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    DSHS HIV/STD Program

    Post Office Box 149347, MC 1873
    Austin, Texas 78714

    Phone: (512) 533-3000

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16th Texas HIV-STD Conference Proceedings Learning Marketplace

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Tuesday, May 20, 2008

Learning Marketplace Proceedings

Poster Exhibit 1 - Evaluating the Use of an Acuity Tool

Shalon Cox, M.P.H.

This poster exhibit will describe acuity tools and determine methods to develop them. By reviewing the methodology used by the Dallas area to develop, pilot, and study the reliability and validity of a standardized acuity tool, participants should be able to determine the objectives of an acuity tool and how to implement an effective tool.

Poster Exhibit 2 - Using Surveillance Data to Evaluate HIV/AIDS Outcomes in Harris County

Biru Yang

This poster exhibit will detail the investigation of concurrent HIV and AIDS diagnoses in Houston/Harris County between 2000 and 2006. People with concurrent HIV/AIDS diagnoses represent an underserved population. They may be diagnosed with HIV late in the disease process because of perceived low risk for HIV and limited access to care. Preliminary results showed women, Hispanics, and older age groups were more likely to have concurrent diagnoses. People who were diagnosed with HIV and AIDS concurrently had poorer survival outcomes. Prevention efforts should be directed to assess unmet healthcare needs in these populations with rising concurrent HIV and AIDS diagnoses.

Poster Exhibit 3 - 2006 HIV Incidence and Prevalence in Houston

Shirley Chan

In the past, incidence of HIV infection was often derived from back-calculation, summarized in retrospective chart review studies or measured in longitudinal cohort studies. These methods are often expensive, time consuming, logistically complicated, or inaccurate. For the first time, the Serologic Testing Algorithm for Recent HIV Seroconversions (STARHS) technology provides an opportunity to determine whether newly diagnosed HIV-positive individuals acquired the virus within six months prior to testing at a population level. Comparing HIV incidence to prevalence data will allow us to track the leading edge of the HIV epidemic. Estimating the number of new HIV infections is crucial in HIV prevention planning, risk behavior assessment and resource allocation.

Poster Exhibit 4 - Hepatitis B as an STD

Zandt Bryan

Hepatitis virus transmission is commonly thought of as occurring through contaminated food and water sources (hepatitis A) and blood exposure (B & C). This presentation will examine incidence, mechanisms, risk groups, and public knowledge of the hepatitis B virus as a sexually transmitted infection.

Poster Exhibit 5 - Going With the Flow: Culturally-Competent Case Management

Shawna Hudson Sanchez, M.A.
Danny Cedillo, L.S.W.

This poster exhibit will identify cultural barriers which may prevent provision of effective HIV/AIDS services to other cultures and populations, and then focus on the specific issue of removing these barriers by being a culturally-competent case manager. Case managers provide individual interventions which may directly influence knowledge, attitudes and behaviors of clients. Case managers provide skills training (i.e. safer sex, medication adherence), personal skills (i.e. self-monitoring and goal setting), interpersonal skills (i.e. how to disclose to a partner), and technical skills (i.e. how to arrange HIV meds and use a condom). In essence a case manager plays an important role in this healing dance and there is a lesson to be learned. In the end in order to provide effective HIV/AIDS services, a client's cultural and health beliefs need to be validated and implemented into the care and treatment plan. In other words, case managers need to go with the flow, understanding it is not our way but the client's way that ultimately decides his or her part in this healing process.

Poster Exhibit 6 - Surveillance Trends of Perinatal HIV Exposures in Houston, 2000-2006

Amanda Kubala, M.P.H.

This poster exhibit will give a general overview of perinatal HIV exposures including a demographic description of HIV/AIDS-infected women delivering in Houston/Harris County from 2000 to 2006. Factors influencing mother-to-child transmission and use of surveillance data in prevention planning will be shown.

Poster Exhibit 7 - Substance Abuse Clients Who Are HIV-Positive

Nancy S. Young, L.C.D.C.

Substance abuse clients who are HIV-positive present special challenges for counselors and social services providers. Identifying the characteristics of substance abusers is a vital step when providing care for HIV-positive clients. This poster exhibit will outline how prioritizing the needs of each client dictates individualized treatment planning leading to improved quality of life. Counselors will learn to help clients take charge of their health. Barriers to care must be identified and addressed, while applying effective counseling techniques with each client.

Poster Exhibit 8 - The Who, What, Why and How of HIV Vaccine Research

Marsha Kaye Jones

What is a vaccine? How does a vaccine work? Why do we need a vaccine? How do I participate in HIV vaccine research? Is vaccine research safe? How do myths and misinformation feed into the mistrust and fear of participation in “research,” especially in minority communities? These and many other questions will be addressed by this poster exhibit using scientific information around vaccine research from a very non-scientific prospective.

