Baton Rouge Strategy Meeting

1. Baton Rouge Strategy Meeting March 1, 2011 Baton Rouge Area Foundation

2. Afternoon Goals • Present information on HIV/AIDS data for the Baton Rouge MSA • Identify an HIV prevention strategy or set of strategies that are community defined and driven • Devise an action plan for community mobilization around the identified prevention strategy or strategies

3. Understanding Baton Rouge’s AIDS Case Rate • What is the Baton Rouge MSA? • Baton Rouge Metropolitan Statistical Area (MSA) is 9 parishes • Ascension • East Baton Rouge • East Feliciana • Iberville • Livingston • Pointe Coupee • St. Helena • West Baton Rouge • West Feliciana

4. Baton Rouge MSA • Population and Demographics • 2009 Total Population is 786,947 • 11.5% increase since 2000 • 49% Female, 51% Male • 60% White • 36.5% Black • 2.3% Hispanic • 1.7% Asian • Median Age 33.7 years (national is 36.3) • Almost 85% of people age 25+ are high school graduates

5. Quick Definitions • Incidence:The number of newly diagnosed cases of a disease (New HIV cases, New AIDS cases) • Prevalence: The total number of cases of disease existing in a population (Persons living with HIV/AIDS) Incidence Prevalence Death

6. Incidence – Baton Rouge MSA2009 • 2009: 331 persons newly diagnosed with HIV • 2009: 216 persons newly diagnosed with AIDS

7. HIV Case Rate by Louisiana MSA2000-2009

8. AIDS Case Rate by Louisiana MSA2000-2009

9. 2008 Estimated AIDS Case RatesUS Metropolitan Areas CDC 2008 HIV Surveillance Report, Vol 20

10. Persons Living in the Baton Rouge MSA2000-2009

11. Is Baton Rouge at a disadvantage statistically because of the number of prisons in the MSA? • 2009 the BR MSA had a HIV Prevalence rate of 553 per 100,000. If you take out the prisoners (in state correctional facilities only) this only drops to 506 per 100,000. • Removing prisons does not account for high prevalence rates in the BR MSA

12. Persons Unaware of Status • The CDC estimates that 21% of all people infected with HIV are unaware of their HIV status. • If you apply this percentage to the Baton Rouge MSA: • 1,208 persons living with HIV in the Baton Rouge MSA who have not been diagnosed and are unaware they are infected.

13. What C&T sites identify the most new positives? Identification of new infections between 10/1/09-9/30/10 • OPH Region 2 STD clinic – 30 (1.0% positivity) • EKL ER – 24 (1.3% positivity) • Metro - Main office – 17 (2.0% positivity) • Metro - Mobile unit – 12 (2.1% positivity) • Capital City – 12 (2.0% positivity) • Hunt Correctional – 8 (.2% positivity) • East Baton Rouge PHU – 6 (.5% positivity) • Metro - EBR Parish prison – 5 (1.6% positivity) ***Example- for Hunt to identify 8 new infections, they tested over 4000 individuals***

14. What are the sub-populations and risk categories we should be concerned about? • African American Men • MSM • IDU • Prisoners • Youth • Pregnant Women, Exposed babies • Transgender individuals

15. Overview of Programs already provided by CBOs in the Baton Rouge MSA

16. Overview of Programs already provided by CBOs in the Baton Rouge MSA- continued…

17. Overview of Programs already provided by CBOs in the Baton Rouge MSA- continued…

18. Map of Services- Whole MSA

19. Map of Services- City of Baton Rouge

20. How much investment is going into program categories *LCAP- Includes funding from AIDS United (National AIDS Fund) Baton Rouge Area Foundation, Wilson Foundation, Pennington Foundation, Keller Family Foundation, OPH-SHP and others

21. Overview of the State’s HIV/AIDS Prevention Funding Categories From the OPH STD/HIV Solicitation of Offers- $1,100,000 (25% likely to go to Region 2): • HIV Counseling, Testing and Referral/Linkage; • HIV Screening and Referral/Linkage; • HIV Testing through Social Networks; • STD Screening; • Prevention Materials Availability; • Programs Targeting Men Who Have Sex with Men; • Outreach, Referral and Linkage; • Prevention With Positives

22. Overview of the City’s Ryan White Funding Categories From the Baton Rouge Part A Application- $3,825,000: • Ambulatory Outpatient Medical Care; • AIDS Pharmaceutical Assistance (Local); • Oral Health; • Early Intervention Services; • Medical Case Management; • Mental Health Services; • Substance Abuse Outpatient Services; • Non-Medical Case Management; • Food Bank; • Legal Services; • Psychosocial Support Services; • Emergency Financial Assistance; • Medical Transportation; • Outreach.

23. Our Collective Community-Level Goal Decreasing/preventing the number of people who test positive for HIV and other STDs in Baton Rouge MSA If this is the goal- where are the gaps? Exercise: Group Discussion and identification of programming gaps

24. Suggested menu of most promising Community Based HIV Prevention Practices • Information, education, and communication (IEC) • HIV/AIDS Awareness Social Marketing Campaign • HIV/AIDS & STD 101; awareness raising • School-based sex education • Condom promotion & distribution • Expanded HIV Counseling & Testing • MSA-wide testing campaign: Example DC or Oakland • Opt-out testing in Emergency Rooms • Social Network Testing • School Based Clinic Testing • Community Health Center Testing • Evidence based interventions • SISTA; Many Men Many Voices; Mpowerment; Project Respect; Willow; SIHLE • Expanded Services • Access to care • Housing • Access to medication • Transportation

25. Criteria for choosing strategies • Reach- The strategy is likely to affect a large percentage of the target population. • Mutability- The strategy is in the realm of the community’s control. • Transferability- The strategy can be implemented in communities that differ in size, resources, and demographics. • Effect size- The potential magnitude of the health effect for the strategy is meaningful. • Sustainability of health impact- The health effect of the strategy will endure over time.

26. Community Mobilization Framework- What is your role? Working on getting a better version of this graphic!!!

27. Group Exercise to Devise a Community Mobilization Plan • Group 1- Information, Education, Communication • What type of media vehicle? • Targeted at whom? • What resources are needed? • How does it match up against the criteria? • Group 2 – Expanded HIV Counseling & Testing • What type of sites? • Targeted at whom? • What resources are needed? • How does it match up against the criteria? • Group 3- Evidence Based Interventions • Who should be targeted? (Community level, group, individual?) • What intervention(s) are best suited to fit the need? • What resources are needed? • How does it match up against the criteria • Group 4- Expanded Services • What service gaps exist? • What is achievable through community mobilization? • What resources are needed? • How does it match up against the criteria?

28. Group Exercise • Break up into your 4 groups • Answer questions on the previous slide…then • What action steps can you take to endorse? • What action steps can you take to support? • What action steps can you take to participate? • What action steps can you take to build action coalitions? Remember: You and your organization are change agents!

29. Deliverables • How intervention rates again criteria • List of action steps that can realistically be done • Schedule next group meeting time and location • Make sure your call to action is completed- submit top part to us and keep the bottom for yourself

30. Group Reports: Action Steps for Mobilizing the Community Around our Goals • Action steps from afternoon group reports • Feedback and critique from morning training participants

31. Next steps after today • Build a community mobilization action plan document • Disseminate amongst today’s participants and other Baton Rouge MSA stakeholders • Others?

32. Questions about today? Please contact: Susan Bergson Louisiana Public Health Institute/Louisiana Community AIDS Partnership sbergson@lphi.org; 504-908-1904 Michael Robinson mrobinson@lphi.org; 504-301-9800