OPA/OFP HIV Prevention Project Annual Technical Support Conference Report from Breakout Sessions – Day 1 Karla Johnson, MSPH Executive Director Development Systems, Inc. Region VII RTC June 13, 2007

Topics Discussed Significant impact stories: More staff and client acceptance of testing as a result of increased training and integration CDC HIV integration toolkit available through Regional Training Centers Changed how HIV test was tracked in charts to clarify whether a test had been performed

Topics Discussed (cont’d) No longer see clients in terms of “high risk” High proportion of clients who tested positive as part of screening were not “high risk” Increased staff awareness of and screening for substance abuse All staff trained to deliver results Negative results available by telephone using password protected dial-in system

Topics Discussed (cont’d) Able to implement HIV rapid testing in more sites, which increased test volume Some clinics have been able to obtain HIV grants funds to cover cost of testing, which means those clinics can offer free HIV testing

Issues Raised Cost of rapid testing and increased demand Financial/legal implications of opt-out testing Resistance to CDC recommendations from AIDS community and CBOs Lack of definition for “integration” Continued limited access to client HIV charts Lack of treatment resources available for clients who test positive Declining availability of federal funding

Issues Raised (cont’d) Need for staff and client surveys to assess training and service needs Staff concerns related to delivering test results (times, resources, support) Moving away from paradigm of HIV “counselingandtesting” is very challenging HIV still viewed by staff as “death sentence” Need for public education about stigma

Issues Raised (cont’d) Resources needed to focus on ABC, evaluation (e.g. staff) at odds with resources needed to implement CDC recommendations (i.e. increased testing) ABC is very difficult to evaluate Some states still require multi-day HIV training before staff can offer test Limited resources to provide staff training; interrupts clinic operations

Suggested Solutions (cont’d) Make HIV testing routine and opt-out Need to lower cost of rapid tests Develop a strategy for making rapid testing sustainable Streamline counseling and shift more resources toward expanding testing Integrate HIV staff into general clinic staffing Identify most effective integration strategies (e.g. HIV test with Pap or STD screening)

Suggested Solutions (cont’d) Education… education… education Reframe HIV as a chronic disease OPA/CDC websites should include best practices, and disseminate sooner than later Keep Annual Technical Support Conference Make “Integrating HIV Prevention in FP” available from OPA website TV, radio commercials and Mobilization Campaign should address stigma

Suggested Solutions (cont’d) Partner with HIV/STD, AETC and ATTC training centers for HIV training Train nurses/staff who may not be skilled in providing services to male users Train staff on new CDC recommendations and new HIVPP requirements Train all staff on HIV basics, including stigma, transmission, prevention