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Evaluating the OPA HIV Prevention Grant: A Collaboration between CFHC and Region IX

Sept 19th - 20th, 2006. California Family Health Council National Title X Grantees' Meeting. 2. Process. Grant application for funding cycle 2004-2006 required evaluation of the ABC interventionNeeds assessment from HIV conference in New Orleans indicated 70% of the grantees were uncertain about how to approach ABC evaluationOpportunity to provide feedback (regionally) on ABC approach.

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Evaluating the OPA HIV Prevention Grant: A Collaboration between CFHC and Region IX

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    1. Sept 19th - 20th, 2006 California Family Health Council National Title X Grantees' Meeting 1 Evaluating the OPA HIV Prevention Grant: A Collaboration between CFHC and Region IX Alissa Perrucci, PhD, MPH Program Evaluation Manager, CFHC Lissa Suden, MA HIV Project Manager, CFHC Maryjane Puffer, BSN, MPA Director, Provider Services, CFHC

    2. Sept 19th - 20th, 2006 California Family Health Council National Title X Grantees' Meeting 2 Process Grant application for funding cycle 2004-2006 required evaluation of the ABC intervention Needs assessment from HIV conference in New Orleans indicated 70% of the grantees were uncertain about how to approach ABC evaluation Opportunity to provide feedback (regionally) on ABC approach

    3. Sept 19th - 20th, 2006 California Family Health Council National Title X Grantees' Meeting 3 Participating Grantees California City and Co. of SF JWCH La Clínica de la Raza NEVHC SDFC Tri-City Valley Arizona Coconino Co. Mt. Graham Maricopa Co. Yavapai Co.

    4. Sept 19th - 20th, 2006 California Family Health Council National Title X Grantees' Meeting 4 Challenges Lack of a standard definition of abstinence No uniform delivery of ABC message Limited exposure to ABC message No funds for a proper study design to evaluate effectiveness

    5. Sept 19th - 20th, 2006 California Family Health Council National Title X Grantees' Meeting 5 Project Aims Current risk assessment at baseline and follow-up Sexually active (vaginal, oral, anal) Number of partners Frequency of condom use Acceptability of ABC message Intentions to reduce risk (original aim)

    6. Sept 19th - 20th, 2006 California Family Health Council National Title X Grantees' Meeting 6 Eligible Participants All clients obtaining HIV testing under the OPA HIV grant Anonymous test patients complete baseline only

    7. Sept 19th - 20th, 2006 California Family Health Council National Title X Grantees' Meeting 7 Design Self-administered survey Baseline @ HIV test Follow-up @ subsequent FP visit No follow-up at results visit Survey is placed in patient chart Exception is anonymous OraSure/blood Survey completed in private after counseling Single page (front and back), 19 questions

    8. Sept 19th - 20th, 2006 California Family Health Council National Title X Grantees' Meeting 8 Design (con’t) 100 baseline surveys collected from each agency Follow-up surveys collected for 15 months from start of baseline Maximum of 100 follow-up surveys Follow-up period long enough to capture patients returning for annual exam Anonymous survey ID links baseline and follow-up

    9. Sept 19th - 20th, 2006 California Family Health Council National Title X Grantees' Meeting 9 Design (con’t) Confidential Testing: Baseline survey at HIV test Follow-up survey placed in chart for collection at any subsequent FP visit Anonymous Testing: Baseline survey at HIV test

    10. Sept 19th - 20th, 2006 California Family Health Council National Title X Grantees' Meeting 10 Concepts: Baseline Survey General health question Informational statement on ABC message Abstinence is defined as “not having vaginal, oral, or anal sex” Prior knowledge of ABC Ever used abstinence as an HIV prevention method

    11. Sept 19th - 20th, 2006 California Family Health Council National Title X Grantees' Meeting 11 Concepts: Baseline Survey Current Risk Assessment Sexually active (vaginal, oral, anal) Number of partners Frequency of condom use Acceptability of A, B, and C Is ___ an option for you now? If no, why? Partner acceptability of B as reported by the patient Demographic data

    12. Sept 19th - 20th, 2006 California Family Health Council National Title X Grantees' Meeting 12 Concepts: Follow-up Survey General health question Current risk assessment Timeframe is since HIV test Sexually active (vaginal, oral, anal) Number of partners Frequency of condom use

