Establishing HIV Peer Education Initiatives in the Texas Department of Criminal Justice
Mike Mizwa, Director of Education, AIDS Foundation Houston
Julie Doyle, Program Coordinator, AIDS Foundation Houston
Liz Moore, L.C.D.C., Peer Education Coordinator, Texas Department of Criminal Justice
Deborah Scott, M.P.H., Community Researcher, Sage Associates
Kelly McCann, Criminal Justice Liaison, Montrose Counseling Center
Tuesday, April 17, 2001, 1:00 - 2:00 p.m., Texas Ballroom VII
This is a must attend workshop for providers who are investigating the possibility of providing HIV/STD prevention services to offender populations in the Texas Department of Criminal Justice (TDCJ) and/or providers who are currently providing HIV services to offenders within the TDCJ system. TDCJ, one of the largest prison systems in the world, is responsible for approximately 150,000 incarcerated individuals, and has an HIV seroprevalence estimated to be between 2.5 and 8 percent. A special task force recommended the implementation and evaluation of a peer-based HIV education program in 1997. TDCJ, in collaboration with AIDS Foundation Houston, University of Texas Medical Branch, and Texas Tech University, implemented a peer-based HIV prevention program in five TDCJ institutions in 1998-99. The program was evaluated comprehensively by Sage Associates, which reinforced existing literature supporting peer education to be an effective methodology of providing HIV prevention education targeting incarcerated populations. The evaluation recognized issues faced by women require the addition of curricula specific to female offenders, as well as additional curricula modules focusing on hepatitis A, hepatitis B, hepatis C, and STDs. This workshop intends to bring community-based HIV prevention providers together to not only review and evaluate existing HIV peer education programs in TDCJ, but to discuss and encourage community-based providers to collaborate with AIDS Foundation Houston and establish linkages with TDCJ in order to expand the scope of HIV peer education programs throughout the TDCJ system. Additionally, the workshop intends to outline what minimum requirements and resources are needed to initiate, maintain, and support a peer education program within a TDCJ institution.
Mike Mizwa, Director of Education, AIDS Foundation Houston since 1988, has presented at over 100 local, state, national, and international conferences on HIV/AIDS related issues. Programmatically, he has received numerous awards including Outstanding Contribution to Youth Award for Services Rendered in Health: Texas Youth Commission; Texas Community Health Award: Texas Department of Health; Outstanding Community Health Promotion Award: U.S. Secretary of Health and Human Services; and Houston Leadership in Action Awards in Health (non-profit); and Health and Human Services.
Julie Doyle, Program Coordinator with AIDS Foundation Houston somce 1998, has been instrumental in the development of offender peer education programs within the Texas Department of Criminal Justice. Julie currently represents the criminal justice populations for the City of Houston HIV Prevention Community Planning Group.
Liz Moore, L.C.D.C.
Liz Moore has worked with the Texas Department of Criminal Justice (TDCJ) since 1994 in various substance abuse capacities including counselor intern, senior counselor, transitional coordinator, and clinical training specialist. In June 2000 she became the Peer Education Coordinator for the HIV/AIDS Peer Education Program with Preventive Medicine in Health Services for TDCJ. This position was created as a result of the successful pilot programs and the need for continued growth of HIV/AIDS Peer Education in the institutions.
Deborah Scott, M.P.H.
Deborah Scott is the founding director of Sage Associates, Inc. and has been actively involved in community research since 1993. During the past seven years in the Houston community, her work has encompassed all aspects of prevention and service delivery for people with HIV disease. Sage projects include needs assessments, program development, and evaluation.
Kelly McCann is the criminal justice liaison for the Montrose Counseling Center (MCC), which receives $1.3 million to provide HIV early intervention (HEI) services to HIV-positive inmates and releasees to the Houston area. The Montrose Counseling Center, in partnership with AIDS Foundation Houston, has initiated offender peer education programs within the TDCJ institutions and they currently are providing HIV early intervention services.
