A8: Successful Adaptation of an EBI in a Correctional Setting, San Antonio Room
The “Sister to Sister” program is a multi-session HIV risk reduction intervention targeted to African American women. Tarrant County Adult Health Services began delivering this EBI in the Tarrant County jail in June 2004. The jail is an excellent place to reach high-risk African American women who have had unprotected sex with multiple partners. In 2005, 476 women attended the intervention; of these, 222 were African American.
The learning objectives are assertive communication; self-esteem building, personal risk reduction plan development, improved STD/HIV knowledge, and self-perception of risk. These incarcerated women have shown an avid response, engagement and appreciation for the program. The participants give consistent positive feedback.
One core element of the program is condom skill building that entails class participants learning “hands on” how to correctly put on a condom. Condom skill building is essential in delivering this EBI and is one of the four outcome monitored activities. This could not be presented as prescribed in the course curriculum because condoms and phallic proxies cannot be brought into the jail. Approval for a creative “substitute” condom skill building segment was secured after the completion of a trial study that determined the substitute materials did transfer to real life condom and proxy skill building.
Condom skill building is accomplished through participants breaking into dyads to observe each other performing the substitute practice. Observations by participants are performed both at the beginning and end of the EBI session. In the beginning, the participants demonstrate how they put on a condom. They then watch the instructor(s) demonstrate the correct way to use a condom, and participants repeat their demonstration again. The adaptation of the condom skill building has been well received by participants and proof that “Sister to Sister” is successful in the correctional facility setting.
Tarrant County Health Department
Fort Worth, Texas
Cheryl Mateen has been an epidemiology specialist for the Tarrant County Health Department for seven years. She has been working with evidence-based interventions in the jail setting for two years. She instructs HIV/STD courses designed for diverse populations and performs epidemiology fieldwork and case management.
Tarrant County Health Department
Fort Worth, Texas
Rhonda Zepeda has been an epidemiology specialist for Tarrant County Health Department for eight years. She has been working with evidence-based interventions in the jail setting for two years. She instructs HIV/STD courses designed for diverse populations and performs epidemiology fieldwork and case management.
B8: Cancer Morbidity Among HIV/AIDS Cases in Texas, San Marcos Room
Persons living with HIV/AIDS are at increased risk for developing certain cancers, including Kaposi's sarcoma and non-Hodgkin's lymphoma. These types of cancers and invasive cervical cancer are considered AIDS-defining conditions in HIV-infected individuals. In addition to AIDS-defining cancers, other cancers may also occur in excess among HIV-infected individuals.
In order to learn more about cancer morbidity among HIV/AIDS cases in Texas, the DSHS HIV/STD Epidemiology and Surveillance Branch electronically matched the HIV/AIDS Reporting System (HARS) to the Texas Cancer Registry in 2006. This presentation will discuss the findings of this match in terms of case demographics, geographic distribution, and trends over time. This match marks the first time that Texas has had population level data on cancer among HIV cases.
Jennifer Chase, M.S.P.H.
DSHS - HIV/STD Epidemiology and Surveillance Branch
Jennifer Chase currently works as an epidemiologist for the DSHS HIV/STD Epidemiology and Surveillance Branch. Since receiving a master of science in public health from Tulane University in 1998, she has worked as an epidemiologist for the Louisiana HIV/AIDS Program and for California STD Control Branch. Chase has worked on several HIV/AIDS matching projects, including matching HIV data to the hepatitis registry, the tuberculosis registry, and vital records.
C8: Community Mobilization Around Syphilis Elimination in Houston, Texas: April 2006, Sabine Room
The CDC selected Houston as one of eight cities to take part in a syphilis summit due to Houston's recent high rate of syphilis cases among MSM. Representatives from the eight cities have been meeting monthly to discuss interventions and identify what is working in their area that may be shared with each other and other cities throughout the United States.
Each month, the Prevention Program from one of the eight cities is asked to lead a discussion to highlight what that program is doing to address a chosen topic (community mobilization, clustering, etc.). The PowerPoint presentation is transmitted through Webinar and broadcast to each program participating in the summit. As one prevention program takes the lead on the issue, other programs submit slides detailing efforts from their area to also be displayed and discussed during the presentation.
The goal of the summit is to exchange information about successful and unsuccessful interventions to avoid spending time and resources on unproductive interventions. By observing working models which can be easily duplicated to address common issues, prevention programs can better use their resources to make an impact on increasing syphilis cases in their area.
