Session 3 Workshops


Session 3 Workshops


TBA December 3, 2019 4:30 pm - 6:00 pm

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Client Contact for the Improvement of PrEP Persistence

Track: Navigation, Retention and Re-engagement

Location: Montgomery A, Level 2

Presenters:

Nicholas Davis, Howard Brown

Chad Hendry, Howard Brown

Howard Brown Health has taken a stance to promote PrEP to our clients who feel they may be at risk of HIV exposure. Until recently, the number of clients who consistently remain on PrEP, however, is less than desirable. The goal of this program is to provide a monthly list of 500, cis-women of color, transgender, and young MSM individuals that will 1) run out of PrEP during the upcoming month and/or 2) have not had a primary care visit in the previous six months. Two PrEP navigators are responsible for attempting, by phone, each of the 500 individuals a minimum of three times as a chance to help the individuals navigate their upcoming refill and possible primary care visit. The goal is to help navigate any circumstances that may prevent a client from continuing to take PrEP, thus increasing our clients’ overall persistence on PrEP continuation.

Sexual Networks and Social Determinants of Health to Increase PrEP Uptake

Location: Clear Lake, Level 3

This workshop will discuss how social determinants of health and sexual networks can increase PrEP Uptake. It will include the following presentations:

The Burden of Transportation

Track: Engagement, Retention and Re-Engagement

Presenter:

Dennis Chau, Texas Health Action – Kind Clinic

Limited data exists on the burden of transportation for patients accessing pre-exposure prophylaxis for HIV (PrEP). This workshop covers techniques for mapping patient locations, identifying clusters of significant PrEP access and lack of access, and quantify the burden of transportation on patients. Methods used to calculate distance will be discussed alongside usage of logistic regression to identify the probability difference associated with each increase in mile of distance away from clinic.

The second part of the workshop focuses on implemented solutions that help alleviate the burden of transportation for patients alongside challenges encountered when implementing different programs. Additionally, this part of the presentation will also include techniques on reaching patients in specific locations such as: physical media, geo-fencing for app-specific advertisements, and outreach events.

How Latino MSM’s Sexual Network Configurations Can Facilitate PrEP Uptake

Track: Implementation Research

Presenters:

Stephen Fallon, Latinos Salud

Yoel Moreno, Latinos Salud

Noe Inestroza, Latinos Salud

Latino men who have sex with men (LMSM) account for 92% of new HIV diagnoses among Latino men living in Miami Dade County. Miami has the highest HIV incidence and third highest HIV prevalence of all metropolitan U.S. cities.  PrEP uptake and continuation are both lower amongst Latino MSM than amongst non-minority MSM in South Florida.  Known barriers inhibit PrEP awareness and acceptance: limited Spanish language campaigns, cost of PrEP medications and required clinic visits, discomfort with healthcare systems.  How can prevention providers reach all of the target community to share information that can overcome these barriers. University researchers wished to understand how information about PrEP travels through networks of Latino MSM in Miami-Dade.  By partnering with a community-based organization, this study identified networks that can be utilized to reach more at-risk community members and ultimately disseminate information about PrEP availability and effectiveness to those who remain unaware, or who have inaccurate information.

The following were authors of the study being discussed: Mariano Kanamori, PhD, Department of Public Health Sciences, University of Miami Miller School of Medicine Stephen Fallon, PhD, Latinos Salud; Victor Gonzalez, Latinos Salud; Cho Hee Shrader, MPH, Department of Public Health Sciences, University of Miami Miller School of Medicine; Susanne Doblecki-Lewis, MD, Division of Infectious Disease, University of Miami Miller School of Medicine; Steven Safren, PhD, Department of Psychology, University of Miami; Guillermo Prado, PhD, Department of Public Health Sciences, University of Miami Miller School of Medicine.

PrEP915: Educating, Providing, and Building PrEP in El Paso, TX

Track: Training Programs

Location: Tanglewood, Level 3

Presenters:

Elias Gonzalez, City of El Paso, HIV Prevention Program

Ogechika Alozie, Sunset ID Care

Richard Omelas, ASP Cares

Christopher Ornelas, Ventura County Health Care Agency

Despite PrEP being approved in 2012 and rapidly expanding in major urban centers, PrEP uptake has been slow to permeate communities most in need. In the context of El Paso, TX that means Latinx MSM and transgender communities on the U.S.-Mexico Border. Panelists will describe their varied efforts through community mobilization and collaboration to introduce and expand PrEP access in El Paso, a city that has unique challenges in the education, training, and provision of PrEP. Speakers will discuss early efforts to provide PrEP starting with a single provider and education provided through community mobilization work groups. Discussion will then detail community development of educational materials, outreach campaigns, and the expansion of PrEP to two local FQHCs and the opening of a PrEP clinic. Community Mobilization and collaboration have been the cornerstone tools that have facilitated the expansion of PrEP in El Paso.

Let It Flow…Exploring PrEP Adherence & Seasons of Pleasure

Track: Engagement, Retention and Re-Engagement

Location: Montgomery B, Level 2

Presenters:

Chantil Thomas, DC Department of Health

Kate Drezner, DC Department of Health

Kenneth Pettigrew, DC Department of Health

Jason Beverly, DC Department of Health

This workshop will feature a community level panel discussion exploring the idea of what it means to be adherent on PrEP and how providers are defining those parameters. Trends show that many providers do not engage patients in conversation regarding pleasure, but more so around prevention, protection, and risk. Using a sex-positive model, our findings show that patients tend to be more receptive to PrEP uptake and are more adherent when their sexual behaviors are not scrutinized. Patients yielded better outcomes when they were able to identify and define their season of PrEP use (also known as the season of pleasure not risk), and were not reprimanded when deciding to discontinue. This also resulted in patients being likely to restart PrEP when new seasons of pleasure presented.

