Recent Shared Action Activity

Welcome back from the Thanksgiving holiday! Today, we wanted to take a chance to inform you of some recent webinars we’ve produced and upcoming technical bulletins in the next few weeks.

Earlier in November, we hosted a webinar on Community Viral Load. The webinar details what CVL is, why it’s important, and how it’s used in HIV/AIDS prevention. You can view the webinar recording here.

We also hosted a webinar on Routine Testing, presented by Thomas Donohue, Director of the UCLA/Pacific AIDS Education and Training Center. You can find the webinar and its discussion of Routine Testing and its relevance to us here.

In the next few weeks, you can look forward to technical bulletins and broadsheets on these topics from us:

  • Organizational Cultural Competence Tehcnical Bulletin
  • HIV Viral Load Measures to Monitor HIV Prevention, Treatment and Care Services Broadsheet
  • Hiring Peers vs. Non-peers Technical Bulletin
  • The Linkage to Care Broadsheet
  • The Logic Model – Step One Technical Bulletin

What other topics would you like to see us address? Let us know in the comments!

Meet Shared Action – Miguel Bujanda

1. How did you get started working in the HIV/AIDS community?

I started my work in HIV Prevention and Education at a local community organization that worked with Latino Youth in East Los Angeles. I just graduated from high school and recently come out as a gay man. I was looking for a place to belong to. I started attending several discussion groups and eventually asked if I could help conduct outreach. I had found a great way to meet people and give back to the community that I belonged to and care for.

 

2. Tell us about your position at Shared Action & Shared Action HD.

I have worked in the HIV Prevention field for almost 15 years. From delivering direct prevention services to clients to evidence based research. I am currently a CBA Specialist at Shared Action. I provide skill building trainings and provide technical assistance to CDC funded organizations to build capacity. I am also trained in DEBIs. I am a trainer for PCC and ARTAS and have experience working and providing capacity building with CTR, POL, MPowerment, Community Promise and CRCS.

 

3. What is your vision for CBA?

Capacity Building is very important to HIV Programs around the country. I have always envisioned CBA for HIV Programs to be a great way of reevaluating great programs with experts from the community and developing collaborations with other organizations around the country.

 

4. Tell us about a particular experience or case you’ve worked on that stood out to you. What made it stand out?

As one of the Trainers for Personalized Cognitive Counseling, I have had the opportunity to speak to many organizations that are currently in the pre-implementation phase of PCC. There are many common questions that come up. In addition to being a trainer, as part of Shared Action, we can also provide Technical Assistance to all organizations that may need assistance. Some of the challenges that have come up are in regards to adaptation of PCC to other communities, especially in Spanish. Other times it is about integrating PCC into their current CTR programs. Since PCC requires a very specific target population, I found that many organizations are having a hard time meeting contractual objectives when there are 2- 3 other interventions utilized for HIV Testing. I have been working with several organizations and having great conversations with organizations that have been able to successfully implements and streamlined the flow of service and other organizations that continue to work towards perfecting the flow.

Routine Testing – USCA

This year at USCA 2012 I had a chance to sit in on a very interesting presentation about Routine HIV Testing in the Southern California Area. Altamed Health Services was recently awarded funds to provide HIV Testing in clinics. What makes this so special? Altamed is a Federally Qualified Health Center adopted the CDC Recommendations for HIV Testing of Adults, Adolescents and Pregnant Women in Health-Care settings in 2011. By doing so, they have incorporated HIV Testing as part of the standards tests for all patients in clinics. HIV Testing will be conducted along with, Cholesterol, Blood Pressure and Diabetes.

Altamed developed some Universal HIV Testing Goals. They systematize routine HIV Testing across its 22 Health Clinics in Southern California to increase the number of HIV screens and link newly identified HIV+ individuals into medical care. In addition to this, they would also develop a replicable model for other community health centers across the nation. Altamed’s presentation highlights some of the challenges and barriers that they encounters when implementing this complex program. They discussed the challenges of learning the essential electronic health record modifications to systematize routine HIV testing and having develop corporate-wide training strategies using videos to conduct these training.

 

Meet Shared Action – Jin Ahn

How did you get started working in the HIV/AIDS community?

