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    DSHS HIV/STD Program

    Post Office Box 149347, MC 1873
    Austin, Texas 78714

    Phone: (512) 533-3000

    DSHS strives to respond to all email requests in a timely manner. It is important to note, however, that messages that you send to us by email may not be secure and may be intercepted by a third party. Therefore, we recommend that you do not send any confidential health information to us by email.

2012 Texas HIV-STD Conference Session Overviews

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October 28-31, 2012
Austin, Texas


Session Overviews


Sunday | Monday | TuesdayWednesday minilogo


Sunday, October 28, 2012

Opening Plenary Session
1:30 p.m. to 5:00 p.m.
Texas Ballroom

Welcome and Introduction
Felipe Rocha, M.S.S.W., Manager, TB/HIV/STD/Viral Hepatitis Unit, Department of State Health Services, Austin, Texas

Commissioner’s Address
David L. Lakey, M.D., Commissioner, Department of State Health Services, Austin, Texas

State of the State
Ann S. Robbins, Ph.D., Manager, HIV/STD Prevention and Care Branch, Department of State Health Services, Austin, Texas

State of the State slides (PDF : 1,751 kb)

Welcome Reception
5:30 to 7:30 p.m.
Hill Country Ballroom


Sunday | Monday | TuesdayWednesday minilogo


Monday, October 29, 2012

Monday, October 29, 2012
Mini Plenary Presentations
8:30 a.m. to 10:00 a.m.

Resistant Gonorrhea
MA1 - Monday, 8:30 a.m. to 10:00 a.m., Texas Ballroom 2-3

This session offers continuing education credits.
Susan Philip, M.D., M.P.H., Deputy Health Officer, Director, STD Prevention and Control Services, San Francisco Department of Public Health, San Francisco, California. Disclosure of Financial Conflict of Interest - Dr. Susan Philip has received funds from Cepheid, Inc. and Abbott Diagnostics for research.
David L. Trees, Ph.D., Lead, Gonorrhea Molecular Epidemiology and Reference Lab, Laboratory Reference and Research Branch, CDC Division of STD Prevention, Atlanta, Georgia
   This presentation will review the concept and dynamics of antibiotic resistance; discuss the current and anticipated future situation with drug resistant gonorrhea; identify the populations most affected by STD/HIV; explain the impact of resistant gonorrhea; identify modifications to clinical practice environments that can facilitate increased STD screening; discuss the urgent need for adequate sexual history taking, rectal/pharyngeal testing, reduction of stigma associated with HIV/STD; and identify the implications of resistant gonorrhea for individuals, labs, and providers. By the end of this presentation, participants will be able to:

  • Discuss the current and anticipated future situation with drug resistant gonorrhea;
  • Explain the impact of resistant gonorrhea; and
  • Identify the implications of resistant gonorrhea for individuals, labs, and providers.

Treatment as Prevention
MB1 - Monday, 8:30 a.m. to 10:00 a.m., Texas Ballroom 1

This session offers continuing education credits.
Moupali Das, M.D., M.P.H., Assistant Clinical Professor, Divisions of HIV/AIDS and Infectious Diseases, SFGH, University of California, San Francisco, California; Director of Implementation Science and Evaluation Research, HIV Prevention Section, San Francisco Department of Public Health, San Francisco, California
   This presentation will address the concept of using HIV treatment to reduce new infections and the results of increased diagnoses and treatment in San Francisco. Dr. Das will touch on all of the key issues involved in the concept, including increased testing to reduce undiagnosed infection, test to treat strategies, linkage and maintenance in care, increasing adherence to care, the resulting decrease in community viral load and its impact on new infections. She will also highlight the benefits and the uncertainties that are part of the ongoing dialogue around this concept, such as the effect that increased risk behavior may have on the success of the strategy and the impact that drug resistant HIV may have. By the end of this presentation, participants will be able to:

  • Discuss the concept of using HIV treatment to reduce new infections; and
  • Describe the benefits and uncertainties that are part of the ongoing dialogue around this concept, such as the effect that increased risk behavior may have on the success of the strategy and the impact that drug resistant HIV may have.

Session MB1 slides (PDF : 3,586 kb)

MC1 - HIV/AIDS Health Disparities Among Gay, Bisexual and Other MSM within the U.S.
Hill Country, 8:30 to 10:00 a.m.

Lamont Scales, M.A., N.C.C., Coordinator for Gay, Bisexual, and Other MSM Activities, Office of Health Equity, Office of the Director, Division of HIV/AIDS Prevention, National Center for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia

HIV Diagnosis: New Tests and New Algorithms
MD1 - Monday, 8:30 a.m. to 10:00 a.m., Texas Ballroom 5-7

Bernard M. Branson, M.D., Associate Director for Laboratory Diagnostics, Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, Atlanta, Georgia

Session MD1 slides (PDF : 4,449 kb)

Monday, October 29, 2012
Mini Plenary Presentations
10:15 a.m. to 11:45 a.m.

The Burden of HIV Disease in the United States
MA2 - Monday, 10:15 a.m. to 11:45 a.m., Texas Ballroom 2-3

Joseph G. “Buzz” Prejean, Jr., Ph. D., Incidence and Viral Resistance Team, HIV Incidence and Case Surveillance Branch, Centers for Disease Control and Prevention, Atlanta, Georgia
   This presentation will describe the components of the national HIV surveillance system and how each of these components is used to describe the burden of HIV infection in the United States. It will include a review of the epidemiology of HIV infection and how data on HIV disease are used to inform prevention services nationally.

Prep for PrEP
MB2 - Monday, 10:15 a.m. to 11:45 a.m., Texas Ballroom 1

Francisco Ruiz, M.S., Senior Manager, Health Equity, National Alliance of State and Territorial AIDS Directors (NASTAD), Washington, D.C.
Dawn Smith, M.D., M.S., M.P.H., Centers for Disease Control and Prevention, Atlanta, Georgia

Session MB2 slides 1 (PDF : 541 kb) | Session MB2 slides 2 (PDF : 830 kb)

TB, HIV and Viral Hepatitis Co-Infection
MC2 - Monday, 10:15 a.m. to 11:45 a.m., Hill Country

This session offers continuing education credits.
Lisa Y. Armitige, M.D., Ph.D., Medical Consultant, Heartland National TB Center, San Antonio, Texas
   This presentation will review the basics of tuberculosis (TB) and the connective epidemiology between TB, HIV and Viral Hepatitis and the overall effect co-infection has on the client and the provider. The lecture targets HIV and STD healthcare providers and will provide much needed education and discussion regarding and the TB, HIV and Viral Hepatitis connection. By the end of this presentation, participants will be able to:

  • Describe the diagnosis and management of TB, HIV and Viral Hepatitis co-infection including:
  • Utilization of diagnostic tools to confirm TB and HIV co-infection
  • Choosing appropriate TB treatment regimens in HIV and HIV/Viral Hepatitis co-infected patients.
  • Recommendations for screening HIV infected persons for latent TB infection

Lunch (on your own)
11:45 a.m. to 1:15 p.m.

Monday, October 29, 2012
Learning Workshops
1:15 p.m. to 2:15 p.m.

Enhancing Advocacy: Best Practices for Effective Grassroots Organizing and Working with School Health Advisory Councils
A1 - Monday, 1:15 p.m. to 2:15 p.m., Hill Country A–B
This session offers continuing education credits.
Kathy Miller, President, Texas Freedom Network, Austin, Texas
   This presentation will introduce the basics of effective grassroots organizing and how to use these skills in your community. The presenter will explain the inner workings of a grassroots campaign, including goal development, target identification and tactic selection. Participants will also learn key points in message development and dissemination. These skills will help participants work to reduce HIV and sexually transmitted infections (STIs) through School Health Advisory Councils (SHACs). By the end of this presentation, participants will be able to:

  • Define grassroots organizing and what makes it effective;
  • Provide real-world examples of effective grassroots organizing;
  • Identify the necessary components of a grassroots campaign;
  • Develop and disseminate messages that are on point and persuasive; and
  • Identify best practices for working with SHACs.