Poster Exhibit 9 - Rapid HIV Testing in Emergency Settings

Glenn Raup, Ph.D., R.N., C.N.A.-B.C.

A Systems-Based Approach is an emerging concept that acknowledges the complexity of the multitude of non-linear interactions among a variety of systems in which heath care is provided. Frequently undiagnosed, untreated patients infected with HIV visit outpatient clinics, emergency rooms, and acute care settings for primary care. Adult and perinatal patients using emergency and OB settings represent populations that benefit from a timely diagnosis that substantially improves health outcomes. This poster exhibit will outline best practices and key strategies in the selection, implementation and optimization of rapid HIV testing among adults and perinatal patients in an integrated county health care system.

Poster Exhibit 10 - Enhancing HIV Resource Information on the U.S. - Mexico Border

Tracy Tessmann, M.A.
Oscar Gonzalez, M.S.

Additional authors (not presenting): Henry Pacheco, M.D.; Laura Armas-Kolostroubis, M.D.; Sylvia Moreno, R.N.; Philip Keiser, M.D.

The U.S.-Mexico border presents a unique situation in the fight against HIVAIDS because of differences in medical care on either side of the border along with mobile populations, poverty and lack of medical insurance. To address this issue the U.S.-Mexico Border AIDS Education and Training Centers Steering Team (UMBAST) has created an HIV/AIDS resource directory for the U.S.-Mexico border. This poster exhibit will detail the evaluation of current use and future needs of this publication in advance of publishing a new edition. Focus groups were conducted with clinicians and case managers working on the border to outline their current use of the directory and the changes they would like to see in a future edition. Through these focus groups, we were better able to understand who the target audience of the directory should be and what changes are needed in order to provide a valuable resource to enhance capacity for providing effective HIV/AIDS care on the border.

Poster Exhibit 11 - Uno, Dos, Tres! A Spanish Micro-Course for HIV/STD Prevention

Ruben Ramirez, M.A.

This micro-course offers the HIV/STD worker or supervisor who is exploring issues in the Latino community with insights into the lives of Hispanics, including men who have sex with men (MSM) and Latinas, who are at risk of acquiring HIV and STDs. This exhibit will provide the participant with some language acquisition basics and survival Spanish language phrases and expressions to begin speaking Spanish. Topics covered include some of the latest data about Hispanic MSM, a description of the many language and cultural barriers found among Latino MSM, and a discussion about strategies that can serve to build trust and communication between participants and this population, and language proficiency considerations, and more. Participants will be able to incorporate culturally and linguistically sensitive practices in their workplace for clients who are Latino and/or Spanish-speaking.

Poster Exhibit 12 - Black Faith-based Health Initiative: Culturally-specific Solutions for Culturally-specific Problems

Rev. Joseph T. Collins

The Black Faith-based Health Initiative (BFHI) is a nationally recognized model program which seeks to educate, inform and empower people in African American communities to take control of their health, eliminate stigma and reduce serious health disparities that disproportionately affect people of color. We accomplish this worthy task by channeling culturally-specific solutions through one of the most trusted institutions in black communities–the church.

Poster Exhibit 13 - Dental Programs in Rural Service Areas

Barry Jackson, D.D.S.
DeWayne Robertson
Betty Sims

There are many challenges to building a dental program including space, equipment, recruitment and maintenance of staff, and operating funds. These challenges are only complicated when that program serves HIV-positive clients. This poster exhibit will explore the creation and maintenance of a dental health program in a rural area.

Poster Exhibit 14 - Practical Implications of the Perinatal Prevention Protocol

Mary Mallory, R.N., C.S.

Since 1994 the Prevention of Mother to Child HIV-1 Transmission (PMTCT) Protocol has drastically reduced the number of HIV-infected infants born to HIV-infected mothers. Current transmission rates can be as low as 1-2% if the protocol is followed. In addition to treatment of the pregnant mother, infant treatment with zidovudine (ZDV) until 6 weeks of age, early testing and follow-up care are vital for the reduction of HIV in exposed infants. Numerous barriers exist to implementing the PMTCT protocol successfully. This session will focus on practical ways to implement this protocol for newly exposed infants. How do you get them referred to your center? How to provide ZDV for the infant at home? How to maintain the child in follow up care?

Poster Exhibit 15 - Improving Programs Using Outcome Monitoring Data

Amana S. Turner, B.A.

This poster exhibit will provide an overview of the outcome monitoring project funded by Center for Disease Control (CDC) for Evidence-Based Intervention VOICES/VOCES (Video Opportunity for Innovative Condom Education and Safer Sex). The exhibit will detail the challenges and lessons learned related to the particular approaches. Examples of data collection tools will be provided. Exhibitor will discuss data collection methods and plans to use the data to improve HIV prevention programs.