Empowerment as HIV Prevention: Bringing the Community to Campus

Track: Community Mobilization

Location: Fort Bend B, Level 2

Presenters:

Kaye Sly, Jackson State University

Kevin Patterson, Jackson State University

Young African-American men who have sex with men accounted for approximately 97% of new HIV cases identified through our on-campus testing center. HIV prevention strategies have been largely ineffective in reducing the rate of infection among this group. Thus, new innovative strategies are needed. Given that the CDC once identified college students as the epicenter for HIV infection, and young African-American college age men in Mississippi (program site) make up the largest number of new cases of HIV cases, it is important that prevention focuses on young men attending historically black colleges and universities (HBCUs).  This presentation will describe an empowerment program for African-American gay and bisexual men that was implemented on the campus of a HBCU located in Mississippi.  The primary goals for the program were to: increase awareness about new HIV strategies (e.g., PrEP) and services, promote advocacy and facilitate linkages to care.

Two Paths, One Goal: Integrating Undetectable and PrEP

Track: Implementation Research

Location: Liberty, Level 2

Presenters:

Matthew Crehan Higgins, Evergreen Health

Ashley Zuppelli, Evergreen Health

Michael Canty, Evergreen Health

Jonathan Jordan, Evergreen Health

As the evolution of Undetectable and Pre-Exposure Prophylaxis has changed the treatment and prevention paradigms, the conversations have remained largely separate – reinforcing the existing HIV status hierarchy rather than seizing opportunity to work toward a single paradigm that makes both paths of biomedical prevention equal. With fear of knowing one’s status and dealing with social implications of the results remaining the largest barrier to testing and action, it is imperative to synergize this conversation. Evergreen Health and Trillium Health are two large community-based providers in upstate New York who will discuss their experience developing robust Pre-Exposure Prophylaxis programs and integrating same day access to treatment for those testing preliminary HIV-positive to their service delivery models. Their experience in quickly fostering newly diagnosed people to Undetectable, many of whom were diagnosed during PrEP consultation, and recognizing that they have achieved virtually the same goal will be shared.

Addressing Sexual Health Disparities In Women Living In Rural Communities

Track: Engagement, Retention and Re-Engagement

Location: Memorial, Level 3

Presenters:

Carleisha Murry, Arkansas AIDS Foundation

Cornelius Mabin, Arkansas HIV Prevention Group

Rural women of color experience poorer health outcomes and have less access to health care then women living in other areas. Many rural areas have limited numbers of health care providers, especially women health providers. An accumulative number of women in the United States are diagnosed with HIV, particularly women of color; the changing epidemic is challenging established mechanisms for the delivery of primary medical care services. Advances in HIV treatments, and the resultant longer life expectancy for those living with the disease, means primary care providers must manage the chronic medical conditions of patients living with HIV.

Fostering Transgender Awareness and Inclusion in HIV Research

Track: Implementation Research

Location: Fort Bend A, Level 2

Presenters:

Rona Siskind, Division of AIDS, NIAID, NIH

Brian Minalga, The Legacy Project

Tori Cooper, Positive Impact Health Centers

Transgender people face stigma and discrimination in all aspects of society, including in medical and research settings. These cumulative traumatic experiences often result in an unwillingness to seek care and participate in research. Given the disproportionate impact of HIV in transgender communities, especially among transgender women of color, a critical need exists to increase transgender inclusion in HIV prevention and treatment research. With this goal in mind, a group of transgender, gender non-conforming, and cisgender researchers and subject matter experts developed a transgender training curriculum to help cultivate responsiveness and cultural humility among HIV research staff.

Increasing PrEP Access: Implementation of a Pharmacist-Driven Program

Track: Implementation Research

Location: Harris, Level 2

Presenters:

Ruston Taylor, Legacy Community Health

Karen Gurwitch, Legacy Community Health

Pre-exposure prophylaxis (PrEP) has quickly become an important part of providing optimal care for any patient at risk for potentially contracting HIV.  Therefore, providing all patients with ready access to PrEP is a necessary part of any public health clinic.  However, there are real-world limitations to the availability of provider appointments to prescribe PrEP to patients.  Legacy Community Health (LCH), in an effort to improve PrEP availability to their patients, implemented a novel, pharmacist-driven program using an approved protocol for select patients to have visits completed by trained clinical pharmacists.

TelePrEP: Overcoming Road Blocks

Track: Finances and Access Models

Location: Sugarland, Level 3

Presenters:

Erika Sugimori, Louisiana Office of Public Health, STD/HIV Program

Sarah Mamo, Mozaic Program at Equitas Health

Using telemedicine for PrEP delivery is increasing due to many benefits perceived by consumers such as convenience, ease, and immediate access to specialty providers. As telecommunication technology has improved and comfort has increased using “online video chat systems like Skype or Facetime, adopting these tools for health care delivery seems inevitable.  So why are we not all doing it all the time? Concerns regarding the quality of the provider-patient interaction and reimbursement for services are just some of the concerns hampering the adoption of telemedicine. TelePrEP is an effective and efficient means to increase PrEP access, but barriers including public policy, state regulation, reimbursement, provider’s skill, and consumer knowledge must be addressed to increase the availability of TelePrEP across the United States.