The Power of Many Voices: Increasing HIV, STD and Viral Hepatitis Integration 2008 National STD Prevention Conference March 11, 2008 Introduce yourself and rest of the panel 1st slide Description The National Coalition of STD Directors (NCSD) in partnership with the Division of Adolescent and School Health (DASH) of the CDC and other national partner organizations (NASTAD, AMCHP, and SSDHPER) has been involved in an on-going national initiative to improve HIV, STD, and unintended pregnancy prevention among school-aged youth by strengthening state health and education agency partnerships. A series of National Stakeholder Meetings (NSM) were conducted from 2003-2007 with teams of state health agency representatives from MCAH, HIV/AIDS, STD, and state education agency representatives to explore common ground, identify current programming gaps, and to generate potential collaborative programming solutions. You might ask yourself well what is a National Stakeholders Meeting

Who We Are NCSD is a nonprofit partnership of public health professionals, dedicated to the prevention of STDs, who direct the overall scope of STD federally funded programs nationally. NASTAD is a nonprofit national association of state health department HIV/AIDS program directors who have responsibility for HIV/AIDS health care, prevention, education and supportive services programs. Goal To explore strategies for increasing integration of HIV, STD/viral hepatitis services where appropriate and identify barriers and methods to address the barriers to meaningful integration activities. The National Stakeholders Meeting (NSM) is a capacity-building process that brings state departments of education and health together to strengthen communication and collaboration and to support and improve HIV, STD and teen pregnancy prevention in schools. The process starts with a 2 day meeting and then technical assistance and capacity building activities follow. The National Stakeholders Collaborative, consisting of representatives from the Association of Maternal and Child Health Programs (AMCHP), the National Alliance of State and Territorial AIDS Directors (NASTAD), the National Coalition of STD Directors (NCSD), and the Society of State Directors of Health, Physical Education and Recreation (SSDHPER) designed the NSMs to promote collaboration at the state level between state health agencies and state education agencies. Since 2003, thirty-three states have participated in the NSM process.

Integration Continuum VT NH WA ME MT ND MA MN OR WI NY RI ID SD MI WY PA CT NJ IA NE IN OH NV IL DE UT WV VA CO MD CA KS MO KY NC TN DC OK AZ SC NM AR AL GA MS AK Here is our map of 33 states that we have worked with thus far. The ones in the orange are our most recent cohort. TX LA FL HI

Where Is Your Organization on the Continuum? No Integration Limited Integration Expanded Comprehensive Services Here is a list of the specific people that attend the meeting and took part in the process. As mentioned before the process is more then just a two day meeting, for approximately a year or a little longer, states that have participated are given the opportunity to request technical assistance as well as participate in some activities that are outlined in the next slides. You might be asking yourself well what why are these four organizations pulling together resources to bring these different groups to the table to increase collaboration.

Identified Challenges During the original 2 day meeting the teams take what they have learned around barriers, challenges and solutions and come up with an action plan. So approximately 6-8 weeks and 4-5 months after the initial meeting the national partners hold individual state team conference calls. Its during this time that there is an Action Plan Check-Up as well as its an opportunity for states to express any Technical Assistance Needs they might have

World Café Activity: Seeking Solutions Within your group brainstorm solutions to each challenge Challenges will rotate so that each group can address all challenges World Tour Summary

Why are collaboration and integration across HIV, VH and STD prevention important? There are common determinants that leads to transmission of HIV, VH and STD. Unprotected sex Injection drug use Interactions between health concerns increase potential for negative health outcomes. Untreated STD increase risk of HIV infection. HIV infection increases the infectiousness of STD. Common strategies can help prevent HIV, VH and STD infection. Abstinence Condoms Clean needles / syringes Health education

Why are integration and collaboration across HIV, VH and STD prevention important?

Why are integration and collaboration across HIV, VH and STD prevention important? Health concerns impact similar populations. The same populations at risk for HIV, VH and STD infection are at risk for negative health outcomes. Syndemic: Two or more afflictions, interacting synergistically, contributing to excess burden of [disparity] in a population.

Health concerns are often influenced by the same root causes. Why are integration and collaboration across HIV, VH and STD prevention important? Health concerns are often influenced by the same root causes. Lack of access to prevention services Lack of quality prevention services Stigma and discrimination, including racism and homophobia Socioeconomic factors, including poverty Lack of funding, i.e., inadequate resources often limit the potential of health efforts Lack of supportive policy, i.e., policies based on ideology often limit the potential of health efforts

Why are integration and collaboration across HIV, VH and STD prevention important?

Making the Case for Integration Uses Resources Effectively Promotes Knowledge Sharing Reduces Programmatic Gaps Applications for both are released 4 to 5 months following the National Stakeholders Meeting

Take Home Recommendations In the concept of speed dating You will have 4 minutes to ask your date for suggestions to any question/concern you have regarding integration or any business topic that will benefit your work.

One Thing? Start Stop Continue To increase integration in your project area

Participant Quote “Real collaboration requires a willingness to give things up and address that territorial stuff. It’s a willingness to share resources, power, and control and that’s really hard to do. But it is amazing what you can get done if you can.” (NSM participant) Before I turn the presentation over to California I wanted to leave you with a quote from one of our stakeholders participants Recite Quote So without further adieu let me turn the presentation over to California so that they can provide an overview of what has happened since their participation in the stakeholders meeting in 2003 and to share with you what they have learned in their work

Thank You! Dana Cropper Williams Director of Training, NCSD dcropper@ncsddc.org Chris Taylor Viral Hepatitis Program Manager, NASTAD ctaylor@nastad.org David Kern Prevention Program Director, NASTAD dkern@nastad.org