Baton Rouge Strategy Meeting March 1, 2011 Baton Rouge Area Foundation

Afternoon Goals Present information on HIV/AIDS data for the Baton Rouge MSA Identify an HIV prevention strategy or set of strategies that are community defined and driven Devise an action plan for community mobilization around the identified prevention strategy or strategies

Understanding Baton Rouge’s AIDS Case Rate What is the Baton Rouge MSA? – Baton Rouge Metropolitan Statistical Area (MSA) is 9 parishes Ascension East Baton Rouge East Feliciana Iberville Livingston Pointe Coupee St. Helena West Baton Rouge West Feliciana

Baton Rouge MSA Population and Demographics – 2009 Total Population is 786, % increase since 2000 – 49% Female, 51% Male – 60% White – 36.5% Black – 2.3% Hispanic – 1.7% Asian – Median Age 33.7 years (national is 36.3) – Almost 85% of people age 25+ are high school graduates

Quick Definitions Incidence: The number of newly diagnosed cases of a disease (New HIV cases, New AIDS cases) Prevalence: The total number of cases of disease existing in a population (Persons living with HIV/AIDS) Incidence Prevalence Death

Incidence – Baton Rouge MSA : 331 persons newly diagnosed with HIV 2009: 216 persons newly diagnosed with AIDS NEW HIV CASESNEW AIDS CASES Sex Females Males 37% 63% 38% 62% Race Black White Hispanic 86% 12% 1% 86% 13% 1% Age at Diagnosis Under and Older 27% 47% 26% 11% 53% 36%

HIV Case Rate by Louisiana MSA

AIDS Case Rate by Louisiana MSA

2008 Estimated AIDS Case Rates US Metropolitan Areas CDC 2008 HIV Surveillance Report, Vol 20

Persons Living in the Baton Rouge MSA

Is Baton Rouge at a disadvantage statistically because of the number of prisons in the MSA? 2009 the BR MSA had a HIV Prevalence rate of 553 per 100,000. If you take out the prisoners (in state correctional facilities only) this only drops to 506 per 100,000. Removing prisons does not account for high prevalence rates in the BR MSA

Persons Unaware of Status The CDC estimates that 21% of all people infected with HIV are unaware of their HIV status. If you apply this percentage to the Baton Rouge MSA: – 1,208 persons living with HIV in the Baton Rouge MSA who have not been diagnosed and are unaware they are infected.

What C&T sites identify the most new positives? Identification of new infections between 10/1/09-9/30/10 OPH Region 2 STD clinic – 30 (1.0% positivity) EKL ER – 24 (1.3% positivity) Metro - Main office – 17 (2.0% positivity) Metro - Mobile unit – 12 (2.1% positivity) Capital City – 12 (2.0% positivity) Hunt Correctional – 8 (.2% positivity) East Baton Rouge PHU – 6 (.5% positivity) Metro - EBR Parish prison – 5 (1.6% positivity) ***Example- for Hunt to identify 8 new infections, they tested over 4000 individuals***

What are the sub-populations and risk categories we should be concerned about? African American Men MSM IDU Prisoners Youth Pregnant Women, Exposed babies Transgender individuals

AgencyHIV C&T Evidence Based Interventions Social Marketing Case Management Medical Care HIV Treatment (Medicatio ns) Other supportive services for PLWH/A FSGBR VOA YWCA Metro Health BRASS YMCA Overview of Programs already provided by CBOs in the Baton Rouge MSA

AgencyHIV C&T Evidence Based Interventions Social Marketing Case Management Medical Care HIV Treatment Other supportive services for PLWH/A Capitol Area Phoenix Initiative EKL-Early Intervention Clinic Capitol Area Reentry Program HAART, Inc. Planned Parenthood Our Lady of the Lake Overview of Programs already provided by CBOs in the Baton Rouge MSA- continued…

AgencyHIV C&T Evidence Based Interventions Social Marketing Case Management Medical Care HIV Treatment Other supportive services for PLWH/A Women’s Hospital Baton Rouge Area Alcohol and Drug Center AIDSLaw Capitol City Family Health Center Face to Face Overview of Programs already provided by CBOs in the Baton Rouge MSA- continued…