The Link in Linkage: Strategies for Strengthening Linkage to Care and Partner Services
B1 - Monday, 1:15 p.m. to 2:15 p.m., Texas Ballroom 1

This session offers continuing education credits.
Amy Leonard, M.P.H., Senior Director of Public Health Services, Legacy Community Health Services, Houston, Texas
Gretchen Hinkle, Prevention Program Manager, AIDS Services of Austin, Austin, Texas
Susan Rokes, HIV Program Director, Planned Parenthood Gulf Coast, Houston, Texas
   Within the current HIV medical treatment paradigm, great emphasis is placed on the importance of testing and treatment. As delays in obtaining primary care have obvious implications for both treatment and transmission, it is important that the barriers and facilitators inherent in the linkage to care process are examined in order to determine a way to lessen any future client delays. The second goal of the National HIV/AIDS Strategy (NHAS) is to “increase access to care and optimize healthcare outcomes for people living with HIV.” This presentation aims at addressing this NHAS goal by offering strategies to increase the number of newly diagnosed people linked to continuous clinical care. These strategies include an early intervention program called “Next Step,” an HIV Prevention Services blog and Disease Intervention Services. By the end of this presentation, participants will be able to:

  • Identify ways to strengthen linkage and adherence as a way to prevent transmission of HIV; and
  • Describe methods for evaluating the effectiveness and impact of HIV prevention programs.

Session B1 slides: set 1 (PDF : 772 kb) | set 2 (PDF : 551 kb) | set 3 (PDF : 464 kb)

HIV and Aging
C1 - Monday, 1:15 p.m. to 2:15 p.m., Texas Ballroom 5

This session offers continuing education credits.
Gene W. Voskuhl, M.D., Medical Director, AIDS Arms, Inc., Dallas, Texas
   The lecture addresses several medical issues facing people with HIV. The speaker will discuss important health aspects facing PLWH over the age of 50 including bone, kidney, cardiovascular, neurologic, and mental health issues as well as cancer. The topics are targeted to an audience that is knowledgeable about HIV topics but a medical background is not required. Those in prevention services will learn some of the issues related to transmission in the older adult population and some of the barriers to testing. Non-medical supportive sevices will gain essential knowledge to facilitate conversations with PLWH. By the end of this presentation, participants will be able to:

  • Identify diseases which affect the HIV patient who is aging;
  • Identify modifiable risk factors that have effects on health; and
  • Counsel people living with HIV on HIV disease and aging topics.

Session C1 slides (PDF : 890 kb)

Health Literacy and Medication Adherence
D1 - Monday, 1:15 p.m. to 2:15 p.m., Texas Ballroom 2

This session offers continuing education credits.
Oralia V. Bazaldua, Pharm.D., FCCP, BCPS, Associate Professor, Department of Family and Community Medicine, The University of Texas Health Science Center at San Antonio, San Antonio, Texas
   This presentation will engage the audience to discuss a vital topic that is essential for optimal health outcomes – medication adherence. Despite the Surgeon General stressing the importance of medication adherence and the topic receiving national attention, rates of medication adherence have not improved. The presenter will review national priorities and summarize practical interventions to improve medication adherence. The audience is encouraged to support and actively participate in the National Action Plan to enhance prescription medication adherence. By the end of this presentation, participants will be able to:

  • Describe evidence of how health literacy affects medication use; and
  • Describe strategies to enhance communication regarding medication use.

AIDSVu: Interactive Maps to Visualize and Contextualize the U.S. HIV Epidemic
E1 – Monday, 1:15 p.m. to 2:15 p.m., Texas Ballroom 3

This session offers continuing education credits.
Jennifer Taussig, M.P.H., AIDSVu Project Director, Rollins School of Public Health, Emory University, Atlanta
Please visit the AIDSVu exhibit and demonstration prior to this presentation from 8 to 11:30 a.m.
   This presentation will entail a detailed demonstration of AIDSVu (www.AIDSVu.org), a website housing an interactive, online map that aims to make HIV prevalence data widely available and locally relevant by mapping it at the state, county and city levels. AIDSVu’s functionality, such as the display of HIV prevalence data alongside social determinants of health data (e.g., poverty) and HIV testing, prevention and treatment site locations, will be highlighted. The presenter will suggest ways in which AIDSVu can be used by participants in their respective work by highlighting resources and information housed on the website and available for download. By the end of this presentation, participants will be able to:

  • Describe how to use AIDSVu to display HIV prevalence data alongside social determinants of health data (e.g., poverty) and HIV testing, prevention and treatment site locations.

Self-Administered Sexual Histories During Registration in STD Clinics
F1 - Monday, 1:15 p.m. to 2:15 p.m., Texas Ballroom 6

This session offers continuing education credits.
Julie Dombrowski, M.D., M.P.H., Acting Instructor of Medicine, University of Washington, Deputy Director for Clinical Services, Seattle & King County (PHSKC) HIV/STD Program, Seattle, Washington
   This presentation will focus on the implementation of self-administered sexual histories in routine STD care. The speaker will describe the experience with computer-assisted self-interview (CASI) for the collection of sexual histories in the Public Health – Seattle & King County STD Clinic, including the rationale for self-administered sexual histories and the related concept of triage to express care in STD Clinics. The presentation will include the results of analyses of data validity, express care triage, patient acceptance, and patient flow in the King County STD clinic. The speaker will discuss lessons learned in King County and options for implementing self-collected sexual histories in other STD Clinics. By the end of this presentation, participants will be able to:

  • Describe computer-assisted self-interviews (CASI) for the collection of sexual histories.

Session F1 slides (PDF : 2,205 kb) | Session F1 handouts (PDF : 292 kb)

Rethinking Professional Development in the Age of Social Media
G1 - Monday, 1:15 p.m. to 2:15 p.m., Big Bend

This session offers continuing education credits.
Corinne Weisgerber, Ph.D., Associate Professor of Communication, St. Edward's University, Austin, Texas
   This presentation will discuss ways to use social media strategically to connect with HIV/STD professionals and experts in an effort to create a personal learning network capable of supporting your professional development needs. The speaker will not only explain how to identify such experts on social media platforms, but also how to connect with them, how to share ideas with them, and how to learn from their knowledge. In essence, the presentation will teach participants to use various social technologies (such as RSS feeds, Twitter and social bookmarks) to set up a customized network of online mentors that acts as an informal alternative to the more formal professional development programs most of us are used to. By the end of this presentation, participants will be able to:

  • Define a personal learning network;
  • Describe the purpose of a personal learning network;
  • Create their own personal learning network; and
  • Identify 3 HIV/STD professionals on two different social bookmarking sites.

Supplemental Surveillance Projects
H1 - Monday, 1:15 a.m. to 2:15 a.m., Texas Ballroom 7

Part I: Substance Use and Sexual Risk among High-Risk Groups for HIV, the National HIV Behavioral Surveillance in Dallas, Texas
Shane U. Sheu, M.P.H., Epidemiologist, TB/HIV/STD Epidemiology and Surveillance Branch, Department of State Health Services, Austin, Texas
   This presentation will show that, despite variations in demographic characteristics and predominant type of HIV risk behavior, non-injection drug use is a common practice among high risk heterosexuals, men who have sex with men, and injection drug users. The association of non-injection drugs and sexual risk, even among IDU, suggests that the risk for HIV among drug users goes beyond the use of needles and is present in groups of the population that may not be primarily targeted in prevention activities. By the end of this presentation, participants will be able to:

  • Describe the epidemiology of HIV among high-risk populations in Texas
  • Describe surveillance systems used to capture HIV and STD related data

Part II: Sexual Risk Behaviors among Persons with HIV Receiving Medical Care in Texas Department of State Health Services
Sabeena Chintapalli, M.P.H., Epidemiologist, Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, Texas
Sylvia Odem, M.P.H., Epidemiologist, Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, Texas
   As of December 31, 2009, 65,473 persons were living with HIV (PLWH) in Texas. Male-to male sexual contact is the transmission category for 54% of PLWH, followed by heterosexual contact, which accounts for 24%. It is estimated that 46% of new HIV infections are transmitted by persons who know their HIV status. Unprotected anal or vaginal sex continues to be a major contributing factor for new infections in the United States. Alcohol is known to cause disinhibition and consumption before sex can lead to risky sexual behaviors. The Texas Medical Monitoring Project (MMP) 2009 dataset was analyzed to assess information on sexual risk behaviors, alcohol use before/during sex, and the access to and utilization of prevention services among people in care for HIV infection. By the end of this presentation, participants will be able to:

  • Identify potential risk factors for unprotected sex among HIV infected persons receiving medical care
  • Identify potential gaps in HIV prevention counseling
  • Describe and identify the need for HIV supplemental surveillance

Part III: The 2009 Texas Medical Monitoring Project: Agreement and Discordance of HIV Medication Data
Douglas Schuster, M.P.H., Epidemiologist/Program Specialist, Epidemiology and Surveillance Branch, Department of State Health Services, Austin, Texas
   This presentation will show how databases documenting multiple events per person can be linked to singularly-observed records for purposes of comparative analysis. Furthermore, it will highlight special considerations in the statistical analysis of data involving medications taken from both patient interviews and medical records databases. By the end of this presentation, participants will be able to:

  • Describe strategies in linking “many-to-one” records
  • Describe how to control for bias in drug data linkages

Part IV: Adherence to HIV Clinical Treatment Guidelines among Healthcare Providers in Texas
Nicole Hawkins, M.P.H., Epidemiologist, TB/HIV/STD Epidemiology and Surveillance Branch, Department of State Health Services, Austin, Texas
   This presentation will examine the provision of HIV patient care via comparison of selected U. S. Health Resources and Services Administration HIV/AIDS (HAB) clinical care measures with the Institute for Healthcare Improvement (IHI) targets for the same measures among Medical Monitoring Project participants who received care in Texas in 2009. By the end of this presentation, participants will be able to:

  • Describe core clinical HIV performance measures
  • Identify potential areas of improvement for HIV care and treatment

Texas HIV/STD Student Research Award Finalist Presentations
I1 - Monday, 1:15 a.m. to 2:15 a.m., Hill County C-D

Part I: Evaluation of a Curriculum assessing Medication Adherence in HIV-Positive Persons recently released from the Texas Department of Criminal Justice System
Olusanya Olufunto Anuoluwa, Texas A&M University Health Science Center, School of Rural Public Health, Department of Epidemiology, College Station, Texas
   Previous studies indicate that less than 30 percent of TDCJ offenders with HIV infection established a continuity of care with the Texas HIV Medication Program (THMP), which provides medication for HIV disease and other opportunistic infections, after release from prison. The Somebody Cares curriculum, implemented by peer educators within the TDCJ system, aims at increasing post-release medication and treatment adherence by changing participants’ attitude, knowledge, self-efficacy and beliefs. The evaluation attempts to measure the effects of the Somebody Cares curriculum on knowledge, behaviors, intentions, attitude and self-efficacy of the current offenders in relation to self-care, management of disease and adherence to medication. Further, the evaluation seeks to assess the post-release effects of the intervention in HIV positive ex-offenders who participated in the course.

Part II: Comparison of risky sexual behaviors between younger and older men who have sex with men in Houston, Texas
Michelle Wilkinson, M.P.H., University of Texas Houston School of Public Health, Department of Epidemiology, Houston, Texas
   Men who have sex with men 50 years or older (MSM; OMSM) continue to be sexually active; therefore, they continue to be at risk for acquiring HIV infection. By 2015, researchers estimate more than 50% of HIV infected individuals in the United States will be among those 50 years old or older, but there is limited research on OMSM risk behaviors. The majority of HIV research among MSM focuses on young MSM2 (YMSM; 13-24 years), yet OMSM engage in comparable risky sexual behaviors with regards to partner numbers and condom use. This study estimated the prevalence of risky sexual behaviors of OMSM and YMSM in Houston and compared the prevalence of behaviors between cohorts.

Part III: Race/ethnicity and HIV/AIDS in the eligible metropolitan areas, transitional grant areas and colonia counties of Texas
Warangkana Ruckthongsook, M.S., University of North Texas, Department of Environmental Science, Denton, Texas
   Higher HIV/AIDS rates mostly occur in metropolitan areas, along the U.S.-Mexico border, and across East Texas. Previous research suggests that spatial and racial/ethnic disparities in HIV/AIDS may reflect differences in extreme poverty and sexual risk behavior that are location specific. This study investigates spatial and race/ethnic disparities of HIV/AIDS in Texas. We hypothesize that: 1) in metropolitan areas and across East Texas, dominant modes of exposure does not differ among race/ethnic groups, and MSM dominates. However, heterosexual sex dominates along the U.S.-Mexico border for all race/ethnic groups; 2) late tester rates are higher along the U.S.-Mexico border than metropolitan areas; 3) late testing is much higher among Hispanics than Whites and Blacks in Texas.

Monday, October 29, 2012
2:30 p.m. to 3:30 p.m.
Learning Workshops

The Texas Black Women’s Initiative: Change Begins with Me… HIV Ends with Us
A2 - Monday, 2:30 p.m. to 3:30 p.m., Texas Ballroom 3

This session offers continuing education credits.
Deborah Carr, Assistant Senior Public Health Advisor, HIV/STD Prevention and Care Branch, Texas Department of State Health Services, Austin, Texas
Linda Hollins, M.B.A., HIV/STD Program Manager, Health Service Region 6/5 South, Texas Department of State Health Services, Houston, Texas
Mary Chapman McIntosh, M.Ed., Capacity Building Consultant, Department of State Health Services, Austin, Texas
   In response to the disproportionate rate of new HIV infections diagnosed among Black women in Texas, the TB/HIV/STD/Viral Hepatitis Unit at the Texas Department of State Health Services (DSHS) in partnership with the National Alliance of State & Territorial AIDS Directors (NASTAD) established the Texas Black Women’s Initiative (TX BWI) in 2010. The goal of the TX BWI is to strengthen the ability of DSHS and their partners to effectively administer and implement HIV/AIDS programs for Black women. The TX BWI features an asset-based, community implementation model of effective and innovative program activities through a design of seven regional teams. By the end of this presentation, participants will be able to:

  • Describe three strategies to launch an effective statewide prevention initiative in rural and urban jurisdictions; and
  • Describe the collaboration between national (NASTAD), state (DSHS) and local (HDs and CBOs).

Session A2 slides (PDF : 1,500 kb) | Session A2 handouts (Zip : 3,541 kb)

Integrating Mental Health and Substance Abuse Care with HIV/AIDS Prevention
B2 - Monday, 2:30 p.m. to 3:30 p.m., Texas Ballroom 5

This session offers continuing education credits.
Sharon Asonganyi, M.P.H., Capacity Building Assistance Coordinator, Behavioral and Social Science Volunteer Program, American Psychological Association (APA), Washington, DC
Kenneth Foster, Sr., Ph.D., Associate Professor, Texas Women’s University – Department of Psychology and Philosophy, Behavioral and Social Science Volunteer (BSSV), American Psychological Association (APA), Washington, DC
   Working with people who have both mental health and substance abuse disorders is a common and difficult challenge for those working on the front lines of HIV prevention. Front line prevention workers often face challenges about how to identify problems and prioritize goals. In part, this confusion arises from the fact that the relevant service delivery systems each have their own goals, language, and set of assumptions about what is best for their clients have remained largely unstated until conflict arises over how to address the needs of a particular client. Unfortunately, organizations and systems associated with primary HIV care, mental health care, substance abuse care, and HIV prevention programs often operate separately and lack integration. This presentation will briefly highlight findings on the relationships between mental health issues, substance abuse disorders, HIV risk behavior, and health-related behaviors for people at high risk for acquiring HIV and for people living with HIV. This session will introduce participants to numerous strategies and resources for developing a coordinated system of screening, brief intervention and referral to treatment that can be integrated into existing HIV prevention programs. For more information about the American Psychological Association’s (APA) Behavioral and Social Science Volunteer Program, a Capacity-Building Assistance (CBA) Provider funded by CDC, visit the Program website. By the end of this presentation, participants will be able to:

  • Describe a triage protocol for how to integrate mental health and substance abuse screening, brief intervention and referral to treatment into the client intake process; and
  • Identify at least two key benefits of integrating MH, SA, and HIV prevention.