STD and HIV Infection: The Interrelationship
Wes Kennedy, University of Texas Southwestern Medical Center at Dallas
Tracee Belzle, University of Texas Southwestern Medical Center at Dallas
Tuesday, April 17, 2001, 2:30 - 3:30 p.m., Texas Ballroom VII
CDC states that the interconnectedness of HIV and other STDs grows increasingly apparent as biomedical and behavioral scientists learn more about people's susceptibility and risks. Many HIV and STD prevention providers lack an understanding of these biomedical and behavioral factors and their interrelationship between HIV and other STDs. To increase their understanding of the biological and behavioral factors that put clients at risk for STD and HIV infection, participants will be given a brief review of STDs and introduced to the infectivity formula. Slides will be shown to assist participants in recognizing STDs and a group discussion will be led to talk about the effects that STD infection has on HIV transmission. Infectivity is the probability of transmission (STD or HIV) from an uninfected person to an infected person after an exposure, and depends on three factors: viral dose, exposure, and resistance. After the trainers introduce the infectivity formula, participants will be able to translate these scientific terms into accessible, usable language. In small groups participants will discuss behavioral factors of STD prevention that facilitate high risk behavior for HIV infection. Participants will be introduced to a self-assessment tool that can be used to help clients personalize their risk. Trainers will facilitate a group discussion to assist providers in incorporating risk reduction messages into their programs. Discussion will focus on three ways to effectively integrate STD messages in HIV interventions. First, by implementing a HIV and STD screening strategy for populations at high risk. For some providers this will include referring clients or developing collaborations with appropriate organizations. A second method would be to offer HIV counseling and testing to individuals who tested positive for other STDs. Third, HIV prevention providers must provide rapid access to STD diagnosis and treatment.
Wes Kennedy is a training specialist with the STD/HIV Behavioral Intervention Training Center in Dallas at UT Southwestern Medical Center (UTSW). Mr. Kennedy earned a bachelor's degree from Auburn University and did his master's work in education at Southwestern Seminary. Prior to his work with HIV, he was a counselor with substance abusing adolescents at psychiatric facilities in north Texas. Mr. Kennedy worked in HIV/STD prevention for five years at the Dallas County Health Department. He began working at UTSW in 1996 as coordinator of the education department with the AIDS Prevention Project. He now provides training across the country for the Prevention Training Centers in the areas of behavioral theory, HIV/STD intervention design, substance abuse and HIV prevention, sexual communication, and community level identification. Most recently, Mr. Kennedy was instrumental in the design and implementation of a HIV prevention program for rural communities surrounding Zimba Mission Hospital in southern Africa.
Tracee Belzle is the program coordinator for the Dallas STD/HIV Behavioral Intervention Training Center. Ms. Belzle teaches three courses and has trained a total of 340 hours to over 400 participants. She joined the AIDS Prevention Project in 1993 to work with the AIDS Community Demonstration Project and served as administrator for the training center for the first two years of it operation. She has specific expertise in adult learning theory and corporate training. In addition, Ms. Belzle has developed and delivered courses using distance learning technology. Ms. Belzle earned a BBA degree from The University of Texas at Arlington.
Transgender: The Unseen Population
Tom Rainer, L.C.D.C., aka Brenda Thomas, City of Houston Health Department, HIV Prevention
Tuesday, April 17, 2001, 4:00 - 5:00 p.m., Texas Ballroom VII
Understanding what defines the transgender population is paramount to offering any solution to the needs of the transgender community. So few people truly understand what constitutes being transgender and how it fits into daily lives. Because of the stigmatization surrounding the transgender population many face significant co-factors with regard to HIV transmission. Because of this stigmatization and isolation many transgenders have resorted to street survival sex for a mere existence, increasing their HIV risk. There have been some needs assessments done around the country that show the seroconversion rate among the transgender community to range between 20 and 80 percent. There is evidence noting significant barriers to prevention messages and prevention services exist, making access to services and adherence to prevention extremely difficult. This training is applicable to clinicians, outreach workers, case workers, HIV prevention workers, and front desk personnel working in both public and private agencies. By the end of this session, participants will be able to: 1) define the transgender population; 2) identify co-factors of HIV prevention; 3) identify personal barriers; 4) identify service barriers; and 5) present specific guidelines to removing those barriers.
Tom Rainer, L.C.D.C., aka Brenda Thomas
Brenda Thomas is employed by the Houston Health Department, HIV Prevention and is the community co-chair elect of the Houston HIV Prevention Community Planning Group. Ms. Thomas has served for several years as a member of the HSDA Consortia as an individual member and is vice-chair of the Houston AIDS Advocacy Team. She has been working in HIV prevention and intervention programs for the last six years and is a group facilitator for Bering Spiritual Support Group in Houston. Ms. Thomas has been extremely active as a transgender activist for the last eleven years and founded and facilitates weekly groups for Helping TransGenders Anonymous (HGA), a support group for transgender individuals. Currently, she is working on a transgender needs assessment for Houston and has established a Transgender Task Force with the health department.
