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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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Karla Johnson, MSPH Executive Director Development Systems, Inc. Region VII RTC

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Karla johnson msph executive director development systems inc region vii rtc

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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