Session B2 slides (PDF : 2,466 kb)

HIV in Latinos
C2 - Monday, 2:30 p.m. to 3:30 p.m., Big Bend

Francisco Ruiz, M.S., Senior Manager, Health Equity, National Alliance of State & Territorial AIDS Directors (NASTAD), Washington, D.C.
   This interactive session will serve as the Texas launch the National Latino AIDS Agenda (the Agenda), a policy document that identifies a set of priorities aimed at addressing the domestic Latino HIV/AIDS epidemics and strategic action steps tied to measurable outcomes. The Agenda was developed based on an extensive literature review, as well as numerous quantitative and qualitative assessments. This session will provide participants with tools to develop local responses to HIV/AIDS among Latino communities. By the end of this presentation, participants will be able to:

  • Describe the unique social and contextual factors that contribute to the HIV/AIDS epidemics in the U.S. Latino population.
  • Identify specific recommendations that address the HIV/AIDS prevention, research, policy and care and treatment needs of Latino communities.
  • Discuss the steps necessary to create robust dialogue and partnerships to effectively strengthen state and local efforts to reduce new infections and ensure access to quality care for all Latinos living with HIV/AIDS.
  • List the recommendations outlined in NASTAD’s seminal documents, including: Latino Policy Document, Call to Action, Latino Gay Men Report and Statement of Urgency.

Texas HIV Medication Program 101 for Service Providers
D2 - Monday, 2:30 p.m. to 3:30 p.m., Hill Country A-B

This session offers continuing education credits.
Dwayne R. Haught, M.S.N., A.C.R.N., Manager, Texas HIV Medication Program, Department of State Health Services, Austin, Texas
   This workshop will introduce service providers and clients to the Texas HIV Medication Program (THMP) and cover issues such as eligibility, medication order processing and recertification. THMP staff will discuss what constitutes a complete application and provide tips on common errors in submitting an application. The presentation will also cover the benefits and the eligibility process for the two programs under the THMP umbrella, the AIDS Drug Assistance Program (ADAP) and the State Pharmacy Assistance Program (SPAP). The workshop will also provide introductory information on how to access medication assistance through drug manufacturers. Personnel who assist individuals in applying for the THMP are encouraged to attend. By the end of this presentation, participants will be able to:

  • Describe the eligibility criteria for the HIV State Pharmacy Assistance (SPAP) Program and the AIDS Drug Assistance Program (ADAP); and
  • Describe two methods of medication assistance available through drug manufacturers.

Community Viral Load
E2 - Monday, 2:30 p.m. to 3:30 p.m., Texas Ballroom 2

This session offers continuing education credits.
Moupali Das, M.D., M.P.H., Assistant Clinical Professor, Divisions of HIV/AIDS and Infectious Diseases, SFGH, University of California, San Francisco, California; Director of Implementation Science and Evaluation Research, HIV Prevention Section, San Francisco Department of Public Health, San Francisco, California
   This presentation will address the importance of community viral load (CVL) as a treatment marker and San Francisco’s strategies and use of CVL. By the end of this presentation, participants will be able to:

  • Discuss the importance of community viral load (CVL) as a treatment marker.

Session E2 slides (PDF : 1,151 kb)

Meeting the Health Care Needs of Lesbian, Gay, Bisexual, and Transgender People
F2 - Monday, 2:30 p.m. to 3:30 p.m., Texas Ballroom 1

Rodney VanDerwarker, M.P.H., Administrative Director and Vice President, The Fenway Institute at Fenway Health, Boston, Massachusetts
   This session will present demographics on Lesbian, Gay, Bisexual, and Transgender (LGBT) communities, some of the health disparities experienced by this population and factors that influence these disparities. Fenway Health is a health care organization founded in 1971 to enhance the wellbeing of the LGBT community through access to the highest quality health care, education, research and advocacy. The presentation will describe Fenway Health’s model of care for the LGBT community, highlight many of Fenway’s programs and share lessons learned. Participants in this workshop will be provided the opportunity to discuss how these lessons can be applied to their own work. By the end of this presentation, participants will be able to:

  • Identify at least two health disparities experienced by LGBT people.
  • Describe two programs that Fenway Health has created to address the needs of the LGBT community.
  • Identify one lesson learned by Fenway Health about working with the LGBT community and apply it to your own organization.

Session F2 slides (PDF : 3,005 kb)

Intimate Partner Violence and HIV/STD: Taking a look at Reproductive Coercion and Provider Responses
G2 - Monday, 2:30 p.m. to 3:30 p.m., Hill Country C-D

Surabhi Kukké, M.P.H., Texas Council on Family Violence, Austin, Texas

Antiretroviral Treatment Access Study (ARTAS)
H2 - Monday, 2:30 p.m. to 3:30 p.m., Texas Ballroom 6

This session offers continuing education credits.
Richard Rapp, Ph.D., Assistant Professor, Wright State University, Dayton, Ohio
   This presentation will provide background on the Antiretroviral Treatment Access Studies (ARTAS), findings from the research and core components of the ARTAS model for linking people newly diagnosed with HIV into medical care. The implications of the findings for working with newly diagnosed and resistant patients will be discussed. By the end of this presentation, participants will be able to:

  • Describe the core components of the ARTAS model.

The Ball House and Pageant Community
I2 – Monday, 2:30 p.m. to 3:30 p.m., Texas Ballroom 7

Kirk Myers, M.P.H., Chief Executive Officer, Abounding Prosperity, Dallas, Texas
Felipe Rocha, M.S.S.W., Manager, DSHS TB/HIV/STD/VH Unit, Austin, Texas
   The Ball House and Pageant Community is largely composed of working class Black and Latino young people. These young people are men who have sex with men (MSM) as well as transgender male-to-female persons at high risk for HIV infection as well as other STDs and who tend not to access conventional medical or HIV/AIDS services. Come learn about this population and the strategies being used to reach them.

Monday, October 29, 2012
Poster Presentations
3:45 p.m. to 5:30 p.m.
Texas Ballroom 4

P1 – Electronic Laboratory Reporting and Hospital Recruitment: Lessons Learned in HIV Surveillance
Biru Yang, Ph.D., M.P.H., Epidemiologist/Biostatistician, Houston Department of Health and Human Services, Houston, Texas
   The Health Information Technology for Economic and Clinical Health (HITECH) Act, enacted as part of the American Recovery and Reinvestment Act of 2009, aims to promote the adoption and meaningful use of health information technology (HIT). In 2010, the HDHHS HIV Surveillance Program started an initiative to actively recruit local hospital laboratories for electronic laboratory reporting (ELR). This poster aims to describe the lessons learned from this initiative and to provide recommendations for future ELR projects. During the ELR project period, we conducted an online survey and identified 25 laboratories that performed HIV tests and were interested in ELR. We successfully recruited nine laboratories during the project period. We developed tools and hosted weekly conference calls to monitor project progress, which included establishing IT connectivity, performing unit testing and/or integrated testing. We also developed a Participation Agreement with hospitals to specify the terms related to ELR. Electronic laboratory reporting can increase the accuracy and completeness of the HIV surveillance data, which is critical for HIV prevention program planning and evaluation. This ELR project piloted the best practices and demonstrated the steps for successful hospital recruitment.

P2 - Integration of Surveillance and Public Health Follow-up for HIV in Texas
Presenting Author:
Rebecca T. Filipowicz, M.P.H., M.S., M.C.H.E.S., Manager, TB/HIV/STD Surveillance Group, Department of State Health Services, Austin, Texas
Additional Authors:
Jennifer A. Chase, M.S.P.H., Department of State Health Services, Austin, Texas
Karen M. Arrowood, M.P.H., Department of State Health Services, Austin, Texas
Jonathon D. Poe, M.S.S.W., Department of State Health Services, Austin, Texas
Sharon K. Melville, M.D., M.P.H., Department of State Health Services, Austin, Texas
   The Centers for Disease Control and Prevention (CDC) strongly recommends that partner services be provided to all newly diagnosed HIV cases in order to decrease HIV transmission and reduce HIV incidence (MMWR, Nov 2008). In accordance with these recommendations, the Texas Department of State Health Services (DSHS) aims to expeditiously initiate public health follow-up for all eligible newly diagnosed cases through integrated HIV surveillance and partner service activities. The objective of this presentation is to review the process through which HIV-related electronic laboratory reports (ELRs) are used to initiate HIV surveillance and public health follow-up activities and highlight outcomes of public health follow-up activities in Texas.