Meet the Plenary Speaker
Thelma King Thiel, R.N., Chair and CEO, Hepatitis Foundation International
Wednesday, April 18, 2001, 1:00 - 2:00 p.m., Texas Ballroom VII
Hepatitis C: Implementation of House Bill 1652
Sharon K. Melville, M.D., M.P.H., Director, TDH, Bureau of HIV and STD Prevention
Ann Robbins, Ph.D., Manager, TDH, HIV/STD Research and Program Evaluation Branch
Gary Heseltine, M.D., Epidemiologist, TDH, Infectious Disease Epidemiology and Surveillance Division (IDEAS)
Kathleen Shupe-Ricksecker, Ph.D., Epidemiologist, TDH, Infectious Disease Epidemiology and Surveillance Division (IDEAS)
Wednesday, April 18, 2001, 2:30 - 3:30 p.m., Texas Ballroom VII
Hepatitis C can cause serious disease of the liver. Concern about this disease continues to increase because it is the leading cause of cirrhosis and liver cancer, and accounts for one-quarter to one-third of all liver transplants in the United States. Hepatitis C is also the most common chronic blood borne infection in the U.S. Based on national estimates of the percent of the population who have been infected with hepatitis C, more than 300,000 Texans are infected with this virus, many of which do not even know they are infected. To address the problem of hepatitis C in Texas, the Texas legislature passed House Bill 1652 which was effective September 1, 1999. Under HB 1652 TDH is to: 1) conduct a seroprevalence study to estimate the current and future impact of hepatitis C on the state; 2) conduct health education, public awareness, and community outreach activities to promote public awareness and knowledge about the risk factors, the value of early detection, available screening services, and the options available for the treatment of hepatitis C; 3) provide training to public health clinic staff regarding the treatment, detection, and methods of transmission of hepatitis C; 4) identify to health care providers and employers the benefits of disease awareness and prevention; and 5) develop a prevention program to reduce the risk of transmission of hepatitis C. TDH must specifically establish voluntary hepatitis C testing programs to be performed at facilities providing voluntary HIV testing in each public health region to make confidential counseling and testing available and must develop and offer a training course for persons providing hepatitis C counseling. This session will focus on presenting the results of the hepatitis C seroprevalence studies conducted as part of this bill including results from a retrospective study conducted in drug treatment centers and a STD clinic, a prospective study of clients of HIV counseling and testing sites and a general population hepatitis C seroprevalence study. Preliminary data on the implementation of hepatitis C counseling and testing in publicly funded HIV counseling and testing sites will also be presented.
Sharon K. Melville, M.D., M.P.H.
Dr. Sharon Melville, a native Texan, holds an M.D. from The University of Texas Medical Center at Houston and an M.P.H. from the University of Massachusetts. Dr. Melville has been at TDH since 1996 and directs the HIV and STD Division of Epidemiology. Prior to her work at TDH, Dr. Melville was Assistant Professor of Community Medicine at the University of Massachusetts Medical School where she taught medical students community health and epidemiology and conducted research in preventive health services. In her spare time Dr. Melville enjoys playing the saxophone and traveling.
Ann Robbins, Ph.D.
Ann S. Robbins holds a Ph.D. in social psychology from the University of Texas, and has been working in the TDH Bureau of HIV and STD Prevention since late 1994. In her capacity as the manager of the Research and Program Evaluation Branch, Dr. Robbins is responsible for oversight of non-morbidity data systems and evaluation of HIV/STD prevention and HIV services programs. Prior to her work with TDH, Dr. Robbins served as Director of Research for Quantum Solutions, working with more than 100 hospitals to create efficient and effective plans for evaluation of their business strategies and clinical programs. While at Quantum, Dr. Robbins also completed a nation-wide benchmark collection of patient and hospital employee satisfaction survey data.
Gary Heseltine, M.D., M.P.H.
