Integrating County Departments with Community-Based Providers to Reach HIV Positive Women in the Jails.

1. �Integrating County Departments with Community-Based Providers to Reach HIV Positive Women in the Jails.� Armida Ayala, MHA, Ph.D. & Marcela Sanchez, BA County of Los Angeles Department of Health Services CityMatCH Annual Urban Maternal & Child Health Leadership Conference August 23-26, 2003 Pittsburgh, PA

2. Background 4,082 Square Miles 9.8 Million Residents Proportion of State Population: 28% Proportion of State AIDS Cases: 35% Living with HIV/AIDS: 53,000 (Estimated) Population:Latino/a 44.6% White 31.1%Asian 12.3%African-American 9.7%Native American 0.5%Pacific Islander 0.3% This is an appropriate slide to use as a way to give an overview of H/A in Los Angeles County. It is not, however, a requirement that the slide be used in every presentation. We have included the slide as an additional resource for times when it is appropriate.This is an appropriate slide to use as a way to give an overview of H/A in Los Angeles County. It is not, however, a requirement that the slide be used in every presentation. We have included the slide as an additional resource for times when it is appropriate.

3. 3 Background Limited data on the number of HIV positive female inmates who are pregnant or of childbearing age Lack of access to perinatal prevention of HIV transmission in jails.

4. 4 Objectives Identify HIV positive female inmates in the jails Develop effective collaborations Integrate existing prevention of perinatal HIV transmission efforts. Part of the problem is that there are women who do not receive prenatal care or refuse treatment or are not offered CT. Another problem is that there is limited data that inform us why this is so. Issues to access of care are several from financial barriers to inadequate capacity of the health care system relied to provide prenatal care, CT and TX. The pervasive and ongoing alienation of Latino women in the state from medical structures within which HIV positive women attempt to access health care system needs more research. Our challenges as providers and researchers are to know who: 1) are these women; how to reach them and how to impact their lives once they result HIV positive. Part of the problem is that there are women who do not receive prenatal care or refuse treatment or are not offered CT. Another problem is that there is limited data that inform us why this is so. Issues to access of care are several from financial barriers to inadequate capacity of the health care system relied to provide prenatal care, CT and TX. The pervasive and ongoing alienation of Latino women in the state from medical structures within which HIV positive women attempt to access health care system needs more research. Our challenges as providers and researchers are to know who: 1) are these women; how to reach them and how to impact their lives once they result HIV positive.

5. 5 Methods Perinatal HIV Learning Cluster Team meetings Integrated surveillance, prevention and training Consolidation of data from PSD surveillance and IMACS (Information Management for AIDS Cases & Services).

6. 6 Results More than 60% of the female inmates were African American and Latino Eighty five percent (85%) received a pre-release plan in the past 3-5 months Only 6% received their HIV medications at this discharge from the jail.

7. 7 Conclusions Successful identification of the target population Increased integration of surveillance, prevention, case management and correctional systems Improved linkage to perinatal prevention of HIV transmission education and related services Increased training of jail providers to include prenatal prevention of HIV transmission education.

8. 8 Next Steps Increase training among providers about perinatal prevention of HIV transmission Enhance health outcomes to avoid recidivism in the jails Improve case finding and follow-up Increase integration of surveillance and evaluation with service planning and project monitoring Expand early detection and testing efforts with other departments.

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