Lessons Learned: PPC’s experience with HIV prevention from 1990 to the present. Susan Lane OPA Title X HIV conference June 12, 2007

HIV/AIDS in Connecticut CT ranks 8 th among states in the rate of AIDS cases (19 per 100,000 in 2005) State health officials estimate that as many as 20,000 CT residents are infected with HIV.  39% are women—as compared to 26% nationally  34% are white; 27% are black; 36% are Hispanic.  About half live in three cities—Bridgeport, New Haven and Hartford.

Late 80s, early 90s We provide information about prevention, but patients referred to local health depts and other agencies for counseling and testing.  HIV still considered peripheral to family planning. 1989: PPC receives funds from U.S. Conference of Mayors to prepare a training video on HIV prevention.

Early 90s 1994: PPC receives federal HIV prevention funds from state Department of Public Health.  Even though PPC not considered an “AIDS organization.” 1995: PPC staff undergoes 5-day state certification for HIV counseling and testing.  State health department directs state funded HCT to send “low risk” referrals to PPC.

Late 90s PPC revises its HIV counseling to incorporate transtheorectical model of behavior change  Meeting clients where they are; rather than one-size fits all counseling PPC integrates HIV testing into annual and initial exams.  In conjunction with state DPH, we develop a special 2-day training for clinicians PPC begins offering Orasure, the saliva-based HIV test.

: PPC allows some patients to receive results by telephone. 2004: Two PPC centers pioneer use of rapid HIV testing.  Today rapid testing accounts for about 30% of all HIV tests.  % would be higher if covered by insurance plans. 2006: PPC pioneers off-site HIV testing  At AIDS Walk New Haven, local fairs, National HIV testing day, as part of outreach at commercial nursery, monthly at a soup kitchen.

What we have learned over the years HIV/AIDS is about sex, sexual health, sexual decision making.  Not just disease prevention. People don’t know their risk  Can anyone really assess his or her risk Women and men will go outside their local town to be tested.  Centers in “high risk” geographical location may not necessary have highest number of positives.

What we have learned over the years People are willing to be tested—but how we test needs to fit into their lives. The culture is changing around HIV/AIDS.  Cost v. confidentiality  Partners “requiring” negative HIV test