Map of Services- Whole MSA

Map of Services- City of Baton Rouge

How much investment is going into program categories Program Category and Funding SourceEstimated Amount Designated for the Baton Rouge MSA Services Ryan White Part A$3,117,985 Ryan White MAI$292,595 ADAP (25% of state total)$5,151,350 Prevention C&T$961,122 Condoms$56,306 Behavioral Interventions & Outreach$296,042 DIS and other staff$548,905 Capacity Building and other gap funding Pennington and LCAP*~$285,000 *LCAP- Includes funding from AIDS United (National AIDS Fund) Baton Rouge Area Foundation, Wilson Foundation, Pennington Foundation, Keller Family Foundation, OPH-SHP and others

Overview of the State’s HIV/AIDS Prevention Funding Categories From the OPH STD/HIV Solicitation of Offers- $1,100,000 (25% likely to go to Region 2): HIV Counseling, Testing and Referral/Linkage; HIV Screening and Referral/Linkage; HIV Testing through Social Networks; STD Screening; Prevention Materials Availability; Programs Targeting Men Who Have Sex with Men; Outreach, Referral and Linkage; Prevention With Positives

From the Baton Rouge Part A Application- $3,825,000: Ambulatory Outpatient Medical Care; AIDS Pharmaceutical Assistance (Local); Oral Health; Early Intervention Services; Medical Case Management; Mental Health Services; Substance Abuse Outpatient Services; Non-Medical Case Management; Food Bank; Legal Services; Psychosocial Support Services; Emergency Financial Assistance; Medical Transportation; Outreach. Overview of the City’s Ryan White Funding Categories

Our Collective Community-Level Goal Decreasing/preventing the number of people who test positive for HIV and other STDs in Baton Rouge MSA If this is the goal- where are the gaps? Exercise: Group Discussion and identification of programming gaps

Suggested menu of most promising Community Based HIV Prevention Practices Information, education, and communication (IEC) – HIV/AIDS Awareness Social Marketing Campaign – HIV/AIDS & STD 101; awareness raising – School-based sex education – Condom promotion & distribution Expanded HIV Counseling & Testing – MSA-wide testing campaign: Example DC or Oakland – Opt-out testing in Emergency Rooms – Social Network Testing – School Based Clinic Testing – Community Health Center Testing Evidence based interventions – SISTA; Many Men Many Voices; Mpowerment; Project Respect; Willow; SIHLE Expanded Services – Access to care – Housing – Access to medication – Transportation

Criteria for choosing strategies Reach- The strategy is likely to affect a large percentage of the target population. Mutability- The strategy is in the realm of the community’s control. Transferability- The strategy can be implemented in communities that differ in size, resources, and demographics. Effect size- The potential magnitude of the health effect for the strategy is meaningful. Sustainability of health impact- The health effect of the strategy will endure over time.

Community Mobilization Framework- What is your role? Working on getting a better version of this graphic!!!

Group Exercise to Devise a Community Mobilization Plan Group 1- Information, Education, Communication – What type of media vehicle? – Targeted at whom? – What resources are needed? – How does it match up against the criteria? Group 2 – Expanded HIV Counseling & Testing – What type of sites? – Targeted at whom? – What resources are needed? – How does it match up against the criteria? Group 3- Evidence Based Interventions – Who should be targeted? (Community level, group, individual?) – What intervention(s) are best suited to fit the need? – What resources are needed? – How does it match up against the criteria Group 4- Expanded Services – What service gaps exist? – What is achievable through community mobilization? – What resources are needed? – How does it match up against the criteria?

Group Exercise Break up into your 4 groups Answer questions on the previous slide…then What action steps can you take to endorse? What action steps can you take to support? What action steps can you take to participate? What action steps can you take to build action coalitions? Remember: You and your organization are change agents!

Deliverables How intervention rates again criteria List of action steps that can realistically be done Schedule next group meeting time and location Make sure your call to action is completed- submit top part to us and keep the bottom for yourself

Group Reports: Action Steps for Mobilizing the Community Around our Goals Action steps from afternoon group reports Feedback and critique from morning training participants

Next steps after today Build a community mobilization action plan document Disseminate amongst today’s participants and other Baton Rouge MSA stakeholders Others?

Questions about today? Please contact: Susan Bergson Louisiana Public Health Institute/Louisiana Community AIDS Partnership Michael Robinson