I started to work in HIV/AIDS community as graphic design and web consultant here at APLA for the capacity building program: Shared Action and Shared Action HD.

Tell us about your position at Shared Action & Shared Action HD.

I currently work as the Capacity Building Assistance Specialist, Information and Communication Technology of AIDS Project Los Angeles’ CBA programs, Shared Action and Shared Action HD under the supervision of the CBA Coordinator for Information and Technology Transfer. I am in charge of developing and accessing new technologies for the improvement of capacity building in HIV prevention (e.g., CBA website, development of online trainings).

What is your vision for CBA?

Bridging the gap between CBOs and HDs.

Tell us about a particular experience or case you have worked on that stood out to you. What made it stand out?

Designing the brand identity: Shared Action and Shared Action HD.

The meaning of the brand identity for the program was very similar to my own core belief about reciprocal learning. It is very important for individuals to give back to the community, the knowledge that you have gained from education and experience.

 

 

Meet Shared Action – Miguel Chion

1. How did you get started working in the HIV/AIDS community?

Miguel Chion, Associate Director of Education - CBA Programs

I was trained as a MD in Perú and during my last year of clinical training I got involved in several AIDS cases in ER and during hospitalization. After finishing medical school and receiving my credentials, I worked as director of services for a CBO in Perú and was in charge of epidemiologic surveillance for the HIV STD National Program at the Peruvian Ministry of Health. After receiving my MPH at UCLA I continue working in the field first in Research and Evaluation at AIDS Project Los Angeles, and then in 2004 I was assigned to develop the new Capacity Building Assistance Program.

2. Tell us about your position at Shared Action & Shared Action HD.

I am the Associate Director of Education-CBA programs, and in charge of leading the capacity building efforts of Share Action and Shared Action HD.

3. What is your vision for CBA?

In the future, any stakeholder in the HIV/AIDS community (prevention providers, care providers, clinicians, leaders, community members, etc.) will have full access to capacity building services that are appropriate for their needs to continue preventing new HIV infections. These capacity building assistance services and resources would be readily available to any request as well as built into health departments and organizations with appropriate infrastructure.

4. Tell us about a particular experience or case you’ve worked on that stood out to you. What made it stand out?

Shared Action was conceived from its beginnings (as Acción Mutua in Spanish) as an evolving, fluid, strength-based, and reflexive program. These programs are continuously evolving because the learning experiences we all go through. One particular case come to my mind: A small CBO, important for the community where it is located, requested services to improve their evaluation capacity for their prevention program. The initial action plan was to conduct a training follow by technical assistance to improve their evaluation plan and activities. APLA provided its “Program Evaluation” training first. This was followed by a session in providing technical assistance (TA). During the latter, we observed that the participants did not retain any of the basic knowledge we provided, regardless how well they did in the pre and post-test. The team brainstormed about this case and came to the conclusion that no matter how standard and proven a training or strategy is, some individuals may need different methods to build their capacity. APLA re-designed the action plan, and this time we provided a clinic/coaching session in which we actively work with them in developing the evaluation plan as well as tools and at the same time reviewing the most important evaluation concepts. After these coaching sessions, the program staff were successful in improving their evaluation capacity which was acknowledged by the funding agency. Capacity building is a (never ending) process of growing that is dynamic and sometimes may require an intense interactive workshop or just sharing a piece of information that was missing. We learned long time ago that we need to get to know our clients/consumers, understand where they are, tailor our services to make appropriate, and walk with them whenever is necessary.

Meet Shared Action – Claudia Rodriguez

1. How did you get started working in the HIV/AIDS community?

Claudia Rodriguez, CBA Coordinator (ICBA)

When I was a student at UCLA, 17 years ago, I was very active in a Queer Latino student organization called “La Familia”. La Familia had a mentorship program in collaboration with a local Latino HIV/AIDS service provider organization. The focus of the mentorship program was for La Familia to work with the youth at the agency and help them get college bound, increase their self esteem and curve the notion, especially for many of the young gay men, that becoming HIV infected was their fate. Many of the activities La Familia organized and supported took place at the agency. This is where I first began to make my connections with HIV/AIDS service providers and learned about the importance of HIV education and prevention. Once I graduated from grad school I immediately got into this field.

