1. Emerging AHP Strategies for Recruitment
Maria E. Alvarez, MPA
CDC/NCHSTP/DHAP/PPB
Public Health Advisor
Duty Point: NYC

2. Recruitment
An activity or set of activities intended to bring persons at high risk for being exposed to or for transmitting HIV into interventions to promote the adoption and maintenance of risk-reduction behaviors
A critical element to the success of any intervention

3. Recruitment
Strategies to engage members of a target audience/population into HIV prevention interventions, care, and services
Promotion of awareness of HIV programs
Outreach, referral network, social marketing, community-level interventions and individual-level interventions

4. Fundamental Strategies for Recruitment
Outreach
Intensive/Enhanced/Targeted
In-reach
Referral Network
Social Marketing
Community Level Interventions (CLI)
Individual Level Interventions (ILI)

5. Outreach
Working in the community rather than waiting for the community to come to the agency or organization
A set of activities conducted in the community to
provide HIV prevention information
communicate the benefits of early knowledge of one's serostatus
conduct risk-reduction interventions
promote agency programs
refer or link persons at high risk to prevention interventions and services

6. Outreach
Conducted by peers, health educators, or outreach workers on the streets and face-to-face
Conducted in specific venues where persons at high risk congregate, such as neighborhood streets, parks, bars, bathhouses, adult book stores, shooting galleries, or crack houses

7. Outreach (Intensive or Enhanced )
Implements a “higher threshold outreach” with specific objectives and methods for engaging high-risk populations and or sub-populations into care and treatment
Uses non-traditional venues and hours
Provides a direct connection to needed and or wanted services as well as consistent support
Encourages recruitment into prevention interventions, care, and services (using highly trained and experienced peers)
Enhanced Outreach Workers are trained and cross-trained in a variety of topics, harm reduction, behavior change and motivational interviewing. They provided consumers with a continum of services that may include HIV counseling and testing, and referring individualss to prevention case management, supportive and health care services.

8. Outreach (Targeted)
Designed to reach a specific population or sub-population of persons, as opposed to “general outreach,” which may involve mass mailings and tabling of information (e.g., health fairs) and is not targeted to any particular audience

9. In-reach
Educational activity that provides HIV prevention information and promotes HIV program services to its own staff and to persons participating in services and programs
Conducted in the waiting areas or during an intake process for programs serving high-risk persons

10. Referral Networks
Are an important strategy for recruiting persons at high risk into HIV intervention activities
Identifies other providers of services to the same population
Develops reciprocal agreements between service providers

11. Referral Networks Bi-directional (most often)
Formal mechanism for client referrals and service provision, delineating responsibilities
Broader HIV prevention services, including
Clinics
Substance abuse treatment facilities
Homeless shelters
Domestic violence programs
Health department based STD, TB, or hepatitis related services

12. Social Marketing
Planning and implementation of programs designed to bring about social change using concepts from commercial marketing
Social Marketing includes the use of
advertising, billboards
media campaigns, public service announcements
Web site development
brochures, palm cards

13. Community Level Interventions (CLI)
Seek to improve the risk conditions and behaviors in a community through a focus on the community as a whole
Work to alter social norms, policies, or characteristics of the social environment
Implement community-wide events, policy interventions, and structural interventions

14. CLI and Activities
Outreach to promote awareness of program services (e.g., agency meetings, conferences, health fairs)
Health communication/public information (e.g., presentations at community forums, use of print/electronic media, telephone hotline, information clearinghouse, resource library)
Social marketing campaigns
Community mobilization

15. Individual Level Interventions (ILI)
Assist clients make plans for individual behavior change and ongoing behavioral appraisals
Facilitate linkages to services in both clinic and community settings in support of behaviors and practices that prevent transmission of HIV
Help clients make plans to obtain needed services
Provide health education/risk reduction counseling to one person at a time

16. ILI Activities Client intake
Assessment of clients’ strengths and developmental assets as well as risks for HIV infection or transmission
Comprehensive HIV prevention education and counseling, e.g., abstinence, risk reduction, interpersonal/ negotiation skills development
Prevention Case Management (PCM)

17. ILI Activities
HIV Counseling and Testing (on-site or through a direct referral agreement)
Partner notification assistance counseling and communication skills-building for HIV positive clients
Referral and follow-up to needed services (e.g., primary health care, STD screening/tx, pregnancy testing, substance use, mental health, housing, education, employment, legal services)

18. ILI Activities Crisis interventions
Outreach to provide HIV prevention/risk- reduction education
Distribution of HIV prevention/risk- reduction supplies and materials (e.g., male and female condoms, dental dams, bleach kits, print/video/audio educational materials)

19. In Conclusion…. Emerging AHP Strategies
Depends gravely on RECRUITMENT
And remains key in effectively working with the three primary areas of HIV prevention that CDC is emphasizing:
Early detection of persons who are HIV positive and referral to care services
Prevention interventions with persons living with HIV
Prevention with persons who are at high risk for HIV infection

20. Recruitment Is Critical to Successful HIV Prevention