Poster Exhibit 16 - Children with Special Health Care Needs Services Program

Melissa Short

The Children with Special Health Care Needs (CSHCN) Services Program provides services to children with extraordinary medical needs, disabilities, and chronic health conditions. The CSHCN Services Program's health care benefits include payments for medical care, family support services, and related services not covered by Medicaid, CHIP, private insurance, or other “third party payers.” The program also contracts with agencies throughout the state to provide an array of clinical and support services to children with special health care needs and their families. The CSHCN Services Program also assists children and their families by supporting case management at Department of State Health Services regional offices throughout Texas.

Poster Exhibit 17 - HIV Patterns in Houston/Harris County – A Spatio-Temporal Analysis

Naqi Mohammad

HIV cases diagnosed and reported to the Houston Department of Health and Human Services (HDHHS) from 1999 to 2006 will be analyzed to understand the distribution and course of the HIV epidemic among the White, African-American and Hispanic race/ethnicity groups. The results will be displayed spatially using GIS capabilities and will show if the subpopulations are disproportionately affected. In this poster we will seek to enhance the awareness of the distribution of HIV cases over time within these race and ethnicity groups.

Poster Exhibit 18 - Trends in New HIV Diagnoses in People Over 50, Houston, Texas

Norma Atherton

In Houston, people over 50 comprised 11% of the newly HIV diagnosed adult population between 2000 and 2006. In an attempt to understand the dynamics of this disease in people over 50, the Houston Department of Health and Human Services will use 2000 to 2006 HIV surveillance data in HIV/AIDS Reporting System (HARS) to analyze the disparity in sex, race, mode of transmission, and different age groups over 50. An insight into the HIV epidemic in people over 50 may give a different perspective and may gain notice for decision makers in HIV prevention.

Poster Exhibit 19 - Surveillance Perspective – Evaluation of the Public Health Follow-up Program in Houston

Marcia Wolverton

Notifying partners about HIV infection is an important component of HIV prevention. Texas law mandates partners be elicited and notified that he/she may have been exposed to HIV and should seek HIV counseling and testing. This poster exhibit will show how HIV/AIDS surveillance data was used to evaluate the timeliness of the public health follow-up efforts on the new HIV diagnoses in Houston, Harris County between August 1, 2006 and July 31, 2007.

Poster Exhibit 20 - Epidemiology of HIV and AIDS in Harris County

Jeffrey Meyer, M.D., M.P.H.

This poster exhibit will analyze the epidemiology of HIV/AIDS in Houston/Harris County. It addresses questions of who (sex, race/ethnicity, age) is being diagnosed with HIV/AIDS, how it is being transmitted, what geographic areas are most affected, and how these factors have changed over time.

Poster Exhibit 21 - Perinatal HIV Exposures Identified through a Birth Registry in Houston, 2005-2006

Hien Le

Houston Department of Health and Human Services (HDHHS) investigates all reports of perinatal HIV exposures. To assure optimal ascertainment of these exposures, HIV infected females in the Texas HIV/AIDS Reporting System (HARS) were matched to Texas Vital Statistics birth files to identify new potential perinatal exposures in 2005 and 2006. One hundred and twenty one mother and infant pairs were identified and investigated by HDHHS. This poster exhibit will present investigation outcomes, reasons identified for lack of reporting perinatally HIV exposed infants and missed opportunities for follow-up of HIV-exposed pregnancy outcomes. Additional measures implemented by HDHHS to improve perinatal exposure surveillance will also be presented.

Poster Exhibit 22 - Behavioral Surveillance of Heterosexuals at Risk in DFW: NHBS System

Sharon K. Melville, M.D., M.P.H.

The National HIV Behavioral Surveillance (NHBS) system collects information regarding the sexual and drug use behaviors of survey participants as well as the participants' HIV testing experiences and exposure to HIV prevention activities. In addition to the survey, participants are offered the opportunity to take an anonymous HIV test. This poster exhibit describes results from the Heterosexuals at Risk phase. The demographics of the survey participants as well as descriptions of their sexual and drug use behaviors will be presented. Additionally, results from the optional HIV tests as well as the participants' testing history and exposure to local prevention activities will be described.

Poster Exhibit 23 - Kidney Health Care

Margarita D. Balderas

The Kidney Health Care Program (KHC) provides assistance to residents in the state of Texas with a diagnosis of End-Stage Renal Disease (ESRD) that have met program eligibility requirements. The program services include prescription drug benefits, coordination of benefits and premium reimbursements for Medicare Part D Prescription Drug Program, co-insurance for immunosuppressive drugs covered under Medicare Part B, limited travel reimbursement, and certain medical expenses.