2. Tell us about your position at Shared Action & Shared Action HD.

Officially my title is CBA Coordinator, ICBA services. This means that I am the person who receives all the individual requests from CBOs and health departments then I process the request and pass them on to one of my colleagues to work on. My teammates make my job real easy for me, with all the networking they do and great reputation that they’ve established, many of the requests we receive have been fostered by them. My job then is to make sure that all the work we do with our clients is properly recorded in our electronic records information system for reporting purposes and communicating with the CDC, our funder, should any concerns arise.

3. What is your vision for CBA?

I would like for CBA to keep on growing, knowledge wise, for us to continue to be a great resources for the community. I would also like for there to be more opportunities to work with medical providers, get their perspective on how to best address this epidemic as well as shed some best practices on how to routinize testing and work effectively with people who are living with HIV/AIDS.

4. Tell us about a particular experience or case you’ve worked on that stood out to you. What made it stand out?

Working in CBA for 6 years now, so many experiences stand out, especially those cases where you’re able to see the progress in the program you’re helping out. For the past year now, I’ve been working with a faith based organization in Puerto Rico that does HIV prevention with high risk women. I’ve helped them with writing grants, reviewing their reports, assisted with evaluation activities etc. What impressed me the most was this agency’s drive, they operate under a $30,000 annual budget yet they are so determined to educate and give so much of themselves to some of the most impoverished communities in Puerto Rico. For me it puts things in perspective, we live in a society that is so driven by excess consumption and seeing the folks at this agency give so much of themselves, literally working for free…it’s a humbling experience. Each time I met with them they were so eager to learn and put into practice their new skills because they knew that the communities they served would be better for it.

Meet Shared Action – Oscar Marquez

Oscar Marquez, CBA Coordinator for Information and Technology Transfer

1. How did you get started working in the HIV/AIDS community?

I have lived in a conservative county (Orange county) most of my life. About ten years ago, all services that were geared towards the LGBTQIA community were hidden in this area, including HIV prevention. However, though I live in Orange County I would socialize in LA County where these services were more visible. Because of my socializing in LA, I found out about support groups. I attended these groups on a weekly basis where we received education; we socialized, and received skills-building workshops. By participating in these groups, it reinforced the idea that this was something I could do and wanted to do to help others.

I first became a volunteer for a few months until I applied in different agencies. My first job was at Altamed Health Services in East Los Angeles. This was an awesome experience. I used to be an HIV testing counselor, PCM manager (now CRCS), I would facilitate groups, and anything that it is done in a non-profit….including moving furniture around.

2. Tell us about your position at Shared Action & Shared Action HD. 

I am currently the CBA Coordinator for Information and Technology Transfer.  My job is to coordinate any activities related to our websites, educational materials, and webinars to name a few. In addition to the coordinator duties, I also assist in the delivery of our core skills trainings as well a technical assistance.

3. What is your vision for CBA?

The best way I can explain on how I see the Capacity Building Assistance programs, or CBA, is to see it as a bridge. In other words, the role of CBA is to connect the dots between directives, such as NHAS or HIHP, and the actual implementation of HIV prevention programs. CBA programs are services that are meant to facilitate the process of implementing effectively programs and strategies to address HIV prevention needs.

My vision for CBA is that our programs become more visible, accepted, and understood so that any agency or jurisdiction can access them without hesitation and we can continue to assist them in enhancing their programs. By enhancing the implementation of programs around the country, it is my hope that collectively all enhanced programs can continue to make a dent in the # of new infections.

4. Tell us about a particular experience or case you’ve worked on that stood out to you. What made it stand out?

Throughout my work with CBA I’ve encountered the fact that a lot of agencies don’t know what CBA is. Sometimes, these agencies are mandated to request our services…and they do so in order to suffice the directives of their funder. One agency in particular requested our services because their funder had instructed them to request our services to address a finding in their audit. When we initially responded to the request, the agency was very hesitant to provide us with any information as they thought we were an extension of their funder and that we were also conducting an audit.

