Prevention and Support Services

Anonymous HIV Counseling & Testing Program in Community & Criminal Justice Settings

Program Description

The Anonymous HIV Counseling and Testing (ACT) Program, managed by the Bureau of Direct Program Operations, was established in 1985 to provide free, anonymous, HIV counseling and testing to individuals at risk for HIV infection. In addition to direct services provided to clients in community and correctional settings, HIV/STD prevention education, outreach and field services are conducted. Client-centered counseling sessions are tailored to address individual client needs. Client-centered counseling includes an HIV risk assessment, assistance in developing a risk reduction plan and skills for negotiating safer sex and safer drug use behavior. Testing method options include rapid HIV testing with confirmatory testing offered immediately to clients that have a reactive screening result. In addition, other support services and referrals are delivered to assist clients and enhance access to care.

Individuals who test HIV positive are provided with partner counseling and notification assistance. Based on client preference they are either directly linked, or referred, to medical and ancillary services. Though the program does not require names to conduct testing, those who test HIV positive are encouraged to change their test result from anonymous to confidential status. This action facilitates access to medical and social services without the need to retest. Follow-up appointments are scheduled for all HIV positive clients to assure their success in accessing services to which they were referred, to help them develop strategies that overcome barriers to care, to make additional referrals to needed services, and to assist in partner notification and risk reduction strategies.

The program utilizes a community-based strategy specifically designed to reach individuals at high risk. To increase the availability and accessibility of services, walk-in and evening clinics operate in high seroprevalence areas. In addition, special initiatives targeting high risk populations, and the use of regional referral arrangements with community-based providers, increase the potential for those at risk to receive information about testing options and be encouraged to test. Clients can easily access information about HIV/AIDS and the availability of local testing by calling the program's statewide toll-free hotlines.

Since 1989, through a Memorandum of Understanding between the NYS Department of Health and the NYS Department of Correctional Services, the AIDS Institute has provided HIV/STD prevention education and HIV counseling and testing to inmates in state facilities. The AIDS Institute also provides technical assistance to correctional health services on testing and early HIV identification and access to care. Technical assistance is also provided to community based and local public health agencies.

Contact:

Mara San Antonio-Gaddy
Director, Bureau of Direct Program Operations
Division of HIV Prevention
(518) 474-3671
mls07@health.state.ny.us

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Criminal Justice Initiative

Program Description

The Criminal Justice Initiative (CJI) was developed in response to the emerging prevention and service needs of HIV infected and at risk detainees, inmates and ex-offenders in New York State. Its goal is to provide a comprehensive, seamless continuum of quality HIV prevention and supportive services to individuals in a correctional setting and ex-offenders returning to their home communities. These services are designed to diminish HIV transmission and improve the health and well-being of individuals living with HIV/AIDS. The CJI uses multiple strategies to ensure effective service delivery.

The services provided in correctional settings may include HIV prevention interventions, peer educator training, anonymous HIV counseling and testing (with the option to convert to confidential), HIV supportive services, and transitional planning. One or more of these services may also be provided to incarcerated or detained individuals in select youth facilities and local county correctional facilities. This initiative also funds community-based organizations to provide re-entry assistance for ex-offenders living with HIV/AIDS. Services include transportation, supportive services, risk reduction counseling, coordination of health and human services, and referral to community case management.

In state correctional facilities the CJI supports the Prison HIV Hotline. This hotline offers state inmates the opportunity to call collect for HIV information and counseling. The hotline is also a clearinghouse for HIV-related information and provides referral services for HIV positive inmates upon release.

The Criminal Justice Initiative is a compliment to the HIV prevention and support portfolio of the Department of Correctional Services (DOCS). DOCS also facilitates the provision of HIV prevention information and related activities to DOCS staff and inmates in State correctional facilities. The collaboration between DOCS and the AI was established to educate civilian, officer staff and inmates in the State prison system about HIV transmission, risk reduction, and the importance of early medical intervention for HIV infected persons; to provide anonymous and confidential HIV counseling and testing services for inmates on a voluntary basis; and, to provide ongoing resource capability at numerous facilities through staff and peer training.

