HIV Education for Pre-Teen Girls in Homeless Shelters

An Interview With Audria Russell

Contributing Editor

My name is Audria Russell. I am the HIV program coordinator at Women in Need [WIN]. Women in Need is a nonprofit organization that first started out providing services to women who were in need of shelter, homeless services. They've expanded their services -- this actually being their 26th year -- to provide services not just for women, but also to their families who are homeless. We also operate shelters throughout the Bronx, Manhattan and Brooklyn that provide services, homeless services, to women who are in transition.

We also operate two substance abuse day treatment programs in the South Bronx and also in Manhattan. The bulk of our work seems to be centered in the area that I work, which is HIV, but we tend to intercross with other disciplines, as HIV never stands alone. There's domestic violence. There's poverty. There's homelessness. There's substance abuse. All those other things are influencing factors that drive the disease.

Primarily, one of the new areas that we've been focusing on is the work that we've been doing with young girls, which started out at one of our medium-sized shelters where I started to do work with girls, providing group sessions with these young ladies who were living in the shelter. We also did some work with young men, but unfortunately we didn't get funded to continue the work with the men.

The name of the program is Kid SISTA. We started doing our interventions late last fall. It is very interesting working with these girls because we're learning more about the needs of the population and how we can tailor services to answer to these needs, which in essence is providing HIV education -- how it's transmitted; providing information that supports them to make good decisions, teaching communication skills; providing education around drug use; and gender and ethnic pride.

We know self-esteem is also one of those big indicators that studies have shown link with women who are positive: If you feel good about yourself, you're more apt to make good decisions, decisions that will not put you at risk for HIV.

The group meets once a week for an hour and a half. The Kid SISTA intervention is modeled after the SISTA [Sisters Informing Sisters on Topics About AIDS] intervention that came out a couple years ago from the CDC [U.S. Centers for Disease Control and Prevention]. Basically, it gives the girls an opportunity to express themselves in a safe space, to talk openly about their concerns, about HIV, but also how they see themselves being portrayed as women of color in society, whether it's in pop culture or in their neighborhoods.

They also will talk about some of the barriers that they will face just in their daily interactions: peer pressure to participate in sexual activity, peer pressure to get involved sometimes with drugs, which we know again is one of those risk factors that are associated with HIV. We provide them with the skills, which hopefully will help them to make those decisions that won't put them at risk for being infected.

The age group that we're working with is from 10 to 13 years old.

What the program does is that we recruit girls from the shelter with the assistance of shelter staff, flyers, information sessions that we'll have with those families who have daughters who are in that age range to get them to participate in the program.

As you know, working with the homeless population presents various challenges, but we have been working closely with the staff to overcome those challenges -- recruiting them and keeping them in the program just for those four weeks that the intervention will run.

They have a lot of fun learning. A lot of times we don't do the regular one and a half hours. We go over that time because there are so many questions and so much that they may bring up surrounding the topic that we may cover on that specific day, so I'll take my time. I'll take an extra hour if it takes that, or two, to sit and explain it to them. You know the old adage: If you can save one, you know, my job isn't done, but that's a big help.

That's the point of reference that I work from -- providing them information and spending the time with them to make sure that they understand it.

We realize the needs of the population -- it's an incentive-driven population. The first week that they come to the intervention, they'll get one of those fabulous red rubber band bracelets that you see a lot of in various colors. Ours is in red with the name of the program on it and the agency's insignia, which is Women in Need, WIN, and "Kid SISTA" imprinted on it.

The second week there's a keychain, then the baseball cap. The final week is a big finale, the T-shirt, and they've always received that well. We use it as an incentive for them to show their friends in the shelter -- to say, "We had fun, but not only did we have fun, we learned, most important, and here are some of the little trinkets and gifts that we got for showing up and participating."

It's been working well with them. It's been received well by the staff and the families whom I've spoken to in the shelter. Most of them have indicated that they would like to have their children participate in it.

Time is also one of the big barriers for them because of changes within Department of Homeless Services. The requirement is that the parents go out and work a lot of times. Sometimes the children who are eligible aren't able to participate because they're helping out doing household chores and catching up on doing schoolwork. We haven't been able to get all of the girls who are within that age range, which is my goal -- to have each and every one of them participate in the program.

We'll be running the program for a year and it should be up until September of 2009. I'm hoping to have more good news about it to share with the public about what we have learned about this population that will put us in a better position to get more funding to do more work, not just with this site, but agency-wide, with girls who are within that age range -- and the young men, hopefully.

How did you get involved in doing HIV work?

It's been an interesting journey for me. I started doing HIV work back in the late '90s, just about when the new HIV medications came out. I started working with a project known as the Bridge Project on Riker's Island, which provided discharge planning services to inmates who were HIV positive and ensured that they had continued services as they reentered the community.

From then, I kind of ventured on to another program that was built on almost the same premise, but directly making sure that they had medication before leaving Riker's Island. That was the MedSpan program, which is still up and running on Riker's.

Most of my interests, my experiences, have also been with the incarcerated population. Then I branched out doing some more work within that population, but more around health care -- advocating for them in the community as they're coming home.

That was very interesting because we saw that although they would have gotten services, leaving the correctional facilities, at times, there were other barriers, such as making sure that they find a place to live, and then maintaining compliance with the medication. So I did more work around that. All of my professional life has been with HIV care.

I do have a passion for the work that I do and for the people that I serve because there is such a need for providing information to those who are at risk, but also to the general population because in doing that, we can help to bring the numbers down.

My spin on it is providing knowledge, giving as much as I can -- as much time and as much energy as I can -- to ensure that someone does not become infected with HIV.

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Audria Russell

Audria Russell