Poster Exhibit 24 - Implementing New Clinic and Lab Policies for Syphilis In Harris County

Byron Oujesky, M.S.

Beginning September 1, 2007, the Houston Department of Health and Human Services was engaged in a rapid response to address the increasing trend of syphilis cases in the Houston/Harris County area. Two new policies were implemented in the clinics and laboratory during the response: stat RPR testing in the City of Houston STD clinics and use of Bicillin prophylactic treatment in the clinics. This poster exhibit will summarize analysis of data collected and assess the effects of the newly-implemented policies regarding: reduced delay in treatment time of high risk patients; enhanced preventive treatment of high risk patients; and benefits to the overall efficiency of the STD prevention program.

Poster Exhibit 25 - Houston Provider Survey Targeting Risk Areas for Syphilis Surveillance

Lupita Thornton

Beginning September 1, 2007, the Houston Department of Health and Human Services was engaged in a rapid response to address the increasing trend of syphilis cases in the Houston/Harris county area. A citywide provider survey conducted during the response was used to assess and plan activities for enhanced syphilis surveillance as well as promote awareness to local providers of the current response activities. This poster exhibit will present the planning activities that proceeded the conduct of the survey, detail the methodology of provider selection and questionnaire design, summarize analysis from data collected, and conclude by discussing some of the surveillance actions taken in response to the survey.

Poster Exhibit 26 - Reasons Patients are not Receiving HAART: Implications for Case Management

Ejeanée Queen, M.S.N., F.N.P.

Additional authors (not presenting): Jennifer Klein, M.S.N., Michelle Ukwu, M.P.H., Marsha Thomas, R.N., Lauren Rogers, M. Keith Rawlings, M.D.

Research suggests that historic racial and gender disparities exist among people who receive antiretroviral (ARV) therapy, but that those disparities are diminishing. This poster exhibit describes the results from a study that attempts to characterize those who are not receiving ARV therapy. The most common reason patients were not prescribed ARV was having a CD4 count greater than 350, followed by being lost to care, patient refusal, and patients being considered poor candidates by their provider. This characterization has implications for case management services to help improve overall access to life-saving antiretroviral therapy.

Poster Exhibit 27 - Validity of Self-reported CD4 and Viral Load among HIV-infected Patients – Harris County

Taiwo O. Fasoranti, M.D.

Additional authors (not presenting): Salma Khuwaja M.D., M.P.H., Dr.P.H.; Osaro Mgbere, Ph.D; Brian Goldberg B.A.; James Gomez, B.S.; Lydwina Anderson, B.S.; and Karen Miller, M.S.

The CD4 T-cell count and plasma HIV RNA (viral load) are two surrogate markers that are routinely used to determine indications for treatment and monitoring of the efficacy of therapy in HIV-infected persons. Therefore the most recent information on these two biomarkers is the strongest predictor of subsequent disease progression and survival among infected persons. This poster exhibit will detail an evaluation aimed at determining the level of validity of self-reported CD4 cell count and HIV viral load among HIV-infected patients.

Poster Exhibit 28 - Tailoring an EBI: Turning Point from Fear to HAART

Jeffery H. Green, B.A.

Turning Point is an HIV risk reduction intervention for injecting drug users and their sex partners. The Tarrant County Public Health HIV Prevention Program is working with the original researchers of the intervention and the state to update a pre-existing program with medical information more relevant to those most at risk in an environment where many who are at risk perceive few adverse consequences to becoming HIV-positive. This poster exhibit will show the challenges in moderating messages of fear to insure that class participants are engaged and can realistically see themselves and their world to then make the changes required to maintain good health. Raising the perceived level of susceptibility, as a required outcome of the intervention, demands a frank acknowledgement that HIV can be a managed chronic disease. This poster exhibit will display some of the proposals currently being used by Tarrant County to update the program to encourage increased perceived susceptibility.

Poster Exhibit 29 - Religiosity, Sexual Attitudes and Behaviors in Women of Genesee County, Michigan

LaQueisa Wilson, M.S.

The poster exhibit will display findings from a survey of religiosity, sexual attitudes and behaviors among African-American women living in Genesee County, Michigan. Tables and graphs will display sexual behaviors, STD/HIV risk, condom use, knowledge and awareness as well as significant associations found among religiosity (religion in daily life, religious practice, religious opposition, adherence to sanctions, and attendance at religious services), sexual attitudes and sexual behaviors (abstinence, age of onset, lifetime partners, condom use and knowledge, and STD/HIV risk).

Poster Exhibit 30 - Patients with HIV/AIDS Experience in a Large Urban ESD

Tom Emanuele, B.S.N., R.N.-B.C., A.C.R.N.

This poster exhibit will describe the experience of individuals with HIV infection who seek emergency medical care in a large urban hospital.

