Implementing Comprehensive HIV and HCV Programs With People Who Inject Drugs: Practical Guidance For Collaborative Interventions (The “IDUIT”)

This tool contains practical advice on implementing HIV and hepatitis C (HCV) programs with people who inject drugs. It is based on recommendations in the WHO, UNODC, UNAIDS technical guide for countries to set targets for universal access to HIV prevention, treatment and care for injecting drug users – 2012 revision and the Consolidated guidelines on HIV prevention, diagnosis, treatment and care for key populations – 2016 update.

Topics covered include community empowerment, including building the capacity of organizations and networks of people who inject drugs; legal reform, human rights and addressing stigma and discrimination; health and support services for the comprehensive package of harm reduction interventions; service delivery approaches, including engaging people who inject drugs as program staff and peer outreach workers; and program management. The tool contains examples of good practices from around the world that can be used to support efforts to plan programs and services with people who inject drugs.

The tool is designed for use by public-health officials, managers of HIV and harm reduction programs, NGOs – including community and civil-society organizations – and health workers. It may also be of interest to international funding agencies, health policy-makers and advocates.

This implementation tool is known informally as the IDUIT and is the third in a series of tools on implementing HIV programs with key populations. Other publications include the sex worker implementation tool (SWIT), published by the World Health Organization (2013), the implementation tool for men who have sex with men (MSMIT), published by the United Nations Population Fund (2015), and the implementation tool for transgender people (TRANSIT), published by the United Nations Development Programme (2016). 

Please click here for a copy of the tool. 

Colloquium: “Ask Me About PrEP – A Three-Part Digital Campaign to Increase PrEP Uptake”

April 13, 2017 – AltaMed has become a pioneer in content marketing for the promotion of HIV prevention and PrEP services. Using a digital approach they have created online conversations in target populations resulting in increased awareness on PrEP, HIV treatment and prevention. The newly launched 3-part digital campaign,“Ask Me About PrEP,” was produced to increase awareness of PrEP and reach a broad audience including medical providers in health care settings, young Black MSM and transgender women. These campaigns are designed to follow the current trend in content marketing, which over the past two decades, has grown significantly as audiences shift to new media, consuming content in entirely new ways.

The videos model conversations around PrEP and answers key concerns around the use of this prevention strategy. The campaign also highlights scenarios where PrEP can be incorporated into a person’s daily routine and why it is a responsible option to preventing HIV.

Objectives:
1. Increase PrEP knowledge and access by communities most impacted by HIV, specifically young Black gay and bisexual men and transgender women.
2. Increase provider knowledge on the effective use of PrEP in primary care settings to address HIV disparities that remain in communities of color.
3. Identify strategies to increase PrEP knowledge and prescriptions to patients in a non-discriminatory and unbiased manner using digital media.
4. Learn how to incorporate PrEP in daily routine using digital media.

2017 April Colloquium Flyer
2017 April Colloquium Slides

 

CHIPTS hosts a monthly HIV Research and Community Colloquia Series in collaboration with the Los Angeles County Commission on HIV to highlight current issues and conversations surrounding HIV. Click here for past lectures and check out the events page for more information on future Colloquia presentations!

Methods Seminar – Priya Bhagwat, PhD on Measurement of Abdominal Fat Changes and Predictors of Excess Fat Gain in HIV-Infected Individuals Initiating Therapy

Priya Bhagwat, Ph.D.
Postdoctoral Scholar
Center for HIV Identification, Prevention, and Treatment Services (CHIPTS),
Semel Institute for Neuroscience and Human Behavior, UCLA

HIV-infected individuals beginning antiretroviral treatment are faced with several metabolic complications including central fat accumulation and severe weight increases. As the HIV-infected population is at an elevated risk for cardiovascular disease, monitoring abdominal fat changes as well as understanding predictors of fat gain are especially important. My research examines the validity of accessible measures of abdominal fat changes including waist circumference and self-reported changes, as well as risk factors of abdominal fat changes and severe weight gain after therapy initiation.

 

The CHIPTS’ Methods Core hosts a monthly seminar series, which are one-hour workshops on research and statistical methods.  The seminars are open to HIV researchers, faculty, students, and community. To see previous seminars, check out the Methods Seminar tag or you can find seminar videos on our Youtube Channel! This series is hosted by the Center for HIV Identification, Prevention, and Treatment Services (CHIPTS) and made possible by funds from the National Institute of Mental Health (MH058107).

Colloquium: “Pre-Exposure Prophylaxis (PrEP) for Women: PrEP and PrEP-Ception”

March 9, 2017 – Dr. Lashonda Y. Spencer, Assistant Professor of Clinical Pediatrics at the University of Southern California presented “Pre-Exposure Prophylaxis (PrEP) for Women: PrEP and PrEP-Ception” at the Los Angeles County Commission on HIV meeting.

2017 March Colloquium Flyer
2017 March Colloquium Slides

CHIPTS hosts a monthly HIV Research and Community Colloquia Series in collaboration with the Los Angeles County Commission on HIV to highlight current issues and conversations surrounding HIV. Click here for past lectures and check out the events page for more information on future Colloquia presentations!