The services provided by funded community-based contractors, AIDS Institute staff and DOCS health services staff are the result of a strong collaborative effort. In facilities served by DOH and its contractors, HIV testing is promoted during inmate orientation and education classes. Anonymous and confidential HIV testing is offered to inmates on a voluntary basis. While confidential testing is available through DOCS health services staff, inmates who test anonymously have the option of changing their test results to confidential status, allowing for their test results to be placed directly in their DOCS medical records. Referrals to DOCS Health Services for treatment and follow-up are made directly for those HIV positive inmates who opt to change their test results to confidential without the need for retesting.

Contact:

Bethsabet Justiniano
Director, Bureau of Community Based Services
Division of HIV Prevention
(518) 486-1412
bxj01@health.state.ny.us

or

Mara San Antonio-Gaddy
Director, Bureau of Direct Program Operations
Division of HIV Prevention
(518) 474-3671
mls07@health.state.ny.us

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Lesbian, Gay, Bisexual and Transgender HIV Initiative

Program Description

In 1994, the AIDS Institute developed the Lesbian, Gay, Bisexual, and Transgender (LGBT) HIV Prevention Initiative. This initiative supports the provision of effective behavior-based HIV prevention interventions and HIV-related supportive services - including alcohol, substance use and mental health counseling - that address the needs of gay men/men who have sex with men (MSM), lesbians/women who have sex with women (WSW), persons who have sex with multiple genders, and transgender individuals.

Seventeen organizations are funded under the initiative to implement programs designed to achieve the following goals:

  1. Increase the number of high-risk LGBT individuals who know their HIV serostatus;
  2. Assist HIV-infected LGBT individuals with access to health care and supportive services as early as possible; and
  3. Increase the number of HIV-infected and high-risk LGBT individuals who access primary HIV prevention interventions to increase the use of condoms and to positively influence the individual’s knowledge, attitudes, beliefs and behaviors regarding HIV/AIDS transmission.

To achieve these program goals, contractors employ a range of HIV prevention strategies, including:

  • Outreach - conducted in the community and targeting high-risk sub-populations of LGBT individuals to promote and facilitate access to HIV counseling and testing services, individual- and group-level HIV/AIDS/STD education and risk reduction counseling, and other HIV prevention interventions and supportive services provided by the agency and elsewhere in the community.
  • Individual- and Group-level HIV Prevention Interventions - single or multiple sessions of health education and HIV and STD risk reduction counseling tailored for and targeting LGBT individuals who are at very high risk for HIV infection. Interventions are designed to assist individuals with developing skills to adopt healthy behaviors and to support his/her efforts to reduce or prevent the risk for HIV infection or transmission. Interventions also facilitate the individual’s access to HIV counseling and testing services, health care and social support services to improve the person’s quality of life.
  • Community-level HIV Prevention Interventions - designed to improve the health of LGBT individuals through a focus on specific sub-populations of the community. Interventions serve to increase community awareness of HIV/AIDS and adoption of behaviors known to reduce or prevent the risk for HIV infection or transmission by influencing the social norms, shared beliefs and values held by members of the community. Interventions may also address the underlying policies and socio-economic factors that contribute significantly to community members’ risks for HIV infection and transmission. Community-level HIV prevention interventions include community mobilization efforts, community-wide events, and presentation and distribution of HIV/AIDS educational information.
  • HIV counseling, testing and referral services either directly or through a collaborative agreement with a provider of these services.

In addition to the programs funded under the LGBT HIV Prevention Initiative, the AIDS Institute contracts with various community-based HIV service organizations throughout New York State to provide a broad range of HIV prevention and supportive services to LGBT communities. These programs are supported with funds awarded under the Communities of Color Peer Initiative, the Community Service Program Initiative, the Multiple Service Agency Initiative, as well as with Ryan White Title II funds.