Poster Exhibit 31 - Universal Rapid HIV Screening for Women in Labor

Patty Hardt, M.D.

Rapid HIV testing is now an option to screen for HIV seroconversion prior to delivery. Patients arriving to labor and delivery with unknown HIV status can lead to missed treatment opportunities and possible increased vertical transmission rates. Large integrated health care systems are complex and it is often difficult to implement practice change in these settings. The purpose of this project was to identify, through a systems based approach, a reasonable and cost-effective method to screen for HIV in women who present to labor and delivery at JPS with unknown HIV status.

Poster Exhibit 32 - Role Model Stories for Community PROMISE

Curtis Jackson

This poster exhibit will describe the eight components of an effective role model story for Community PROMISE and share effective role model stories developed by other agencies implementing PROMISE across the country.

Poster Exhibit 33 - Outcome Monitoring Data and Case Note Review of CRCS in Jails

M. Elaine Rogers, L.C.D.C./A.A.C.

Comprehensive Risk Counseling and Services (CRCS), an individual level intervention, has multiple sessions of client-centered HIV risk-reduction counseling. This poster exhibit will present outcome monitoring data and case note review results about CRCS clients seen in the county jail.

Poster Exhibit 34 - HIV Behavioral Risk among IDUs in DFW: NHBS

Doug Kershaw

Dallas is one of 25 cities funded by the Centers for Disease Control and Prevention (CDC) to conduct the National HIV Behavioral Surveillance (NHBS) program, a recurring series of behavioral surveys that characterizes HIV-associated risk behaviors and use of local HIV prevention services. This poster exhibit will offer results from data collected during the Injecting Drug User (IDU) cycle of NHBS from August 2005 through February 2006 and a social network analysis of IDU recruited for the survey. Specific trends in sexual and drug use behaviors and experience with prevention services will be discussed.

Poster Exhibit 35 - Trends in Risk Factors among MSM and non-MSM Syphilis Cases in Houston/ Harris County

Osaro Mgbere, Ph.D.

This exhibit displays an analysis of the trends and differences in risk behaviors of men who have sex with men (MSM) and non-MSM in Houston/Harris County from 2000 to 2006. Changing risk behaviors over time was observed between the two groups. An understanding of the patterns and associated networks in the groups will ensure that prevention interventions are holistic and more effective.

Poster Exhibit 36 - Epidemiology of HIV/AIDS among Hispanics in Harris County

Yvonne Lu, M.D., M.P.H.

This poster exhibit will display the epidemiological characteristics of Hispanics and HIV/AIDS in Houston/Harris County. It will address the following questions: where these subpopulations of patients come from, what age groups are highly infected, what are their risk factors, and what zip code areas were consistently high in case number?

Poster Exhibit 37 - Hepatitis C Testing in Texas

Dorian Galindo Hinterlong

The poster exhibit will highlight the activities of eight agencies that provide Hepatitis C testing and services to the community. Hepatitis C and HIV share similar at-risk populations, especially intravenous drug users. It is imperative that testing and services are identified to significantly reduce the transmission of both viruses. Agencies include MHMR CARE (Austin), Tarrant County Public Health, UT Southwestern (Dallas), BEAT AIDS (San Antonio), Land Manor-PALM Center (Southeast Texas), City of Laredo Health Department, Coastal Bend AIDS Foundation (Corpus Christi), and Special Health Resources (Northeast Texas).

Poster Exhibit 38 - Creating Alliances for Adult Video Store Outreach

Kay Dreiss, L.B.S.W.

This exhibit will show how creating partnerships with adult sex venues and offering their customers a service, which preserves their confidentiality, helps to develop the venue owners and staff as advocates for HIV/STD prevention. This alliance with adult video stores is a cost effective method of prevention and case finding. By tailoring interventions specific to the special population, the health department can access a high-risk population that otherwise would be reluctant to seek testing.

Round Table Discussion 1 - Comprehensive Qualitative Needs Assessment

Chris Wilkie, D.H.S., M.P.H., A.C.S.
Beverly Stiles, Ph.D.
Sylvia Alonzo Rawlings

In 2005 the North Central Texas HIV Planning Council (Abilene – Fort Worth – Wichita Falls) began reviewing past needs assessments for HIV care and services and the utility of the information gathered from these assessments. Information provided included overall client services use, needs, and gaps. The overall issue of how to get clients not in care into care and maintain medical care for clients currently in the system was not well understood from these assessments. Working as a committee, the Council members chose to have a document created that looked at specific populations in the 38 county area (urban, rural and frontier) which appear most out of care and determine what are their factors for not accessing care and how to best address these factors. Results Consulting in collaboration with Midwestern State University was selected to conduct the needs assessment and analyze the results. The charge from the Council to Results Consulting: create a qualitative process which provides valid data in helping meet the Council's goal for addressing out of care clients. This discussion will focus on the processes used and results of this assessment which began in August 2007 and was completed in February 2008. This round table discussion will focus on how the results are being used by the Council to redirect service efforts to address the issues from the study.