Methods Seminar – Kodi B. Arfer, PhD on Comorbidity and Medical Costs Among Medicare Beneficiaries with HIV in California: A Case Study in Predictive Data Analysis

Kodi B. Arfer. PhD
Postdoctoral Scholar
Center for HIV Identification, Prevention, and Treatment Services, Semel Institute for Neuroscience and Human Behavior, UCLA

Data analysis typically focuses on inference about the unobservable true parameters of a postulated true data-generating model. An alternative is to focus on the model’s accuracy in predicting values on outcome variables. Predictive data analysis allows evaluating a wide variety of models in a straightforward way. It produces measures of predictive accuracy that show how practically useful a model and a set of variables are in predicting an outcome. Using Medicare claims data from HIV-positive Californians, I investigate how comorbidity information—knowing what conditions other than HIV a patient has been diagnosed with—can be used to predict medical costs. I show how difficulties in the data, from highly skewed distributions to the differences between Medicare and Medicaid, can be addressed with predictive strategies. I find that comorbidities are indeed predictively useful, especially for inpatient costs.

The CHIPTS’ Methods Core hosts a monthly seminar series, which are one-hour workshops on research and statistical methods.  The seminars are open to HIV researchers, faculty, students, and community. To see previous seminars, check out the Methods Seminar tag or you can find seminar videos on our Youtube Channel! This series is hosted by the Center for HIV Identification, Prevention, and Treatment Services (CHIPTS) and made possible by funds from the National Institute of Mental Health (MH058107).

Colloquium: “HIV Biomedical Prevention Efforts in Los Angeles County”

February 9, 2017 – Dr. Sonali Kulkarni, Medical Director of the Division of HIV and STD Programs, and Dr. Leo Moore, Associate Medical Director & Clinical Prevention Specialist, both from the Los Angeles County Department of Public Health presented “HIV Biomedical Prevention Efforts in Los Angeles County” at the Los Angeles County Commission on HIV meeting.

2017 February Colloquium Flyer
2017 February Colloquium Slides

 

CHIPTS hosts a monthly HIV Research and Community Colloquia Series in collaboration with the Los Angeles County Commission on HIV to highlight current issues and conversations surrounding HIV. Click here for past lectures and check out the events page for more information on future Colloquia presentations!

National Native HIV/AIDS Awareness Day: Incorporating Culture as Prevention

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Crystal Lee (Navajo)

Written by Crystal Lee (Navajo), Post-Doctoral Fellow at UCLA

March 20th is National Native HIV/AIDS Awareness Day recognizing that Native American/Alaska Natives (Natives) are often “invisible” and face challenges accessing HIV testing, treatment, and care. Although Native HIV prevalence rates are comparable to their 1.7% U.S. population, they have lower survival rates compared to any other racial/ethnic group.

  • Of the estimated 44,073 new HIV diagnoses in the United States in 2014, 1% (222) were among AI/AN. Of those, 77% were men and 22% were women.
  • From 2005 to 2014, the number of new HIV diagnoses increased 19% among AI/AN overall and 63% among AI/AN gay and bisexual men.
  • From 2010 to 2014 Natives had the second highest rates of chlamydia, gonorrhea, and syphilis among all racial/ethnic groups in the U.S.

There are ~572 federally recognized tribes in the U.S. with each tribe possessing their distinct language and cultural practices. However, Natives possess similar cultural philosophies and worldviews. As an enrolled tribal member of the Navajo Nation, I recognize that Native culture is the forefront for prevention of physical and mental health disparities.

The literature review demonstrates that there is lack of HIV evidence-based interventions research for Natives despite numerous research studies in this research discipline. For a pilot research project, I adapted an evidence-based intervention, Becoming A Responsible Teen, for Native adolescents ages 14-18 years old using culture as the foundation. Below are some examples that were included in the adapted curriculum to demonstrate relationships to self, family, community and the natural environment in a cultural context:

Assiniboine Tribe
(This narrative grants the connection between self and Mother Earth)

“…Our Indian religion, the Great spirit; we’re thankful that we’re on this Mother Earth. That’s the first thing when we wake up in the morning, is to be thankful to the Great Spirit for the Mother Earth; how we live, what it produces, what keeps everything alive. I know my old father-died about twenty years ago, almost a hundred years old-he never neglected his thanks early in the morning when he’d be out and the sun came up, shining-that’s the eye of the Great Spirit…No matter what he’s doing, certain times, he looked up, just before it got into the middle of here in the sky-that’s the throne of the Great Spirit. When the sun got about there, noon, he stopped, just for a few seconds, gave thanks for the Great Spirit and asked to be blessed. Then again when the sun was going down, he watched that until it got out of sight. Those are the things I always think are wonderful when we’re talking about our Indian life.”