As CBA providers, we had to take a step back and, instead of addressing the request right away, we had to build the relationship and trust with them. This, in turn, worked in everyone’s favor. The agency learned to trust us and saw that we could really assist them in better implementing and evaluating their programs. What started as one request that was supposed to last no more than three months turned into three additional requests that expanded over a one year period.

Meet Shared Action – Andi Zaverl

 1. How did you get started working in the HIV/AIDS community?

Andi Zaverl, CBA Evaluation Specialist

I started working in the HIV/AIDS community as a graduate student looking for an internship and work experience in the field of public health and evaluation. A colleague who I had worked with in undergrad and graduated from my Master’s program worked for APLA and told me about the internship. After I applied and was accepted for the position I realized how much work was still needed in the area of HIV prevention and I found my place in working in the HIV/AIDS community.

2. Tell us about your position at SA & SAHD.

I am the CBA Evaluation Specialist. I more or less handle all things evaluation related, but my position really has two sides. On one side, I provide assistance with any request we receive that has to do with evaluation whether it be training, technical assistance, or information transfer. On the other side, I am also in charge of evaluating our own CBA activities to ensure we are delivering quality services, and to look at the affect our work is having on our clients. I am always curious as to how our work helps improve clients’ organizations. And, as most who work in the non-profit world know, I am not limited to Evaluation topics; I am also a trainer for the CDC DEBI intervention, ARTAS!

3. What is your vision for CBA?

As cheesy as it may sound, I really think our CBA name “Shared Action” is exactly how I visualize CBA. While we have a great deal of knowledge and experience with programs, interventions, and systems that are effective for HIV prevention, we need the experiences and context of the agency to really make these programs sing. By working together, sharing knowledge and experiences, we can assist agencies with their planning and implementation to maintain successful programs.

4. Tell us about a particular experience or case you’ve worked on that stood out to you. What made it stand out?

I was helping one agency design an evaluation plan for their social media campaign. At first this case didn’t really stand out from others. They had all the pieces, but just needed direction on how to put them together. I planned an intensive evaluation planning meeting with their stakeholders, and we meet for a full day to hammer out all of the details. What stood out was their complete dedication to the process and their program. While evaluation meetings can put most people to sleep, they had so much commitment to their campaign that their participation really created a solid practical evaluation plan that they’ve been able to maintain and implement, and has yield results that has been presented at two conferences. More and more I’m finding it’s not the programs that are successful, but the people behind the programs that make them successful.

Meet Shared Action – Jordan Blaza

1. How did you get started working in the HIV/AIDS community?

Jordan Blaza, CBA Specialist

After high school my mentor came out to me and his other favorite students that he is gay and HIV+. He told me that he could see me working in a field where I could help a lot of people like me. I wasn’t sure what he meant until some friends of mine in a club I used to go to invited me to volunteer for an HIV/AIDS organization. That’s when I learned, this could be the field my mentor saw me working in. So I volunteered and I loved it. An employment position opened at the organization, I applied, and I got it. Through work experience I learned this is the field I’m supposed to be in.

2. Tell us about your position at Shared Action & Shared Action HD.

My position here as a CBA Specialist has allowed me to use all my knowledge and skills that I’ve gained in my years working in this field. My background includes outreach, counseling, program coordination and quite a few public speaking events. I’ve also worked with people of color and with trans women. Now, a lot of the trainings I do are to help front line stuff do better in their jobs and that’s where I started, a front line staff. It’s fun that we talk about a lot of things that are not typical workplace topics; sex, drugs and alcohol. So when I tell people about my job title and description I usually end with “It’s never the same thing twice.” And they get jealous.

3. What is your vision for CBA?

CBA can keep the HIV/AIDS field from being stagnant. When I started out a while back, I thought that getting 100 completed paper surveys from people in Los Angeles county who are at risk of HIV infection was great. And because of CBA, which I didn’t understand was CBA at the time, I learned what else to do with those surveys and how the data can support our programs. Workers in this field are expected to come in with a certain level of knowledge and experience. But realistically, some things you will need extra help on because they weren’t taught in school.