Larry J. Prescott
Syphilis Elimination Coordinator
Houston Department of Health and Human Services
Larry Prescott has worked for the City of Houston STD Prevention Program since 1995 and has served as the Syphilis Elimination Coordinator since 2000. He has conducted presentations throughout Houston, the eight-city summit, and has served as a syphilis consultant to CDC. Prescott has been involved with every aspect of syphilis elimination since Houston was named as a high morbidity area. He serves as the focal person for most of Houston's interventions and also serves as coordinator for Houston's Syphilis Elimination Advisory Committee.
D8: Directly Observed Therapy for STDs in Urban Settings, Trinity B
With STD prevention dollars being stretched thin, innovative, cost-saving methods to treat infected individuals and their partners have been implemented. The Austin/Travis County, Houston, and San Antonio Metropolitan Health District's STD/HIV Programs now provide STD medication to certain individuals outside clinical settings. Individuals treated in the field include persons infected with or exposed to specific STDs. This allows rapid disease intervention to take place with regard to individuals who are, for a variety of reasons, unable or unwilling to come to the clinic. This also helps alleviate clinic congestion while freeing up STD clinicians. The San Antonio Metropolitan Health District has also begun treating extremely high-risk individuals preventively for syphilis as a component of case-related outreach and screening activities. Examples of these activities will be shared.
Susan Barondes, R.N.
Public Health Nursing Supervisor
San Antonio Metropolitan Health District
San Antonio, Texas
Susan Barondes is a graduate of the Emory University School of Nursing and has been employed by the San Antonio Metropolitan Health District for eight years. She is currently the nurse manager/nursing supervisor of the STD/HIV clinic in downtown San Antonio. She trained as a disease intervention specialist at the Dallas County Health Department in 2005 and participates in multi-agency blitz activities including giving bicillin in the field. She is an active member of the Eliminate STD's in San Antonio (ESSA) Coalition. Susan has three Aggie daughters.
Assistant Program Manager
San Antonio Metropolitan Health District
San Antonio, Texas
Scott Salo has been working with the San Antonio Metropolitan Health District since 2005. He previously served as STD/HIV Program Manager for Corpus Christi-Nueces County, Syphilis Elimination Coordinator for the City of San Antonio, and began his public health career in 1995 as a Disease Intervention Specialist for Tarrant County (Fort Worth). He values learning from and forming productive working relationships with other health care agencies throughout Texas and the U.S.
Communicable Disease Unit Manager
Austin/Travis County Health and Human Services
John Harborth has 16 years of experience in public health, serving as Disease Intervention Specialist and STD Supervisor for the Dallas County Health and Human Services Department, STD Program Manager for the Waco/McClennan County Public Health District, STD/HIV Training Specialist at the Texas Department of Health, and most recently Communicable Disease Unit Manager for Austin/Travis County Health and Human Services. As a trainer and manager, he has experience working with most public health STD and HIV prevention programs across Texas and many major public health programs in the Southeast Quadrant of the United States. He has learned from them, and shared among them the common challenges and various approaches to reducing disease burden in their communities.
City of Houston Department of Health and Human Services
John Paffel is an advisor to HIV/STD program officials at the City of Houston Department of Health and Human Services. He was instrumental in developing Houston's policies and procedures for directly observed therapy for gonorrhea and chlamydia. Paffel also played a key role developing protocols for expanded prophylactic treatment for syphilis using risk-based profiles.
E8: A Review of the Medical Monitoring Project Outcomes of Interest, Trinity A
The Medical Monitoring Project (MMP) arose out of the need for a nationally representative, population-based surveillance system to assess clinical outcomes, behaviors and the quality of HIV care. This project has been funded for a four-year period (2005-2008) at 26 state and city health department sites.
MMP employs a three-stage sampling design resulting in annual probability samples of adults in care for HIV. In the first stage of sampling, 26 state or city health departments were selected, using probability proportional to size (PPS) sampling methods based on AIDS prevalence. The second stage sampled facilities providing HIV care in each of these geographic areas. The third stage is a random sample of patients chosen from the patients seen at facilities selected in the second stage of sampling.