Contact:

Donald Lee
Program Coordinator, LGBT Unit
Bureau of Special Populations
Division of HIV Prevention
(212) 417-4667
djl02@health.state.ny.us

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Lesbian, Gay, Bisexual and Transgender (LGBT) Health & Human Services Initiative

Program Description

While many of the health and human service needs of LGBT individuals are similar to the population at large, many LGBT individuals experience a variety of factors and barriers that impact their access to, and interaction with, the health and human services system. Because of general lack of knowledge by the health care system related to LGBT sexuality, gender identity, and gender expression, LGBT individuals may neglect routine screenings and/or delay treatment for chronic illness. They may avoid mainstream service providers out of fear that sharing information about their lives and sexuality will subject them to rejection and discrimination. Even when LGBT individuals access health care, lack of knowledge and information sharing between LGBT individuals and their service providers may result in less than comprehensive assessment or treatment. In addition, service providers themselves may not be trained to recognize the stressors impacting LGBT individuals, couples and families. These stressors include, but are not limited to, "coming out," family disruptions, alcohol and substance abuse, violence, poor health, harassment in school and homelessness.

LGBT individuals, who are also part of communities that have historically experienced barriers and marginalization (e.g., people of color, transgender individuals, immigrants, women, low income individuals, the mentally ill and disabled), may face additional discrimination. The multiple obstacles of these and other target populations such as seniors, families served by the criminal justice system and youth compound the issues of isolation, access and quality health services.

The initiative is geographically diverse, with providers serving the LGBT community in regions throughout New York State from Long Island to Buffalo and many regions in-between. The initiative supports a broad and diverse range of services (non HIV-specific) including services for youth, seniors, mental health and substance abuse prevention, communities of color and lesbian specific projects. Several grants also support research on LGBT health and human services and education for the broader community of health providers on the health and human service needs of the LGBT community. One organization with a statewide reach is funded to provide or arrange for technical assistance and training for grantees; to develop and implement an annual conference for programs funded by this initiative and other emerging organizations; and to coordinate requests from State agencies for information and to promote awareness, sensitivity and knowledge of LGBT issues and concerns.

The primary objectives of the initiative are:

  • To improve access to health and supportive services for LGBT individuals, their families and members of their support systems;
  • To improve the health outcomes and quality of life for LGBT individuals;
  • To enhance the capacity of organizations and communities to serve LGBT individuals, their families and members of their support systems; and
  • To increase community awareness of the health and human service needs of LGBT individuals, their family members and members of their support systems.

Contact:

Carmen Vazquez
Coordinator
LGBT Health & Human Services Unit
(212) 417-4711
cmv02@health.state.ny.us

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Harm Reduction Initiative

Program Description

Injection drug use is a primary risk factor for new AIDS cases in New York State. To date, the number of injecting drug users with AIDS is reported to be more than 71,000. The AIDS Institute recognizes that harm reduction strategies are needed to prevent the transmission of HIV to substance users, their sexual partners, and children.

The Harm Reduction Initiative supports comprehensive and complementary services with funds from the Centers for Disease Control and Prevention (CDC), the Ryan White CARE Act Parts A and B, and the New York State Department of Health (NYSDOH). Harm Reduction Initiative contractors receive funding from a combination of these sources to provide an array of services to substance users, their families, and communities. The CDC funds HIV prevention services to substance users including outreach, interventions delivered to individual and groups, and support groups. Ryan White Part A funds harm reduction/recovery readiness/relapse prevention services to HIV positive substance users which includes intakes and assessment, individual and group counseling, support groups, acupuncture, referrals to health care, supportive services, and substance use treatment. The Mental Health Services in Harm Reduction Settings Initiative, also funded by Ryan White Part A, provides mental health services including psychiatric intakes and assessments, and individual and group interventions. Ryan White Part B funds counseling and supportive services targeted to special populations to address regional priorities. The New York State Department of Health funds comprehensive harm reduction/syringe exchange programs as described below.

