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Emerging AHP Strategies for Recruitment. Maria E. Alvarez, MPA CDC/NCHSTP/DHAP/PPB Public Health Advisor Duty Point: NYC [email protected] 212-268-6221. Recruitment.

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Emerging AHP Strategies for Recruitment

Maria E. Alvarez, MPA


Public Health Advisor

Duty Point: NYC

[email protected]


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  • 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

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  • 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

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Fundamental Strategies for Recruitment

  • Outreach

    • Intensive/Enhanced/Targeted

    • In-reach

  • Referral Network

  • Social Marketing

  • Community Level Interventions (CLI)

  • Individual Level Interventions (ILI)

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  • 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

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  • 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

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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)

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  • 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

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  • 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

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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

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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

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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

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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

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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

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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

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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)

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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)

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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)

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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