Gary Heseltine grew up in the Great Lakes area, one of four children. Camping and cycling were his favorite pastimes outside of academic work. After he moved to Texas, he spent time sailing in the Gulf, with occasional trips to Mexico. Construction work (rebuilding an abandoned house) and trips to Big Bend consumed his energies and time. At present he enjoys roller blading, camping, and the study of various academic topics, from computers to probability theory.
Kathleen Shupe-Ricksecker, Ph.D.
Although a native Texan, Kathleen Shupe-Ricksecker grew up in the Pacific Southwest, returning to Texas her senior year in high school, allowing her to attend The University of Texas as a resident. Always curious by nature, she decided to sample the traditions of Aggieland while working on her Ph.D. Different cultures have always attracted her, so she moved to the Northeast (New York and Pennsylvania) for her postdoctoral work. She spent eleven years as a professor of microbiology and immunology for the University of Dallas before moving to the Infectious Disease Epidemiology and Surveillance Division at TDH. Kathleen's world includes her daughter and three cats, who all vie for attention (usually at the same time). After hours are spent teaching aerobics and traveling anywhere exotic where there are ample scuba diving opportunities.
Integrating Hepatitis C Into Your HIV Prevention Program: A Model for CBOs
Eric Roland, Director of Education, Montrose Clinic, Houston
Wednesday, April 18, 2001, 4:00 - 5:00 p.m., Texas Ballroom VII
With a rise in hepatitis C diagnosis in this country, integrating a hepatitis C prevention program with an existing HIV prevention program may not only be a logical expansion, but may give a boost to current HIV prevention programs. Since HIV and hepatitis C have overlapping risk factors, such as shared needles and sex, health education and risk reduction (HERR), as well as testing for hepatitis C can coincide with an established HIV prevention program. In this workshop, emphasis will be focused on methods to locate funding, training staff, and implementing a hepatitis C prevention program in a community-based HIV organization. While adding hepatitis C educational information to existing HIV HERR programs may cost little and just be an issue of training staff, funding to cover the cost of hepatitis C testing may be the greatest barrier to the complete integration of these services. Since direct governmental funding is limited or nonexistent, creativity in locating funding sources becomes imperative. As this public health crisis gains notoriety, funding from private foundations, local area hospital charities, and specific fundraisers may be the best avenue for securing resources at the present time. After receiving funding, training staff on all form of hepatitis, their symptoms, diagnosis, treatment, and risk factors becomes an important, yet fairly easy task. Offered by drug companies, health departments and sometimes, private medical providers, training sessions covering information about all forms of hepatitis should be conducted with all HIV prevention workers. Additionally, HIV counseling and testing staff, who are required to be certified in HIV prevention counseling (which now includes information on hepatitis C in the pre-course manual), can be trained to conduct hepatitis C testing within the existing prevention counseling model. Outcomes for a hepatitis C prevention program include educating the public about the disease, thus reducing transmission rates, getting persons at risk tested for the disease, and referring those who test positive for appropriate medical care and social services. Depending on the targeted populations (IDUs and the incarcerated will be higher), a positivity rate as high as 8 to 14 percent can be expected. A secondary outcome may be that HIV prevention numbers will increase, especially if the HIV and hepatitis C tests are offered together. Offering dual testing may inspire those who have not been HIV-tested in a long period of time to get tested for hepatitis C and get retested for HIV. Adding a hepatitis C prevention program will benefit any current HIV prevention program through expanding educational parameters, getting at-risk persons tested for the virus while boosting HIV testing numbers, and supplement community-based organizations' budgets.
As Director of Education at Montrose Clinic in Houston, Texas, Eric Roland oversees several state- and city-funded prevention programs, including in-house and outreach HIV testing programs. Mr. Roland also teaches Next Step, an educational workshop for persons recently diagnosed with HIV. In January 2000, he helped implement the clinic's hepatitis C testing program and is now working with a TDH workgroup to coordinate and collaborate educational and implementation issues for a statewide hepatitis C testing program. Mr. Roland was graduated in 1990 from Miami University with a bachelor's degree in English and has been working in HIV services since 1995.