P3 - Unique Testing Experience for acute HIV Infection: Dallas County NAAT
Presenting Author:
Brian Emerson, B.S., QC/QA Coordinator and HIV-1 RNA (NAAT) Supervisor, Dallas County Health and Human Services, Laboratory Services, Dallas, Texas
Additional Authors:
Shayma Haq, B.S., Dallas County Health and Human Services, Dallas, Texas
Jennifer McCarver, M.P.H., Dallas County Health and Human Services, Dallas, Texas
Barry Mullins, M.P.H., Dallas County Health and Human Services, Dallas, Texas
Daniel Serinaldi, B.S., Dallas County Health and Human Services, Dallas, Texas
Edward Bannister Ph.D., Laboratory Director, Dallas County Health and Human Services, Dallas, Texas
   Detecting Acute HIV Infections is critical in HIV prevention since individuals are the most infectious during this stage. The DCHHS Laboratory developed and validated a pooling method testing nonreactive EIA specimens and nonreactive or indeterminate Western Blot specimens using the Gen-Probe HIV-1 RNA Qualitative Assay. DCHHS detected 119 HIV-1 RNA reactive specimens from 2009-2011. Twelve new HIV diagnoses were found through public health follow-up (2010-2011).

P4 - HIV Perinatal Transmission Prevention: Substance Abuse among HIV-Infected Pregnant Women
Presenting Author:
Tristan Broussard, M.P.H., Surveillance Investigator, HIV/STD Surveillance, Houston Department of Health and Human Services, Houston, Texas
Additional Authors:
Karen J. Chronister, Ph.D., Houston Department of Health and Human Services, Houston, Texas
Shawta Sackett, R.N., M.P.H., Grant County Health District, Washington
Veronica Anderson, Houston Department of Health and Human Services, Houston, Texas
Robert Hines, M.P.H., Houston Department of Health and Human Services, Houston, Texas
   The rate of perinatal HIV infection among HIV-exposed infants in Houston/Harris County was 2.6% in 2999, 1.6% in 2005, and 1.2% in 2008. Epidemiologists and prevention partners should examine potential barriers to continuing and maximally reducing the perinatal HIV transmission rate. One barrier may be the use of illicit drugs during pregnancy. This poster is a descriptive analysis of HIV-exposed infants and their mothers in Houston/Harris County. Crude and adjusted odds ratios were calculated for positive HIV status and various exposures including substance abuse noted on an HIV positive pregnant woman’s chart, a positive urine analysis for substance abuse during pregnancy, and a positive urine analysis for substance abuse during or after labor and delivery. Odds ratios were also calculated for the three well-known missed opportunities for preventing perinatal transmission as outcomes (no prenatal care, no antiretroviral medications during pregnancy, and no antiretroviral medications during labor and delivery or at birth) with the same individual exposures. Between 2005 and 2008, 18% of HIV positive pregnant women in Houston had substance abuse noted in their prenatal or labor and delivery records. Of the HIV-positive infants born between 2005 and 2009, 43% had mothers with substance abuse. In Houston/Harris County, the odds ratio of having an HIV infected infant when an HIV-positive woman has substance abuse noted in her chart is 3.39 (95% confidence interval = 1.2 – 9.4). The odds ratio of an HIV-positive woman not having prenatal care who had substance abuse noted in her chart is 5.5 (3.0 – 10.0). Identifying HIV-positive pregnant women with substance abuse issues during pregnancy may further reduce the rate of perinatal HIV infection in Houston/Harris County.

P5 - Syphilis (All Stages and Congenital) Epidemiology in Bexar County
Presenting Author:
Cara J. Hausler, M.P.H., Interim STD/HIV Branch Manager, San Antonio Metropolitan Health District, San Antonio, Texas
Additional Author:
Sonya M. Hughes, M.P.H., San Antonio Metropolitan Health District, San Antonio, Texas
   In order to effectively inform and direct STD and HIV prevention and service activities, timely and accurate epidemiological data are needed. This poster will provide a general overview of the current epidemiology of syphilis in Bexar County over time, with a focus on congenital syphilis. The Bexar County 2010 congenital syphilis rate (42.8) was five times higher than the national average (8.7) and 1.7 times higher than the state of Texas (25.3). It will address questions of who (sex, race/ethnicity, age) is being reported with syphilis, how it is being transmitted, what geographic areas are most affected, and how these factors have changed over time. An insight into the local populations with syphilis will assist decision makers in syphilis prevention.

P6 - HIV Infection Epidemiology in Bexar County
Presenting Author:
Cara J. Hausler, M.P.H., Interim STD/HIV Branch Manager, San Antonio Metropolitan Health District, San Antonio, Texas
Additional Author:
Sonya M. Hughes, M.P.H., San Antonio Metropolitan Health District, San Antonio, Texas
   In order to effectively inform and direct HIV and STD prevention and service activities, timely and accurate epidemiological data are needed. This poster will provide a general overview of the current epidemiology of HIV infection in Bexar County over time. Preliminary data indicate that new HIV infections in Bexar County increased in 2011 by over 25%. It will address questions of who (sex, race/ethnicity, age) is being diagnosed with HIV, how it is being transmitted, what geographic areas are most affected, and how these factors have changed over time. An insight into the local populations with HIV infection will assist decision makers in HIV prevention.

P7 - Monitoring of HIV-Infected Cohort Receiving Antiretroviral Therapy in Houston/Harris County, Texas: Clinical Outcome and Treatment Response
Presenting Author:
Osaro Mgbere, Ph.D., M.P.H., Epidemiologist-Biostatistician/Project Coordinator, Houston Department of Health and Human Services, Houston, Texas
Additional Authors:
Salma Khuwaja, M.D., M.P.H., Dr.PH., Houston Department of Health and Human Services, Houston, Texas
James Gomez, B.S., M.P.H., Houston Department of Health and Human Services, Houston, Texas
Brian Goldberg B.A., Houston Department of Health and Human Services, Houston, Texas
Lydwina Anderson, B.S., Houston Department of Health and Human Services, Houston, Texas
Karen Miller, M.S., Houston Department of Health and Human Services, Houston, Texas
Cepeda Grimes, B.S., M.P.H., Houston Department of Health and Human Services, Houston, Texas
   The CD4 count and HIV viral load are used to help determine when to initiate therapy, and they provide prognostic information on HIV disease progression and response to therapy. This study examined the outcome of antiretroviral treatment regimens on viral load and CD4 cell counts of HIV-infected cohort in Houston/Harris County, Texas. Data from a population-based behavioral surveillance project conducted in 2009 was used for this study. The data comprised of medical record abstractions of 398 HIV+ patients (≥ 18 years of age) receiving medical care in Houston/Harris County. CD4 cell count was described using median values, while viral load was based on viral load suppression levels (detectable and undetectable). These were compared between classes of clinical and demographic variables. Data was subjected to statistical analysis using SAS 9.2 (SAS Institute Inc., Cary, N.C.) procedures for complex survey data. Findings indicate that 76% (95%CI: 69.7-82.0) of the study population were on antiretroviral therapy. Females recorded a significantly (p<0.05) higher median CD4 cell counts than males (472.4 ± 27.8 cells/µL vs. 426.7 ± 13.7 cells/µL). Overall, 37.5% (95%CI: 31.8-43.1) of the patients had undetectable viral load with a male-female ratio of 3:1. Age category of patients was significantly (p<0.01) associated with viral load suppression, with age less than 50 years being 2 times (OR: 1.96; 95%CI: 1.19-3.25) more likely than age greater than 50 years to have undetectable viral load. About 17.5% of the patients were at AIDS-defining stage (below 200 cells/µL). The race/ethnicity of the patients and number of healthcare visits had no significant (p>0.05) effects on CD4 cell count and viral load. The study shows significant improvement in the health status of the HIV-infected patients. Community-wide monitoring of viral load and CD4 cell count may assist in determining HIV disease progression and effectiveness of therapy at population and individual levels, and promote optimal health outcomes.