Collection of data from interviews with HIV-infected patients will provide information on the current levels of behaviors that may facilitate HIV transmission: patients' access to, use of, and barriers to HIV-related secondary prevention services; utilization of HIV-related medical services; and adherence to drug regimens. In combination with data collected from the abstraction of medical records, MMP will also provide information on clinical conditions that occur in HIV-infected persons as a result of their disease or the medications they take as well as the HIV care and support services being received by these patients and the quality of these services. Ultimately, this surveillance project will produce data about needs for HIV care and prevention services that can be used to evaluate these services and to direct future resources for HIV-infected patients.
Sylvia L. Odem, M.P.H.
HIV/STD Epidemiology and Surveillance Unit
Department of State Health Services
Sylvia Odem is the Project Coordinator for the Medical Monitoring Project, the first statewide supplemental surveillance project to look at both clinical outcomes and behavioral activities in conjunction. She previously coordinated the Supplement to HIV/AIDS Surveillance (SHAS) project in Texas (2000-2004) and in Los Angeles, California (1995-1997), a patient interview project. She also coordinated the Adult Spectrum of Disease (ASD) project in Texas (1999-2004), a medical chart review data collection project. Prior to her work in HIV/AIDS, she worked on research projects related to prenatal care access and the use of hospital education centers.
Contributors to this presentation:
Nita Ngo, M.P.H., Epidemiologist, DSHS
Katharine Carvelli, M.P.H., Epidemiologist, DSHS
Tammy Sajak, M.P.H., Manager, DSHS
F8: Health Literacy: Improving Clear Health Communication for Better Patient Outcomes (Part II), Concho Room
See F7 for presentation overview and speaker information.
G8: Maintaining Security and Confidentiality for Surveillance and Reporting (Part II), Pecos Room
See G7 for presentation overview and speaker information.
H8: The Role of Spirituality in the HIV-Infected Woman, Ballroom A
The majority of newly-infected HIV cases among women occur among minorities. This presentation will explore risk factors for HIV acquisition among minority women and address the multi-faceted challenges for women infected with HIV as well as the role of spirituality in prevention, service, care, and treatment planning. The importance of providing holistic care; acknowledging and nurturing the mind, body, and spirit will be highlighted using a literature review of the latest research. This presentation will provide a historical perspective on caregiving and self-care among chronically ill patients, an overview of emerging trends and paradigm shifts, and present barriers to incorporating spirituality into HIV care and treatment. This presentation will also discuss the link between spirituality, patient quality of life, and medication adherence. In addition, the presentation will provide a case study of current interventions incorporating spirituality into HIV care. Participants will have an opportunity to examine their own personal spiritual beliefs as they relate to HIV care, prevention, and treatment.
Ratonia C. Runnels, L.M.S.W.
Department of State Health Services
Ratonia Runnels is a Development Specialist for DSHS. Her work experience includes street outreach, HIV testing and counseling, substance abuse counseling, case management, training, group facilitation, contract monitoring, and grant writing. Runnels has been approved by CDC as a SISTA Project Instructor/Trainer, Facilitator, and Technical Assistance Provider. She currently volunteers as an educator, speaker, and technical assistance provider with the Black Faith-Based Health Initiative. Runnels is also the founder of TrinityVision Consulting, an independent consulting agency offering capacity-building assistance, faith-based curricula, and motivational speaking services to for-profit, non-profit, faith-based, and community-based organizations.
LaTonya Noel, M.S.W., Ph.D. Candidate
The University of Texas at Austin School of Social Work
La Tonya Noel has worked for several years with Community Medical Centers of Central California providing psychosocial assessments, and individual and group therapy for chronically ill patients. Noel began her doctoral studies at The University of Texas at Austin in the fall of 2003. She has focused her studies and her research on coping strategies of medically ill patients, multicultural issues, religious beliefs, depression, and the integration of mental health into the primary medical setting. She plans to continue her research in the integration of mental health into the primary medical setting, with particular focus on chronic physical illness, the role of spirituality in coping, and the presentation of depression among minority patients.
I8: Disparities in the African American Community: The Underlying Issues Behind the Statistics, Ballroom B
The presentation will explore underlying issues of why the rates of disease, incarceration, and teenage pregnancy are so prevalent in the African American community. It will also attempt to explore some solutions that have already been set in place and what we as health educators can do to address disparities in the Black community. This presentation is statistically based, but not statistically focused.
Larry Alexander, Jr., L.C.D.C.