    13. Sept 19th - 20th, 2006 California Family Health Council National Title X Grantees' Meeting 13 Lessons from Pre-testing Assessment of plans/likelihood to use A, B, or C complicated by: Reference point (when/for how long) Different answers for different partners Abstinence can be used intermittently “Likelihood” concept too complex Measurement matrix too complex

    14. Sept 19th - 20th, 2006 California Family Health Council National Title X Grantees' Meeting 14 Lessons from Pre-testing Measuring patient recall of ABC message too evaluative of counselors “Option” language met with approval Short questions and definitions Fifth grade reading level

    15. Sept 19th - 20th, 2006 California Family Health Council National Title X Grantees' Meeting 15 Limitations Not able to evaluate the effectiveness of ABC message No comparison group Passive follow-up No response rates Can the impact of exposure to the ABC message be measured? Variation in counseling styles Duration and delivery of message Those practicing abstinence may not return to the clinic

    16. Sept 19th - 20th, 2006 California Family Health Council National Title X Grantees' Meeting 16 Contributions Comparison of risk assessment at baseline and follow-up Can look at differences across gender, age, race/ethnicity and marital status Differences in risk assessment/option Regional collaborative effort

    17. Sept 19th - 20th, 2006 California Family Health Council National Title X Grantees' Meeting 17 Preliminary Results: Baseline N=751 Language 54% English 46% Spanish Gender 82% Female 18% Male Ethnicity 68% Latina/o

    18. Sept 19th - 20th, 2006 California Family Health Council National Title X Grantees' Meeting 18 Preliminary Results: Baseline

    19. Sept 19th - 20th, 2006 California Family Health Council National Title X Grantees' Meeting 19 Preliminary Results: Baseline Heard of ABC? 51% Yes 49% No Had ____ sex in the last 6 months? 90% had vaginal sex 56% had oral sex 13% had anal sex

    20. Sept 19th - 20th, 2006 California Family Health Council National Title X Grantees' Meeting 20 Preliminary Results: Baseline Condom use during vaginal sex: 26% Always 43% Sometimes 28% Never 3% Don’t have this type of sex

    21. Sept 19th - 20th, 2006 California Family Health Council National Title X Grantees' Meeting 21 Preliminary Results: Baseline Condom use during oral sex: 3% Always 12% Sometimes 53% Never 32% N/A Condom use during anal sex: 4% Always 6% Sometimes 13% Never 77% N/A

    22. Sept 19th - 20th, 2006 California Family Health Council National Title X Grantees' Meeting 22 Preliminary Results: Baseline Is abstinence an option for you now? 48% Yes Is monogamy an option for you now? 92% Yes Is monogamy an option for your partner now? 70% Yes 23% Not sure Are condoms an option for you now? 78% Yes

    23. Sept 19th - 20th, 2006 California Family Health Council National Title X Grantees' Meeting 23 Preliminary Results: Baseline

    24. Sept 19th - 20th, 2006 California Family Health Council National Title X Grantees' Meeting 24 Preliminary Results: Baseline

    25. Sept 19th - 20th, 2006 California Family Health Council National Title X Grantees' Meeting 25 Preliminary Results: Baseline

    26. Sept 19th - 20th, 2006 California Family Health Council National Title X Grantees' Meeting 26 Preliminary Results: Baseline

    27. Sept 19th - 20th, 2006 California Family Health Council National Title X Grantees' Meeting 27 Preliminary Results: Baseline Abstinence is not an option: Why? I enjoy sex In a relationship, Estoy casada, Tengo pareja, I’m married I use condoms, I use birth control, We’re monogamous I am in love and I want to make love

    28. Sept 19th - 20th, 2006 California Family Health Council National Title X Grantees' Meeting 28 Next Steps Individualized analyses for OPA HIV Refunding Applications Link baseline and follow-up surveys Qualitative analysis of write-in responses

    29. Sept 19th - 20th, 2006 California Family Health Council National Title X Grantees' Meeting 29 Contact Information Alissa Perrucci California Family Health Council, Inc. 2550 Ninth Street, Suite 110 Berkeley, CA 94710 perruccia@cfhc.org (510) 486-0412 ext.2316

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