4. Tell us about a particular experience or case you’ve worked on that stood out to you. What made it stand out?

In one of the trainings I conducted, the topic of transgender and HIV came up. One participant was confident in saying that the population should be served by those who specialize in trans issues. Another participant said that the problem is with regions where there’s no trans service specialists, like with this person’s organization, where they serve primarily migrant farm workers. Someone responded that there’s really no connection between migrant farm workers and trans people. This stood out for me because I was one of those workers who didn’t know these connections. Years ago, I didn’t know much about the risk taking behaviors of migrant farm workers nor their interactions with trans sex workers who “follow-the-crops”. This is how we came up with looking at the intersections of trans people with other high risk groups. We look at how trans people can be provided important and relevant non-gender specific services, like HIV testing or access to food banks, with limited to no funding.

 

HIV Pre-Exposure Prophylaxis (PrEP) is not for everyone

The Food and Drug Administration (FDA) recently approved the re-labeling of the HIV medication Truvada, which is a combination of tenofovir plus emtricitabine, for use as pre-exposure prophylaxis (PrEP) for HIV prevention.  PrEP involves the daily use of HIV antiretroviral medications HIV-uninfected individuals as a way of reducing their chances of becoming infected with the virus.  For many in the HIV prevention community the FDA approval was hailed as a milestone in the development of new biomedical HIV prevention strategies. For others, concerns remain regarding the potential for developing drug resistance among those who become infected while taking Truvada, and also the possibility of condom abandonment among PrEP adopters.  In order for PrEP to be effective in reducing new infections, it must first be accepted as a viable HIV prevention strategy by high-risk groups.

Several PrEP acceptability studies have indicated that men who have sex with men (MSM) are extremely enthusiastic about PrEP and would most likely use it.  However, the time these studies were done was before we even knew if PrEP would even work in preventing HIV infection.  Today a new reality exists for PrEP that may impact how MSM perceive of PrEP. This new reality includes the completion of multiple PrEP clinical trials, known efficacy levels of PrEP for different high-risk populations, safety information, drug resistance information, the Centers for Disease Control and Prevention’s (CDC) guidance for administering and monitoring PrEP use with MSM and, as mentioned, the FDA approval of Truvada for use as PrEP.  As a result of this new context for PrEP, the high levels of enthusiasm demonstrated in previous acceptability studies may be diminished given the true realities associated with PrEP adoption (e.g., only partially efficacious, required regular HIV testing, ongoing medical monitoring, side effects, toxicities, costs, unknown long-term side effects, etc.).  Today, the question remains, who will want and should use PrEP for HIV prevention.

PrEP is undoubtedly one of the most important contributions to our HIV prevention tool box in recent years; however, it is not a panacea and it is most definitely not for everyone.  There are particular segments of the MSM population that would most likely benefit from PrEP, such as MSM who must engage in sex work or survival sex, MSM who are unable to use condoms consistently, and HIV-negative MSM with HIV-positive partners.  For this last group, PrEP may be particularly beneficial.  HIV-negative individuals with HIV-positive partners have a continuous threat of exposure to the virus with every sexual encounter.  In a study we did with minority serodiscordant gay couples, Latino and African-American HIV-negative men told us why they would want to use PrEP:

“I am very positive about it. I think that if you are in a relationship where one partner is positive and the other isn’t, I think that to have the option to take something that has been proven to be effective is tremendous, I really do.”

“If I was prescribed the pill I would not negate condoms just because I was on the pill. I would still take that extra precaution, but just having that pill would give me just that much more assurance that I won’t contract the disease.”

“I would take it for better sex with my partner and not having the stress on my brain, worried about whether or not we did something wrong and did I contract the virus.”

For these men, PrEP would not only help prevent HIV infection, it would also help reduce the psychological distress associated with being in a relationship with someone who is HIV-positive.  There may be concerns with PrEP, and given the steps involved in accessing and using PrEP, we cannot predict if high-risk MSM will actually adopt PrEP, but to exclude it from our HIV prevention tool box, particularly for high-risk MSM noted here, would only place them at continued risk of becoming infected with HIV.  PrEP is not for everyone, nor was it intended to be, but there are certain high-risk MSM that would truly benefit from its availability.