Cedar Creek, Texas
Larry Alexander has been conducting substance abuse counseling with diverse populations as well as training and facilitating DSHS curricula through the Workers Assistance Program/Texas HIV Connection for the last seven years. He is also a motivational speaker and past presenter at the 13th Texas HIV/STD Conference.
J8: AETC Border Issues Track: HIV/AIDS SPNS on the Border, Wedgewood Room
This presentation will discuss the impact of the end of the five–year Health Resources and Services Administration (HRSA) funded SPNS Border Health Initiative (Special Projects of National Significance) in the U.S./Mexico Border region. The overall goal of this initiative was to develop models of community-based health care networks that effectively reduced barriers to early identification of HIV disease and assure entry to high quality primary health care for individuals who live and/or work in the U.S. region of the U.S./Mexico Border area. The five funded projects were in San Diego, Tucson, Las Cruces, El Paso and Harlingen. The topics were presented at a conference held during the 2006 Border Summit in El Paso. The challenges encountered by the U.S./Mexico Border agencies in maintaining the treatment and outreach capacity developed under the Project in the absence of the SPNS funding were addressed. To understand the impact of the SPNS funding on the U.S./Mexico Border, this workshop will address what was done with SPNS funding; lessons learned and collateral benefits; post-SPNS activities, including possible next steps for Border SPNS agencies. The presentation will focus on gaps, challenges and opportunities that resulted from Border SPNS. The presentation will highlight the work of the five SPNS funded border agencies that serve on the US/Mexico Border.
Henry Pacheco, M.D.
Texas/Oklahoma AIDS Education & Training Center
Dr. Henry Pacheco is the Director of TX/OK AETC and is responsible for overall direction and coordination of the AETC program. He directs the development, implementation, evaluation, and dissemination of education, training, clinical consultation, and technical assistance services for health care professionals treating HIV seropositive patients. Dr. Pacheco serves as the primary contact for HRSA, NAAETC, DSHS, and other federal/state agencies.
Director of Nursing
La Fe Care Center
El Paso, Texas
America Jones has been the Director of Nursing and HIV services in Clinica La Fe, in El Paso, Texas since 2005. She also regularly makes presentations on Latinos and AIDS-related topics along the US/Mexico Border, lecturing to professionals across the United States and border states in Mexico.
Sylvia Moreno, B.S.N., R.N.
Director of Nursing
Parkland Health and Hospital System
Sylvia Moreno has been the Director of Nursing and HIV Services at Parkland Hospital since 1986, where today she supervises a staff of about 80. As nursing director, she oversees the department, its budget, personnel, patient issues and performance improvement. As grants manager, she helps bring in the more than $5 million annually it takes to fund the program. Sylvia has chaired several local health organizations in Dallas including the AIDS Interfaith Network and the Dallas Concilio of Hispanic Service Organizations. Each year, she volunteers her skills to HELPS International as a member of its Guatemala Medical Relief Team. She also regularly makes presentations on AIDS-related topics to organizations around the globe, lecturing to professionals across the United States and in Brazil, Thailand, Spain, Mexico, and Greece.
Oscar Gonzalez, M.S.
Texas/Oklahoma AIDS Education & Training Center
Oscar Gonzalez is the Border Health Coordinator at the TX/OK AETC. Prior to joining the TX/OK AETC, he worked as Training Coordinator at the Dallas STD/Prevention Training Center for the University of Texas Southwestern Medical Center and CDC. Gonzalez has 15 years of experience in the field of HIV/AIDS as an anthropologist and ethnographer. His areas of expertise include HIV/AIDS training and technical assistance, rapid assessment, evaluation, treatment and medications adherence in HIV/AIDS patients, prevention for positives, HIV behavior surveillance, HIV intervention for men who have sex with men, injection drug users and high-risk heterosexuals with priority in minority women, and HIV and intimate partner violence in women. His expertise and specialization is in Latino communities in United States, Latin America, and the Caribbean. Subsequent to working with the TX/OK AETC, he worked in many research projects funded by CDC, NIDA, NIH, HRSA, and several universities. He has also provided multiple consultations for HIV/AIDS international organization and agencies. He also participates in nationwide and international HIV conferences. Gonzalez is bilingual and bicultural. Being an anthropologist is a rewarding career in which he is always able to learn and share how to improve the lifestyles of people.