P8 - Profile of Poor Survivors after Diagnosis with AIDS, Texas, 1997–2005
Presenting Author:
Craig L. K. Boge, M.P.H., Epidemiologist, TB/HIV/STD Epidemiology and Surveillance Branch, Department of State Health Services, Austin, Texas
Additional Authors:
Jennifer Chase, M.S.P.H., Department of State Health Services, Austin, Texas
Miranda Fanning, M.P.H., Department of State Health Services, Austin, Texas
Rebecca Filipowicz, M.P.H., M.S., C.H.E.S., Department of State Health Services, Austin, Texas
Sharon Melville, M.D., M.P.H., Department of State Health Services, Austin, Texas
   Healthy People 2020 established a nationwide goal that 90.2% of all cases diagnosed with AIDS would live at least three years after diagnosis. From 1992-1996, Texas observed a large increase in the proportion of AIDS cases in the state surviving at least three years. Since 1997, no significant reductions in the proportion of poor survivors, defined as those not living at least three years after AIDS diagnosis, have been observed, which has kept Texas below the Healthy People 2020 survival goal. This study looked to determine whether significant changes in the profile of poor survivors may provide an explanation for the stable three-year survival proportion.
P8 - Poster (PDF : 59 kb)

P9 - Epidemiology of HIV and AIDS in Houston/Harris County
Presenting Author:
Jeffrey A. Meyer, M.D., M.P.H., Epidemiologist Supervisor, Houston Department of Health and Human Services, Houston, Texas
Additional Authors:
Yvonne Lu, M.D., M.P.H., Houston Department of Health and Human Services, Houston, Texas
Karen J. Chronister, Ph.D., Houston Department of Health and Human Services, Houston, Texas
Marcia Wolverton, M.P.H., Houston Department of Health and Human Services, Houston, Texas
   This poster will describe the epidemiology of HIV and AIDS in Houston/Harris County, Texas. Analysis of AIDS cases showed a rapid increase from 1981 through 1992. With the use of highly active antiretroviral therapy (HAART) in 1996, the number of new AIDS cases precipitously dropped through 1999. Early in the epidemic, 2% of the AIDS cases were in females, 11% in blacks and 6% in Hispanics. By 2010, 26% of new cases were female, 57% black and 27% Hispanic. From 1999 through 2010, AIDS cases have been gradually increasing among both sexes with differences by race. Analysis of HIV infection diagnoses showed a decrease from 1999 through 2003 with a gradual increase through 2010. However, the number of new cases in young men who have sex with men (13 to 24 year olds) has more than tripled over the same time period, mainly in blacks and Hispanics. In 2010, the rate of new HIV infection diagnoses (diagnoses/100,000 population) in males was 3.3 times the rate in females. Blacks had 6.1 and Hispanics 1.5 times the rate of new HIV infection diagnoses in whites. Graphs and tables will be presented showing trends in AIDS and HIV cases and the current proportion of new cases by sex, race, age, and transmission risk factor. A map will be presented showing the geographic distribution of new HIV cases by zip code.
P9 - Slides for poster (PDF : 500 kb)

P10 - Effectiveness of Abstinence Only versus Comprehensive Sex Education for Youth
Dwayne Morrow, Jr., Prevention Services Program Manager, AIDS Foundation Houston, Houston, Texas
   The city of Houston is the fourth largest city in the nation, with a population of over two million residents. Houston, along with the rest of Texas, has adopted an abstinence-only sex education approach in public schools. Pregnancy rates and sexually transmitted infections in the youth population continue to increase on a yearly basis. Abstinence-only programs fail to provide teenagers with the knowledge and skills needed to make informed decisions regarding sexual health. The implementation of a comprehensive and culturally sensitive sex education program will supply teenagers with the skills and knowledge they need to protect themselves from HIV, STDs, and unwanted pregnancy.

P11 - Retrospective Analysis of HIV Epidemiology in an Academic Center with a Mixed Rural and Non-Rural Population
Presenting Author:
Travea A. McGhie, M.D., M.P.H., Infectious Disease Fellow, Texas A&M College of Medicine, Scott and White Memorial Hospital, Temple, Texas
Additional Authors:
John K. Midturi, D.O., M.P.H., Texas A&M College of Medicine, Scott and White Memorial Hospital, Temple, Texas
Maureen Johnson, M.Sc., Texas A&M College of Medicine, Scott and White Memorial Hospital, Temple, Texas 
   There is a paucity of information on people living with HIV/AIDS in Central Texas, in terms of rural verses non-rural residents and their respective outcomes. The objectives of this study were to determine epidemiological characteristics and outcomes of these patients in an HIV clinic at an academic center. To accomplish these goals, a retrospective analysis of patients in the HIV clinic from January 1990 to December 2008 was performed. Individuals’ demographics, including immune profiles at enrollment and most recent were obtained. Patients were analyzed as active, lost to follow-up, or deceased, and as residing in rural (<10, 000 population) or non-rural (>10, 000 population) communities. This data was then analyzed.
P11 - Handout (PDF : 154 kb)

P12 - Comparing the Spatial Patterns of HIV/AIDS among Areas of Extreme Poverty in Urban and Rural Texas
Presenting Author:
Meagan Hatton, University of North Texas, Denton, Texas
Additional Authors:
Joseph Oppong, M.A., Ph. D., Chetan Tiwari, M.A., Ph. D.
   The epidemiologic profile of persons living with HIV (PLWH) in Texas presents a complex relationship between infection and a variety of demographic, behavioral, and socio-economic factors. While it is known that the number of PLWH are highest in areas with extreme poverty and low socioeconomic status (SES), with particular emphasis on educational attainment and poverty, a comparison of the influence of these factors on the disease between urban and rural contexts has not been done. This study presents a comparative epidemiological profile of PLWH among areas of low SES stratified by urban and rural location.

P15 - Implementing “Healthy Relationships” with Women of Color: Lessons from the Field
Presenting Author:
Nancy Amodei, Ph.D., Clinical Professor, Division of Community Pediatrics, University of Texas Health Science Center at San Antonio, San Antonio, Texas
Additional Authors:
Veronica Villela-Perez, B.Sc., University of Texas Health Science Center at San Antonio, San Antonio, Texas
Mercedes Vaughn, M.S., University of Texas Health Science Center at San Antonio, San Antonio, Texas
Amanda Miller, M.P.H., University of Texas Health Science Center at San Antonio, San Antonio, Texas
   Although the majority of people living with HIV/AIDS know their status, about a third continue to engage in risky behaviors that put others at risk of infection and themselves at risk of acquiring other pathogens. Women’s HEART is a federally-funded multi-component intervention designed to improve timely entry and retention in quality HIV care for women of color in the San Antonio Targeted Grant Area. The intervention was intended to enhance the current system of care by providing outreach, medical coordination, patient navigation, peer advocacy and a cognitive-behavioral HIV prevention intervention. This presentation focuses on our experience in implementing the HIV prevention intervention component, namely “Healthy Relationships,” an evidence-based group-level intervention designed for men and women living with HIV/AIDS. The presentation will review our experience in implementing the intervention with mostly Hispanic women and will provide suggestions for other agencies wishing to implement this intervention.
P15 - Poster (PDF : 360 kb)

P16 - Condom Access and HIV/STD Incidence in San Antonio, Texas: Is There a Connection?
Presenting Author:
April Biasiolli, M.A., Research Area Specialist (Intermediate) ,University of Texas Health Science Center at San Antonio, San Antonio, Texas
Additional Authors:
Mercedes Vaughn, M.S., University of Texas Health Science Center at San Antonio, San Antonio, Texas
Anthony A. Scott, Ph.D., University of Texas Health Science Center at San Antonio, San Antonio, Texas
   While attitudes and intentions, and their relationship to condom use, have been studied extensively, little work has examined the connection between condom access and HIV/STD incidence. This study examines condom access in seven Bexar County zip codes, comparing condom access in demographically similar areas with HIV and chlamydia incidence. Although condoms are widely available in all incidence categories, important differences can be found. Prices were higher in high-HIV areas. Likewise, other factors that make condom purchase and use more likely (privacy while selecting, lack of need for staff assistance, and availability of larger packages) were largely not in place, especially in higher-incidence areas.