Round Table Discussion 2 - Care and Treatment Management: Creating a Medical Case Management Program

Gary Isaacs, L.C.S.W.
Jason Nevoit, R.N.
Jennifer Self

The rewritten Ryan White legislation significantly changed the intent for providing case management services for HIV-positive persons. Medical Case Management (MCM), the only case management considered a core service, was minimally defined but heavily emphasized. Most of the nation operated under a social case management model, as did we. With the new law emphasizing MCM, the North Central Texas area undertook a study on the legislative intents of the MCM program; HRSA and DSHS expectations; best practices from across the nation; and, a serious review of our current case management programs. Working closely with providers, clients, the Administrative Agency and planning council members - a new model for case management was created following the elements required, as well as being client-need driven. Our Care and Treatment Management, a medical outcome, medical centered program for client management was developed and funded in 2007. This workshop will focus on the processes used to create the program, its implementation, the changes required of agencies, the effect it is having on client care, and the challenges we still face. This discussion features members from the planning body who researched and authored the plan, a representative from our largest provider of social services provider, and a key medical provider in Tarrant County (Fort Worth). They will discuss using examples used in the development of the program and what is currently underway to further refining the program's intent.

Round Table Discussion 3 - MSM Cultural Diversity

Mikael Andrews

Providing HIV/STD prevention and care to the men who have sex with men (MSM) population can be challenging. The MSM Cultural Diversity round table discussion will help participants better serve their MSM clients by giving them real life overviews of the differences, similarities, and unique challenges of growing up as MSM. This discussion will explore the emphasis on family, religious, educational, and racial/ethnic backgrounds along with other cultural and societal factors among MSM.

Round Table Discussion 4 - Women Involved in Sharing Hope (WISH)

M. Naomi Madrid
Julie Doyle

Too often prevention strategies are developed in geographic areas that are socially different than the conservative and “proper” culture of East Texas. With this in mind, and in collaboration with two prominent service providers, we have developed a creative, innovative, and effective intervention targeted to African American women who reside in rural east Texas. Concentrating on using southern, conservative, respectful Texas “norms and values” we will present a new approach to outreach, small group discussions, and community networking. Our data will show what has worked, with whom, and where. Best practices will be shared. This new program Women Involved in Sharing Hope (WISH) is funded through the Office of Women's Health.

Round Table Discussion 6 - October 2, 2009-A Post Ryan White Imagineers Workshop

Christopher Hamilton, M.P.H.
Jamie Schield, M.P.H.A.

The Ryan White HIV/AIDS Treatment Modernization Act of 2006 will be repealed on October 1, 2009, completely dismantling the entire Ryan White system of care. This discussion will look at possible alternatives and scenarios. Attendees will participate in a guided discussion to design the elements of a new program to provide care to people living with HIV/AIDS in the U.S.

Round Table Discussion 7 - Implementing Respondent-Driven Sampling

Paige Padgett, Ph.D.
Jane Richards
Hafeez Ur Rehman, M.D., M.P.H.

This discussion will offer instructions for implementing respondent driven sampling as a method for finding hidden populations. Specifically, we will describe how to complete formative work, develop coupons, identify seeds, and initiate recruitment. We will describe the dual incentive system, and discuss reasons why clients may only recruit a limited number of peers. The purpose of this round table is to help others realize the value of respondent driven sampling as a method for recruiting a probability sample for research and for prevention outreach projects.

Round Table Discussion 8 - Defining Heterosexuals at Risk for HIV Infection

Richard K. Yeager, Ph.D.

The National HIV Behavioral Surveillance (NHBS) system recently completed a pilot phase targeting Heterosexuals at Risk. The national research protocol included poverty and geography as elements and proxy variables for defining Heterosexuals at Risk. Does this definition truly capture Heterosexuals at Risk for research purposes or are other elements missing from the definition? Come join the discussion.

Round Table Discussion 9 - Building and Maintaining Strong HIV Consumer Input Groups

Ray Moore
Gil Flores

Positive Voices Coalition (PVC) has been the voice of persons infected with HIV in the Fort Worth/North Central Texas region for more than 10 years. It serves as the consumer council for many of the federal mandates for Part A, B, C, D, F, HOPWA and regional needs. Let's discuss how this and other consumer groups throughout the state remain a viable and intriguing voice for HIV prevention and services.

