderson is a freelance writer based in Brooklyn, New York. Her work has appeared in Essence, POZ, Real Health and Ebony magazines, among others.