Apache Tribe
(This narrative explains the connection between an Apache female reaching womanhood during her Apache Sunrise Puberty ceremony to honor her womanhood and the sacredness of womanhood)

“The puberty ceremony may be interpreted as isolating symbolically four critical life-objectives towards which all Apache girls on the threshold of adulthood should aspire. These are physical strength, an even temperament, prosperity, and a sound, healthy-age. To understand why these particular life objectives are emphasized…consider their relation to other aspects of Western Apache culture, powers, the role of women in native economy, the conduct of interpersonal relationships, and the natural environment.…the puberty ceremonial not only defines longevity as a life-objective but also helps the girl attain it.”

NNAAD3

Participants consistently stated that the Native content/activities helped them connect to the intervention because it was specifically made for their culture, helped them feel more connected to their self-identity, and connected culture to making responsible decisions. The participants consistently stated they enjoyed the cultural stories/teachings that were dispersed throughout the intervention. In conclusion, the results demonstrated that the participants liked the adapted intervention, connected to the activities, and felt it was overall culturally appropriate.

 

 

 

Addressing the Intersection of Racism and HIV

On December 12, 2016, the City of Los Angeles AIDS Coordinator’s Office, in collaboration with many key img_8164community partners, hosted a one-day event on “Addressing the Intersection of Racism and HIV.” The event discussed important topics such as the role of mass incarceration in the spread of HIV, provision of health care services by jails and police departments to economically disadvantaged people and other individuals who come in contact with law enforcement, and the shifting demographics of HIV and how that impacts the policy decisions being made. Speakers challenged those of us in attendance to reflect on the ways in which organizational practices could have unintended, negative img_8148consequences that disproportionately impact HIV-positive people of color. Additionally, panelists discussed the ways in which the direct criminalization of HIV promulgates stigma and fear among the community. The event was a great success, providing important and relevant information to over 120 frontline staff, including Drug and Alcohol Counselors, MSWs, MFTs, public health professionals, and LCSWs! 

Congratulations to the conference planning committee for coordinating a wonderful event! UCLA Center for HIV Identification, Prevention, and Treatment Services (CHIPTS) is proud to be a co-sponsor of the event.

 

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S.H.E (Self. Healing. Empowerment.) is Beautiful

The “S.H.E (Self. Healing. Empowerment.) is Beautiful” event held on Wednesday, December 14, 2016 was a huge success. pic1Over 125 HIV clinical and service providers and their clients attended the event.   This one-day training was coordinated by the Los Angeles Women PrEP Network, which includes community representatives from the Los Angeles Women’s Collaborative, LA County HIV Drug & Alcohol Task Force, APLA Health, UCLA Center for AIDS Research (CFAR), One Woman Can, and UCLA/Los Angeles Family AIDS Network (LAFAN).

pic3The event included presentations from Dr. Nina Harawa, Associate Professor from UCLA and Charles R. Drew University, Dr. Gifty-Maria Jane Ntim, Medical Director at APLA Health and Wellness, Dr. LaShonda Spencer, Assistant Professor from the University of Southern California, Dr. Hilda Sandoval, Mental Health Manager at AltaMed, Roxanne Lewis from Universal Condom Work Group Los Angeles, and many others. There was a consumer workshop on HIV and PrEP (Pre-Exposure Prophylaxis) facilitated by Susan Alvarado, MPH from APLA Health and Wellness, in addition to a workshop on HIV prevention strategies led by Traci Bivens-Davis. A major highlight of the event was the community panel discussion, which included women who are currently using PrEP. They shared their real-life stories behind why they decided to use PrEP and their experiences using this novel biomedical intervention.

pic4The event was sponsored by the County of Los Angeles, Division on HIV and STD Programs. Additional funding was provided by UCLA Center for HIV Identification, Prevention, and Treatment Services (CHIPTS), and Walgreens.

Congratulations to the LA Los Angeles Women PrEP Network for hosting a wonderful event and to everyone who attended!

Methods Seminar – Antonio Pedro Ramos, PhD on Measuring Inequality in Early-Life Mortality Within and Between-Groups Over Time: A Bayesian Approach with Application to India

Antonio Pedro Ramos. PhD
Postdoctoral Scholar
Department of Biostatistics,
Fielding School of Public Health, UCLA
California Center for Population Research, UCLA

Most studies on early-life mortality compare mortality rates between large groups of births, such as across countries, income groups, ethnicities, or times. These studies do not measure within-group disparities. The few studies that have looked at mortality across the entire population of births, however, have used tools from the income inequality literature. Using a large data set from India, we estimate mortality risk for over 400,000 births using a Bayesian hierarchical model. We show that while measures based on the income inequality literature, such as Gini indices, are not appropriate for mortality risk, most of the variance in mortality risk occur within-groups of births. We developed a novel approach to investigate inequality in mortality risk. Our approach uncovers several important patterns in the dynamics of inequality in infant mortality and has broader applicability to other health outcomes.

The CHIPTS’ Methods Core hosts a monthly seminar series, which are one-hour workshops on research and statistical methods.  The seminars are open to HIV researchers, faculty, students, and community. To see previous seminars, check out the Methods Seminar tag or you can find seminar videos on our Youtube Channel! This series is hosted by the Center for HIV Identification, Prevention, and Treatment Services (CHIPTS) and made possible by funds from the National Institute of Mental Health (MH058107).