Round Table Discussion 10 - Critical Issues for Implementing Prevention Programs with Positives

Alric “TC” Tirado

The moderator will lead a discussion with participants on strategies for dealing with stress related to stigma, discrimination, and disclosure issues for People Living with HIV/AIDS.

Round Table Discussion 11 - Love and Liability: What's the Basis for Criminalizing HIV Transmission?

Aurelio Rodriguez
Scott Salo

The purpose of this round table discussion is to open a dialogue for and against the idea of using criminalization as an HIV structural intervention. A brief introduction to the different laws that have been or could be used in this way will be provided. There will also be an examination of recent and past prosecutions. An assessment of the effects that criminalizing HIV transmission could have and how they could destabilize or strengthen overall HIV prevention goals will be covered. Moderators will foster discussion on the movement toward and in opposition to criminalization. The role of the victim will be assessed. Other social purposes for this type of HIV structural intervention will be examined.

Round Table Discussion 12 - HIV Testing Practices in Emergency Departments

Nell H. Gottlieb, Ph.D.
KKaye Harris, Ph.D.
Katharine Carvelli, M.P.H.

The panel will begin with a synopsis of the new CDC recommendations for HIV screening and a review of the current regulations for HIV screening and informed consent in Texas. We'll then summarize the results from a literature review and formative study of perceived barriers and logistics of screening for HIV in emergency departments. Discussions will be based on the issues addressed in the formative study.

Round Table Discussion 13 - Making Quality Management Work in Your Ryan White Program: Tips and Tricks from the Experts

Kathleen Clanon, M.D.
Susan Traynor, C.A.R.N., B.S.N., R.N.

This discussion will provide an introduction of National Quality Center (NQC) as well as the quality requirements mandated by the Health Resources and Services Administration (HRSA), HIV quality measures, data for measures, disposition of data results, and future directions HRSA is taking with quality measures will also be presented.

Round Table Discussion 14 - Beyond the Generation Gap: Values Related to Human Sexuality Across the Ages

Mary Chapman McIntosh, M.Ed.

Every generation has its own unique characteristics. For example, the “Greatest Generation” (born prior to 1946) places great value on hard work. “Baby Boomers” (born 1945-1964) value personal growth. Both “Generation X” (born 1965-1980) and “Generation Y” (born 1981-1995) value techno-literacy. Every generation has a different view of human sexuality, too. We encounter this cultural diversity, consciously or unconsciously, with clients as well as co-workers, family and friends. This discussion will work to increase understanding of how culture and sexual identity intersect as well as to increase comfort when addressing and discussing a wide range of sexual topics with all generations.

Round Table Discussion 15 - Providing Quality HIV Prevention EBIs in Texas

Jeffrey R. Wagers, B.A.
Rosa Laura Valdez, B.A.

Texas has been on the forefront of the nation in using evidence-based interventions for HIV/STD prevention. This discussion will focus on the different types of evidence-based interventions (EBIs) proven to work in HIV/STD prevention and the lessons learned from the implementation of EBIs. Key issues discussed will include the different types of interventions, terminology, logic models, target populations and factors that influence behavior. New interventions on the cutting edge of HIV/STD prevention will be addressed. Innovations and tailoring of EBIs will be discussed, especially in terms of providing current information, and reaching those populations at the highest risk.

Round Table Discussion 16 - The HIV Prevention Blueprint

Murray J. Penner, B.S.W.

On November 29, 2007, the National Alliance of State and Territorial AIDS Directors (NASTAD) released A New Blueprint for the Nation: Ending the Epidemic Through the Power of Prevention, along with a companion policy agenda. The Blueprint provides guidelines for state and territorial health departments for ensuring they have the financial, political and programmatic resources necessary and in place to meaningfully scale up domestic HIV prevention efforts for the future. This round table discussion will focus on the major themes identified in the Blueprint and its companion policy agenda.

Round Table Discussion 17 - Brothers in the Life: Exploring the Issues for Young Black MSM

Justin C. Smith

Young Black men who have sex with men (BMSM) continue to shoulder a disproportionate burden of the HIV epidemic in the United States. Young BMSM are more likely to be HIV positive than other MSM, despite engaging in comparable, or even lower, levels of risk behavior than their counterparts. This discussion will present research findings that seek to explain the disproportionate rates of HIV infection among BMSM as well as discuss strategies for how this epidemic may be addressed. New research projects focusing on BMSM will be discussed. The discussion will also explore some of the social forces that have an impact on BMSM and may facilitate HIV transmission, including trauma, racism, poverty and spiritual violence.

Round Table Discussion 18 - Family Planning and HIV Integration

Alex A. Fisher, M.Ed.

Six contractors in Texas have received special funds to routinely screen for HIV within family planning clinics on an annual or as needed basis. Discussion will be around the barriers, procedures and outcomes of the integration of HIV testing into existing clinic services.