Brothers and Sisters! HIV/AIDS Does Not Discriminate! - Using New Methods to Relay an Old Message
Angela Shelf Medearis, Author, The Sisters' Circle/Book Boosters
Thursday, April 19, 2001, 1:00 - 2:00 p.m., Texas Ballroom VII
Women, particularly African-American women in Texas and the United States, are contracting HIV/AIDS in alarming numbers. Minority women are less likely to have personal physicians, to have quality health insurance coverage, or to be treated with respect and understanding in negotiations with health care institutions. (Bair & Bayleff, 1993). In the recent past, social and health workers have provided the African-American and Latino community with AIDS information; however, their focus was on homosexual men, intravenous drug users and prostitutes. The stigma of receiving information from a health organization or attending a community meeting on the topic of HIV/AIDS is obvious. There is an alarming lack of accurate information about HIV/AIDS within the African-American community. Many perceive it as a disease only within the confines of the homosexual community. HIV/AIDS is rarely discussed on any level because of its association with two African-American cultural taboos -- homosexuality and drugs. There has also been resistance by African-American leaders and organizations, including pastors and church groups, the N.A.A.C.P., and The National Urban League to take any kind of definitive stand on the issue. AIDS service organizations have also been slow to keep pace with the changing demographics of the disease. A lack of information, coupled with a lack of leadership and services, has unleashed a disease of epidemic portions which is devastating the African-American community. The docudrama Always a Bridesmaid was created to inform women of color about the epidemic spread of HIV/AIDS through cultural and community-based activities in a non-threatening, non-accusatory manner. AIDS prevention and intervention information is presented in a culturally-acceptable fashion. These methods have not been used by health agencies and social workers in the past. Methods for thinking outside of the box will be discussed during this presentation, including outreach services and seminars conducted through beauticians trained through special seminars, manufacturers of African-American hair care products, African-American bookstores (as part of lecture series), fraternities, sororities, and community and social clubs. Using non-traditional methods to disseminate information is an important part of this project as the spread of the disease indicates that traditional methods have not been successful or embraced by the targeted community. This presentation is designed to educate outreach professionals in new and unique ways to spread an old message.
Angela Shelf Medearis
Angela Shelf Medearis is the award-winning author of more than 70 books. She has been called "one of the most influential writers of children's literature in Texas" by Texas Monthly magazine, and rightly so. Her desire to write books for children was the result of working with secondgraders who had difficulty reading. Ms. Medearis went on to become the founder of Book Boosters, a non-profit organization dedicated to tutoring elementary school children who need a boost in their self-esteem and help with their reading. Alarmed by the large number of African-American children who are born HIV-positive and the equally alarming number of children left orphaned due to the disease, Ms. Medearis has turned her attention to reaching African-American and Latino women and men, using her creative writing skills and experience creating videos as weapons against the onslaught of infections that have devastated the African-American and Latino communities. Her first short film Always a Bridesmaid has received national attention, and she recently created a brochure designed specially for African-American and Latino men.
Session F8 and F9
The Mpower Model: A New Direction in Effective HIV Prevention Programming For Young Gay Men
Carter, Jesse, Project Coordinator, Austin Men's Project/AIDS Services of Austin
David Sweeney, Project Coordinator, Austin Men's Project/AIDS Services of Austin
Thursday, April 19, 2001, Part I 2:30 - 3:30 p.m., Texas Ballroom VII
Part II 4:00 - 5:00 p.m., Texas Ballroom VII
Most young men getting infected with HIV are between the ages of 18-24. The purpose of this presentation is to describe the design and implementation process of the MPower Model, a community level, peer based HIV intervention for young gay, bi, and curious men. The MPower Model consists of four main components: community center, large events programming, safer sex and event promotion outreach, and specialized small group programming. The four components work interdependently, and with a community advisory board and an ongoing publicity campaign to attract a diverse group of young men to the program. This model is effective because it is free from the stigma of AIDS service organizations and existing HIV prevention programming. This is achieved by the young men actively participating in the design and implementation of the program. This model is the only program for young gay men listed in the CDC compendium of effective HIV prevention programs.
Jesse Carter is one of the coordinators of the Austin Men's Project (AMP). He has worked within the GLBT community in Austin for several years on issues of inclusion, gender, youth, organizing, and HIV. With his work at AMP, he is also assisting in the development of replicating the Mpowerment Model in communities across the country.
David Sweeney is one of the Coordinators of the Austin Men's Project. Mr. Sweeney has worked in HIV prevention with diverse communities in Austin, Texas, for five years, including homeless adolescents, substance abusers, and queer youth. Mr. Sweeney has presented at several state and regional conferences, and in addition to AMP, he is working on replicating the Mpowerment Model in various communities across the country.