P17 - Disclosure, Sexual Risk Factors and Health Protective Behaviors of HIV Positive Women
Presenting Author:
E. Gail Gutierrez, R.N., B.S.N., M.S.N., FNP-BC, CDE, Clinic Manager, Scott and White Healthcare, Waco, Texas
Additional Author:
Jane Dimmitt Champion, Ph.D., D.N.P., M.A., A.P.R.N., FNP, AH-PMH-CNS, FAAN, Texas Tech University Health Sciences Center, Lubbock, Texas
   Over one fourth of all new HIV infections occur among women. Of these new infections the majority were attributable to heterosexual contact. Due to this mode of transmission, prevention programs have been challenged to refocus from a prevention approach with presumably HIV-uninfected individuals to prevention with HIV-positive individuals. This study seeks to describe the association between self-disclosure of HIV status, sexual or physical abuse, and education of family and friends regarding healthy sexual practices following disclosure among HIV-positive women.

P18 - Case Manager Perspective: Recommendations for Building Capacity to Serve HIV-Positive Clients
Presenting Author:
Michele A. Rountree, Ph.D., Associate Professor, University of Texas at Austin, School of Social Work, Austin, Texas
Additional Authors:
Jeremy Goldbach, Ph.D.
Meredith Bagwell, M.S.S.W.
   It is important to increase access to the mental health (MH) and substance abuse (SA) services of PLWHA in order to enhance their quality of life and improve adherence to HIV/AIDS treatment. HIV case managers play a critical role in linking clients with specialized services. This discussion will review the findings of a study seeking to examine HIV case managers’ knowledge of the barriers and facilitators encountered by their HIV-positive clients when seeking and adhering to MH and SA treatment as well as determine the level of use of MH and SA assessment tools by case managers, and their comfort level in administering those assessments.

P19 - Depression Correlates with Poor Virologic Suppression in an Urban Ryan White Clinic
Gene W. Voskuhl, M.D., Medical Director, AIDS Arms, Inc., Dallas, Texas
   Depression is a significant confounder to adherence to HAART, with a direct impact on mortality and progression of HIV. We examined the correlation of depression based on the Patient Health Questionnaire (PHQ-9) to clinical outcomes. A retrospective review was done of all individuals receiving outpatient medical care at our clinics between January 1, 2010 and December 31, 2011 who completed a depression screen using the PHQ-9. We analyzed differences in demographics and clinical outcomes for individuals with a PHQ-9 score <10 versus ≥10. Of the 1261 HIV infected individuals, 84.9% were screened for depression. A higher proportion of white females had a score ≥10 compared to those with a score <10 (29% vs. 13%). Viral suppression (VL <48) was a higher proportion in the group with PHQ-9 scores <10 than those with a score ≥10 (60.9 vs. 45.2%). Individuals with PHQ-9 scores ≥10 are less likely to be virally suppressed. There appears to be a racial difference in answering PHQ-9 questions. Additionally, depression may impact adherence to HAART as depicted in the percentage of those virally suppressed. This emphasizes the importance of depression screening in managing HIV patients.

Monday, October 29, 2012
20x20 Presentations
3:45 p.m. to 4:15 p.m.


T1 - Writing Errors
Texas Ballroom 7

Loretta Holland, C.F.R.E., Executive Director, Waterloo Counseling Center, Austin, Texas
   Do you struggle with the “writing” part of grant writing? Learn common mistakes made in writing grant proposals and how to avoid them.
T1 - 20x20 slides (PDF : 1,892 kb)

T2 - Preparing for the Next Level – Applications, Resumes and Interviews
Hill Country C-D

Deborah Carr, Assistant Senior Public Health Advisor, HIV/STD Prevention and Care Branch, Department of State Health Services, Austin, Texas
   Career advancement or simply trying a new job can be tough in the current job market. This presentation will focus on completing your job application, fine tuning your resume and preparing for an interview.
T2 - 20x20 slides (PDF : 608 kb)

T3 - Sexual Assault: Special Considerations for STD Prevention and Treatment
Texas Ballroom 3

Rachel Lowry, R.N., B.S.N., CA-CP SANE, Dallas County Health and Human Services, Denton County SANE Team, Dallas, Texas
   Sexual assault is a very traumatic experience and can happen to anyone regardless of age, gender or sexual orientation. This could lead to behavioral changes could lead to more risky behavior and increases the possibility of contracting STDs. If someone has been a victim of sexual assault, there needs to be a huge emphasis follow-up care regarding physical and mental health.

T4 - Organizational Evaluation to Promote System-wide Organizational Improvements
Hill Country A-B
Manisha H. Maskay, Ph.D., Associate Executive Director, Community and Client Services, AIDS Arms, Inc., Dallas, Texas
   Process and outcome evaluation have become a routine and expected part of program development and implementation in the public health arena. In order for individual programs to thrive, all critical agency processes and outcomes must function optimally. Conducting regular agency-wide evaluations enables organizations to identify specific areas that need improvement and/or must be strengthened in order to improve performance at all levels, overall quality of services, sustainability, staff development and other key components. It also contributes significantly to the integration of programs and the removal of silos. This session will use a ‘20X20’ format to quickly present strategies for conducting an organization-wide evaluation and allow ample time for audience engagement and discussion regarding promoting staff and board engagement, managing challenges and obstacles, as well as analyzing and utilizing results for optimal impact.
T4 - 20x20 slides (PDF : 303 kb)

T5 - A Community-Based Program Using Antiretroviral Therapy as Prophylaxis Following Sexual Exposure to HIV
Texas Ballroom 2

Kimberly Fitzpatrick Malerba, R.N., B.S.N., Nurse Manager, LMC, Legacy Community Health Services, Houston, Texas
   Despite general availability of condoms and HIV prevention education, an estimated 1,200 new HIV infections occur annually in Houston. Although significant advances have been made in the treatment and clinical management of HIV disease, new infections impose a heavy burden on infected individuals and their families, and heavy costs on society and the healthcare system. Research data from the animal model suggest that the timely use of antiretroviral therapy may abort a nascent HIV infection. Through a collaboration of private donors, community-based organizations, pharmaceutical research companies, and healthcare professionals who specialize in infectious diseases, we developed and implemented a program of non-occupational post-exposure prophylaxis (nPEP) that targets communities at high risk of HIV acquisition. Our program aims to make evidence-based use of a biomedical intervention to prevent the forward transmission of HIV infection.

T6 - The Psychological Side of Taking HIV Medication
Texas Ballroom 6
Melissa Grove, M.S., L.P.C., Executive Director, Legacy Counseling Center, Dallas, Texas
   The key to successful living with HIV is medical compliance and adherence to medication. These lifesaving actions are often ignored or done inconsistently, with negative results on the health of the HIV-positive person. The majority of the time, this is due to psychological barriers such as denial, fear, and anxiety, as opposed to physical barriers such as side effects. This brief talk will address the psychological barriers that clients face in taking medications and attending doctor’s appointments.
T6 - 20x20 slides (PDF : 267 kb)

T7 - Conducting Population-Based HIV/AIDS Survey: Challenges and Integrated Experiential Solutions
Texas Ballroom 5

Presenting Author:
Brian Goldberg B.A., Epidemiology Surveillance Investigator, Houston Department of Health and Human Services, Houston, Texas
Additional Authors:
Lydwina Anderson, B.S., Houston Department of Health and Human Services, Houston, Texas
Karen Miller, M.S., Houston Department of Health and Human Services, Houston, Texas
James Gomez, B.S., M.P.H., Houston Department of Health and Human Services, Houston, Texas
Osaro Mgbere, Ph.D., M.P.H., Houston Department of Health and Human Services, Houston, Texas
Salma Khuwaja, M.D., M.P.H., Dr.PH., Houston Department of Health and Human Services, Houston, Texas
   HIV/AIDS surveys have been conducted for a variety of purposes and on a diverse set of populations with established records of successes and disappointments under different scenarios. This presentation discusses the issues and challenges faced in locating, recruiting, tracking, and interviewing HIV/AIDS patients receiving care in outpatient clinics. Recognizing the socio-economic and cultural diversity of the target clients population, we developed a varied approach to track and interview patients. The presentation also describes the approach taken to maintain the methodological rigor of the evaluation, which includes adapting a flexible interview protocol, maintaining the objectivity of the interviewer, maintaining the independence of the interviewer from job roles, and protecting client confidentiality among others. The Medical Monitoring Project (MMP) is a surveillance project designed to learn more about the experiences and needs of people who are receiving care for HIV. It provides information about the behaviors, medical care, and health status of people living with HIV. The project uses a three stage-probability sampling method to achieve annual representative samples of adults (18 years and above) receiving HIV/AIDS care in Houston/Harris County. A sample of about 400 patients is selected each year from participating health care facilities in Houston/Harris County. Patients are recruited for a face-to-face or telephone interview. The patient’s medical chart abstraction is then used to complement the interview data. Knowing the potential challenges and pitfalls in recruiting sampled HIV/AIDS patients and the recommended guidelines and solutions could help improve the representativeness of the sample, reduce the apparent bias of the respondents, and yield more diverse participants. Information gathered from the MMP may be used by prevention planning groups, policy leaders, health care providers, and people living with HIV to highlight disparities in care and services and advocate for additional resources.