Round Table Discussion 19 - Syringe Exchange in Texas

Melissa “Moe” Lujan, B.S.N., R.N.

This discussion will introduce the Bexar Area Harm Reduction Coalition and personal observations of the syringe exchange in Bexar County. The moderator will focus on the obstacles of harm reduction with respect to conducting the syringe exchange in high risk targeted populated areas within San Antonio, the conflicts of educating the clients about the importance of not sharing needles, the proper disposal of “dirty” injection equipment, and how to emphasize the need to rotate and carefully choose an injection site. This discussion will also explore the various barriers that exist among other non-profit organizations focused on risk reduction, highlight the link between the negative social stigma and the knowledge deficit of the syringe exchange, and encourage the campaigning for more HCV funding and resources.

Round Table Discussion 20 - Social Networks Strategy

Maestro Evans, D.C.C., L.C.S.W.

An overview of the Social Networks Strategy and training opportunities will be presented. This discussion will address the lessons learned from implementing social network strategies for identifying undiagnosed HIV infection in hard to reach populations. Presentations and interactive discussion with CDC staff describing experiences implementing and providing training and technical assistance will be featured.

Round Table Discussion 21 - District School Health Advisory Councils

Marissa Rathbone

The purpose of this roundtable discussion is to provide an overview of Texas Education Code 28.004, which addresses health education requirements as a part of coordinated school health programming as well as school health advisory council requirements.

Round Table Discussion 22 - Hepatitis C and Legislation

Sharon Philips

This round table discussion will center on past and current state and federal legislation and appropriations for Hepatitis C. Currently there is a federal bill, National Hepatitis C Epidemic Control and Prevention Act, lead by Senator Kennedy and Senator Hutchison that will provide funding for every state to build and integrate Hepatitis C programs. The CDC Viral Hepatitis Division has had appropriation cut over the past six years and need at least $50 million now. Texas has also eliminated appropriations for all HCV programs and the discussion will look at what can be done in the next legislature.

Round Table Discussion 23 - STD Screening in a Charter School Setting: Lessons Learned

Jennifer Curtiss, M.Ed.

As a project of the Texas Infertility Prevention Project, DSHS collaborated with People's Community Clinic in Austin and a local charter school to implement a mass chlamydia/gonorrhea screening event on campus. Using a urine amplified test, over 100 students were counseled and screened. The 10 percent positivity rate justified the need for easily accessible counseling and testing, as well as referral sources for other services.

Round Table Discussion 24 - DSHS HIV Case Management Training Program

Ann Dills, M.S.W.

The HIV Case Management Training Program at the Texas Department of State Health Services provides free trainings to Administrative Agencies and their subcontractors receiving Ryan White Part B funds through the DSHS HIV/STD Program. Trainings offered through this program address case management and HIV-related medical issues. This roundtable is an open forum for discussion of HIV case management training issues. All HIV Case Managers are invited to participate.

Round Table Discussion 25 - ESDA Methods to Monitor Chlamydia Incidence in Texas: 2004-2005

Kwame Owusu-Edusei Jr., Ph.D.

Monitoring sexually transmitted disease is an integral part of implementing effective control and prevention programs. Exploratory Spatial Data Analysis (ESDA) methods provide a more pictorial way for achieving this end and allow for testing the significance of variations in levels as well as changes overtime by identifying global and local outliers. This poster exhibit will demonstrate the application of ESDA methods in monitoring county-level chlamydia incidence in the state of Texas.

Round Table Discussion 26 - Correlations between Racial/Ethnic Composition and Chlamydia/Gonorrhea: (Ordinary and Spatial Econometric Models)

Kathryn K. Koski, M.S.Ed., M.P.H.

Several studies have reported the positive association between county-level minority racial/ethnic composition and the incidence of sexually transmitted diseases (STDs). However, the strength of association may also be different for different STDs. This poster exhibit will explore the differences in the magnitude of association between county-level racial/ethnic composition and two STDs (chlamydia and gonorrhea) and assess potential differences by comparing results from ordinary least squares (OLS) and spatial econometric models.

Round Table Discussion 27 - Texas HIV Medication Program

John Allen
Tara Geotas, M.P.H.
Becky Ruiz, B.S.W.
Katherine Wells, M.P.H.

Staff from the Texas HIV Medication Program will be on hand to answer questions about the AIDS Drug Assistance Program (ADAP) and the new State Pharmacy Assistance Program (SPAP). Stop by the table to learn more about these assistance programs, pick up copies of the newly revised program application and meet program staff.

Round Table Discussion 28 - DSHS Laboratory

Liz Delamater

Liz Delamater from the DSHS Laboratory will be on hand to answer laboratory-related questions.


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Last updated May 22, 2013