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OPA/OFP HIV Prevention Project Annual Technical Support Conference Report from Breakout Sessions – Day 2. Karla Johnson, MSPH Executive Director Development Systems, Inc. Region VII RTC. June 14, 2007. Internal Challenges & Solutions. Challenges HIV testing viewed as “separate”

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OPA/OFP HIV Prevention ProjectAnnual Technical Support ConferenceReport from Breakout Sessions – Day 2

Karla Johnson, MSPH Executive Director

Development Systems, Inc.

Region VII RTC

June 14, 2007

internal challenges solutions
Internal Challenges & Solutions

Challenges

  • HIV testing viewed as “separate”
  • Clinic flow for integrating rapid tests

Suggested Solutions or Actions

  • “Relentless” training of staff
  • Revise clinic flow systems, consent forms to accommodate rapid testing
  • Use example of open access
internal challenges solutions1
Internal Challenges & Solutions

Challenges

  • Staff resistance to testing

Suggested Solutions or Actions

  • Train staff on importance of testing and needs of clients
  • Develop systems that incorporate HIV testing into clinic services
internal challenges solutions2
Internal Challenges & Solutions

Challenge

  • “Silo” funding - separate staffing, appointment systems, protocols
  • Sustainability of rapid testing (dependent on OPA funding)

Suggested Solutions or Actions

  • Targeted testing at specific sites
  • Sliding scale fee for rapid testing
internal challenges solutions3
Internal Challenges & Solutions

Challenges

  • Burden of paperwork
  • Writing procedures

Suggested Solutions or Actions

  • Streamline and redefine reporting and documentation requirements
  • PPFA Clinical Guidelines Manual
internal challenges solutions4
Internal Challenges & Solutions

Challenges

  • False positive with rapid tests

Suggested Solutions or Actions

  • Training/counseling to prepare staff/clients for false positives
  • Quality control (i.e. storage issues)
internal challenges solutions5
Internal Challenges & Solutions

Challenges

  • Staff turnover
  • Staff burnout

Suggested Solutions or Actions

  • Revisit agency mission statement
  • Get buy-in from management team
  • Support professional development
  • Network with model programs
internal challenges solutions6
Internal Challenges & Solutions

Challenges

  • Cultural competency

Suggested Solutions or Actions

  • Understand cultural diversity and needs of client population
  • Provide staff training and follow-up with implementation and support
  • Counseling supervision & feedback
external challenges solutions
External Challenges & Solutions

Challenge

  • Stigma around HIV

Suggested Solutions or Actions

  • Full implementation of training materials that address stigma
  • Social marketing and education
  • Normalize HIV testing
external challenges solutions1
External Challenges & Solutions

Challenge

  • Collaboration between HIV/AIDS CPGs and FP agencies

Suggested Solutions or Actions

  • OPA collaborate with CDC to determine how family planning and CPGs can work together
external challenges solutions2
External Challenges & Solutions

Challenge

  • State requirements don’t match CDC recommendations (e.g. many require separate HIV consent)

Suggested Solutions or Actions

  • Collaborate with other CBOs, ASOs to advocate for public policy to support best practices
external challenges solutions3
External Challenges & Solutions

Challenge

  • Some states require testing sites to run daily controls (huge expense)

Suggested Solutions or Actions

  • Review state laws nationwide to determine extent of this issue
  • Find models for legislative change
external challenges solutions4
External Challenges & Solutions

Challenge

  • Reimbursement (e.g. rapid testing, post-test counseling)

Suggested Solutions or Actions

  • Quantify potential loss of income and consider whether this income could be offset (e.g. sliding scale fees, streamlining)
external challenges solutions5
External Challenges & Solutions

Challenge

  • Excessive training requirements

Suggested Solutions or Actions

  • Negotiate less extensive training requirements with authorizing agency for family planning staff
external challenges solutions6
External Challenges & Solutions

Challenge

  • Difficulty identifying referral linkages in rural settings

Suggested Solutions or Actions

  • Network with HIV organizations to find out where PLWHA receive care, and seek out those providers for cross-referral
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