T8 - HIV Among Adolescents: A Texas-Sized Dilemma
Big Bend
James Dalton Keel, III, M.S.N., R.N., C.C.R.N., Nurse Consultant, Pan-West Regional HIV Services, STARCare Specialty Health System (formerly Lubbock Regional MHMR), Lubbock, Texas
   The 2009 HIV Surveillance Report, published by CDC, revealed growing rates of adolescents and young adults contracting HIV. Middle and late adolescence is a time when young people engage in risk-taking and sensation-seeking behaviors. Although, drugs and alcohol can increase the chances of unsafe behavior by altering judgment and decision-making, engaging in unsafe sexual practices greatly increases the risk of contracting HIV. Surprising insight is noted with regard to some race and socioeconomic groups being impacted more than others. The presenter will demonstrate missed opportunities for early detection, peer driven risk behaviors, and sexual and social contributors to risk among youth.

T10 - Alternative Sexuality and Risk Reduction
Texas Ballroom 1
Darriane Martin, M.S., Program Director, HIV Prevention Department, AIDS Arms, Inc., Dallas, Texas
   Conversations about sexual behavior and sexual based risk reduction are required for HIV/STD prevention. However, too often those charged with helping individuals become aware of and reduce sexual-based risks are uncomfortable discussing ‘traditional’ sexual activities (vaginal and oral) while alternatives to traditional sexual activities such as needle-play or anal sex outside the MSM population are rarely even considered. Being unwilling or uncomfortable in discussing alternative sexual activities inhibits the counselor’s ability to adequately assess the client’s risk behaviors and offer relevant risk reduction information. This discussion will offer an opportunity for those working in HIV/STD prevention a safe place to learn about and explore high-risk alternative sexual activities. Strategies for managing discomfort related to assessing risk as well as working with the client to brainstorm effective risk reduction techniques will also be discussed. Participants will also develop skills for remaining sex positive while helping the individual integrate risk reduction techniques in their sex life.
T10 - 20x20 slides (PDF : 1,291 kb)

Monday, October 29, 2012
20x20 Presentations
4:30 p.m. to 5:00 p.m.

T11- United Black Ellument: Using Social Events as Effective HIV Prevention Methods
Texas Ballroom 2

Doran Senat, B.A., Administrative Coordinator, United Black Ellument/Resource Center Dallas, Dallas, Texas
   Young black MSM (YBMSM), aged 18-29, are contracting HIV at very high rates, and innovative approaches to increasing HIV testing and reducing sexual risk behavior are needed. Many YBMSM do not want to go to programs that are clearly about HIV/AIDS. One strategy that is being used to reach this population is to create and host social events to draw out this population. This discussion will discuss important ingredients in such social outreach methods that are likely to increase the HIV prevention content of such events. We will discuss the model used by United Black Ellument, a theory-based, community-level HIV prevention intervention method being implemented in Dallas, Texas by Resource Center Dallas in collaboration with the Center for AIDS Prevention Studies, University of California, San Francisco. Workshop participants will get experience in developing social outreach events of varying types, will learn about how to implement such events with the use of volunteers and a youth advisory group, and will experience how to develop safer sex and HIV testing materials.
T11 - 20x20 slides(PDF : 2,033 kb)

T13 - Early Diagnosis Program (EDP): a Community Approach
Texas Ballroom 1

Norman Mitchell, CEO, Bee Busy Learning Academy, Inc., Houston, Texas
   Communities of color are particularly impacted by the HIV epidemic, and are disproportionately infected, having nearly seven times the number of new HIV infections as that of their white and Hispanic counterparts. The Early Diagnosis Program (EDP) is designed to provide community level awareness and free HIV screenings to the highest impacted residents of Houston and surrounding areas. EDP locates persons who are newly diagnosed as being HIV positive and links them into care and services. Clients are recruited and retained in care through street outreach, internet outreach, social marketing and simple program incentives. Once engaged, clients receive the EDP brand of "In-Yo-Face" counseling and testing that has had a tremendous impact on the targeted population. This presentation will share client level data gathered by EDP within the last 12 months.
T13 - 20x20 slides (PDF : 1,080 kb)

T14 - A Peek Behind the Medical Curtain: HIV Stigma Among Healthcare and Social Service Providers
Texas Ballroom 6

Leslie Denice Conley, L.M.S.W.-IPR, HIV Services Part D Case Manager, Parkland Health and Hospital System, Dallas, Texas
   Stigma is one of the greatest barriers to providing timely HIV treatment and preventing new HIV infections. The consequences of stigma on patients are wide ranging and contribute to psychological suffering, decreased access to services, denial, disclosure issues, and lack of prevention efforts. Unknowingly, healthcare staff and social service providers often contribute to this stigma through their beliefs and actions. While HIV stigma was painfully obvious and often acceptable in the late 1980s, there is still limited recognition of the link between HIV stigma and public health outcomes. Not only does stigma strike at an individual and family level, it also has significant implications as it interferes with our attempts to fight the epidemic and prevent new infections worldwide. This presentation will cover the effect of stigma on the HIV care continuum, including identification of stigmatizing behaviors, care and support of individuals with HIV, and prevention of HIV stigma. Various examples of such behaviors and beliefs will be provided and discussed.
T14 - 20x20 slides (PDF : 545 kb) | handout #1 (PDF : 116 kb) | handout #2 (PDF : 262 kb)

T15 - The Innovation Project
Texas Ballroom 3

Mary VanWisse, Ph.D., Training Specialist, Health Communication and Community Engagement Group, TB/HIV/STD/Viral Hepatitis Unit, Department of State Health Services, Austin, Texas
Mary Cullinane, R.N., WHNP-BC, Nurse Consultant, HIV/STD Prevention and Intervention Services Group, Department of State Health Services, Austin, Texas
   The Innovation Project began as a response to changes occurring at a state and national level as well as a desire for changes in the way we work. Complexity theory, neuroscience and readings focused on human motivation guided group members to use tools like appreciative inquiry, learning circles, the reflexive practice and other methods to “lift our vision” of the way we work. Participants have discovered better ways to work and seek to share ideas in hub chats and through everyday conversation. Ideas will be shared with discussion to follow.
T15 - 20x20 slides (PDF : 1,286)

T16 - Case Manager Perspective: Recommendations for Building Capacity to Serve HIV-Positive Clients
Texas Ballroom 7

Michele A. Rountree, Ph.D., Associate Professor, University of Texas at Austin, School of Social Work, Austin, Texas 
   It is important to increase access to the mental health (MH) and substance abuse (SA) services of PLWHA in order to enhance their quality of life and improve adherence to HIV/AIDS treatment. HIV case managers play a critical role in linking clients with specialized services. This discussion will review the findings of a study seeking to examine HIV case managers’ knowledge of the barriers and facilitators encountered by their HIV-positive clients when seeking and adhering to MH and SA treatment as well as determine the level of use of MH and SA assessment tools by case managers, and their comfort level in administering those assessments.

Performance as Prevention – The T.R.U.T.H. Project
Monday, October 29, 2012
6:30 p.m. to 8:30 p.m.
Texas Ballroom I


Tuesday, October 30 and Wednesday, October 31 can be found here

 


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Last updated November 16, 2012