Lessons Learned: PPC

1
Lessons Learned PPCs experience with HIV
prevention from 1990 to the present.

• Susan Lane
• OPA Title X HIV conference
• June 12, 2007

2
HIV/AIDS in Connecticut

• CT ranks 8th among states in the rate of AIDS
  cases (19 per 100,000 in 2005)
• State health officials estimate that as many as
  20,000 CT residents are infected with HIV.
• 39 are womenas compared to 26 nationally
• 34 are white 27 are black 36 are Hispanic.
• About half live in three citiesBridgeport, New
  Haven and Hartford.

3
Late 80s, early 90s

• We provide information about prevention, but
  patients referred to local health depts and other
  agencies for counseling and testing.
• HIV still considered peripheral to family
  planning.
• 1989 PPC receives funds from U.S. Conference of
  Mayors to prepare a training video on HIV
  prevention.

4
Early 90s

• 1994 PPC receives federal HIV prevention funds
  from state Department of Public Health.
• Even though PPC not considered an AIDS
  organization.
• 1995 PPC staff undergoes 5-day state
  certification for HIV counseling and testing.
• State health department directs state funded HCT
  to send low risk referrals to PPC.

5
Late 90s

• PPC revises its HIV counseling to incorporate
  transtheorectical model of behavior change
• Meeting clients where they are rather than
  one-size fits all counseling
• PPC integrates HIV testing into annual and
  initial exams.
• In conjunction with state DPH, we develop a
  special 2-day training for clinicians
• PPC begins offering Orasure, the saliva-based HIV
  test.

6
2000-2006

• 2003 PPC allows some patients to receive
  results by telephone.
• 2004 Two PPC centers pioneer use of rapid HIV
  testing.
• Today rapid testing accounts for about 30 of all
  HIV tests.
• would be higher if covered by insurance plans.
• 2006 PPC pioneers off-site HIV testing
• At AIDS Walk New Haven, local fairs, National HIV
  testing day, as part of outreach at commercial
  nursery, monthly at a soup kitchen.

7
What we have learned over the years

• HIV/AIDS is about sex, sexual health, sexual
  decision making.
• Not just disease prevention.
• People dont know their risk
• Can anyone really assess his or her risk
• Women and men will go outside their local town to
  be tested.
• Centers in high risk geographical location may
  not necessary have highest number of positives.

8
What we have learned over the years

• People are willing to be testedbut how we test
  needs to fit into their lives.
• The culture is changing around HIV/AIDS.
• Cost v. confidentiality
• Partners requiring negative HIV test