OPA/OFP HIV Prevention Project Annual Technical Support Conference Report from Breakout Sessions – Day 2 Karla Johnson, MSPH Executive Director Development Systems, Inc. Region VII RTC June 14, 2007
Internal Challenges & Solutions Challenges HIV testing viewed as “separate” Clinic flow for integrating rapid tests Suggested Solutions or Actions “Relentless” training of staff Revise clinic flow systems, consent forms to accommodate rapid testing Use example of open access
Internal Challenges & Solutions Challenges Staff resistance to testing Suggested Solutions or Actions Train staff on importance of testing and needs of clients Develop systems that incorporate HIV testing into clinic services
Internal Challenges & Solutions Challenge “Silo” funding - separate staffing, appointment systems, protocols Sustainability of rapid testing (dependent on OPA funding) Suggested Solutions or Actions Targeted testing at specific sites Sliding scale fee for rapid testing
Internal Challenges & Solutions Challenges Burden of paperwork Writing procedures Suggested Solutions or Actions Streamline and redefine reporting and documentation requirements PPFA Clinical Guidelines Manual
Internal Challenges & Solutions Challenges False positive with rapid tests Suggested Solutions or Actions Training/counseling to prepare staff/clients for false positives Quality control (i.e. storage issues)
Internal Challenges & Solutions Challenges Staff turnover Staff burnout Suggested Solutions or Actions Revisit agency mission statement Get buy-in from management team Support professional development Network with model programs
Internal Challenges & Solutions Challenges Cultural competency Suggested Solutions or Actions Understand cultural diversity and needs of client population Provide staff training and follow-up with implementation and support Counseling supervision & feedback
External Challenges & Solutions Challenge Stigma around HIV Suggested Solutions or Actions Full implementation of training materials that address stigma Social marketing and education Normalize HIV testing
External Challenges & Solutions Challenge Collaboration between HIV/AIDS CPGs and FP agencies Suggested Solutions or Actions OPA collaborate with CDC to determine how family planning and CPGs can work together
External Challenges & Solutions Challenge State requirements don’t match CDC recommendations (e.g. many require separate HIV consent) Suggested Solutions or Actions Collaborate with other CBOs, ASOs to advocate for public policy to support best practices
External Challenges & Solutions Challenge Some states require testing sites to run daily controls (huge expense) Suggested Solutions or Actions Review state laws nationwide to determine extent of this issue Find models for legislative change
External Challenges & Solutions Challenge Reimbursement (e.g. rapid testing, post-test counseling) Suggested Solutions or Actions Quantify potential loss of income and consider whether this income could be offset (e.g. sliding scale fees, streamlining)
External Challenges & Solutions Challenge Excessive training requirements Suggested Solutions or Actions Negotiate less extensive training requirements with authorizing agency for family planning staff
External Challenges & Solutions Challenge Difficulty identifying referral linkages in rural settings Suggested Solutions or Actions Network with HIV organizations to find out where PLWHA receive care, and seek out those providers for cross-referral