In May 1992, the Department of Health filed emergency regulations for authorization to conduct hypodermic syringe and needle exchange programs. Section 80.135 of Title 10 of the State of New York Official Codes, Rules and Regulations provides the regulatory authority by which community -based, not-for-profit organizations, and government entities may be granted a waiver to obtain, possess, and furnish hypodermic syringes and needles without a prescription in programs designed to reduce the transmission of HIV. The target population is injection drug users (IDUs) who are not ready, willing, or able to abstain from drug use or enter substance use treatment programs. The regulations require that syringe exchange services be provided within a comprehensive harm reduction model, where clients can learn about risk reduction measures for themselves and their partners. Programs must elicit and obtain community support in order to receive approval for their waiver applications.

In addition to the provision of clean injection equipment, harm reduction services include:

  • outreach and education on risk reduction practices related to sexual and drug-using behaviors;
  • distribution and demonstration of male and female condoms and dental dams;
  • distribution and demonstration of bleach kits and safer injection techniques;
  • distribution of other harm reduction supplies and literature;
  • provision of supportive services, HIV counseling and testing, partner notification assistance, case management, health care, legal, and housing services. Programs must provide referrals for these services if they are unable to provide them directly.

There are currently seventeen approved harm reduction/syringe exchange programs in New York State: thirteen in New York City, and one each in Buffalo, Rochester, Ithaca/Binghamton, and Mount Vernon. To date, approved programs have collectively enrolled more than 115,800 injection drug users (IDUs), 75% male and 25% female. Approximately 49% have been Latino, 25% African-American, 25% Caucasian, and 1% more than one race. Ninety-five percent of participants are over 30 years of age.

Program models include street-side services, mobile vans, storefront centers, walking teams, hospital-based program, and visits to single room occupancy hotels. Syringe exchange programs (SEPs) have shown a rapid and remarkable rate of growth along with strong evidence of effectiveness.

Researchers from the Baron Edmond de Rothschild Chemical Dependency Institute of Beth Israel Medical Center have conducted evaluations of New York State's syringe exchange programs. Following are some of the findings from their research:

  • comparison of HIV among injection drug users (IDUs) show a significant decrease in transmission in IDUs. In 1990, it was estimated that 50% of IDUs were infected with HIV. In 2000, the percentage of infected IDUs had decreased to 20%. For 2002, it is estimated that there has been a further decline in HIV infection in IDUs to 13-15%.
  • there is a 76% decrease in the buying or renting of syringes among SEP participants; and
  • there is a 50% decrease in borrowing or sharing of used syringes.

The Beth Israel study also demonstrated that syringe exchange does not attract people to drug use. In fact, among SEP participants the frequency of injecting declined by 8%. Further, the findings show a threefold increase in the number of participants who use alcohol pads as a disinfectant before injecting. This practice results in a decrease in the number of injection-related infections.

The number of referrals provided by syringe exchange programs continues to increase. Over 158,800 referrals have been made to detoxification and substance use treatment programs, health care services, HIV counseling and testing, and social services.

Contact:

Maxine Phillips
Director, Harm Reduction Unit
Division of HIV Prevention
(212) 417-4661
map03@health.state.ny.us

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Expanded Syringe Access Demonstration Program (ESAP)

Program Description

In May 2000, the New York State Legislature enacted Chapter 56 of the Laws of 2000 creating the Expanded Syringe Access Demonstration Project (ESAP). The purpose of this program is to reduce the transmission of blood borne diseases, including HIV and hepatitis, by enhancing access to clean (new) syringes. Under this program, up to ten syringes may be sold or furnished to a person 18 years of age or older without a prescription by pharmacists, health care facilities, and health care practitioners who have registered with the New York State Department of Health.

As of August 31, 2008, there were 3,261 registered ESAP providers. Of these registered providers, 1,298 (39.8%) are located in the five boroughs of New York City. The remaining ESAP providers were located outside of New York City. There are ESAP-registered providers in every New York State county with the exception of Hamilton.

Of the registered providers, 3,160 (96.9%) are pharmacies. Major pharmacy chains account for 2,194 (71%) of all registered pharmacies. Approximately 80% of all community pharmacies in New York State are registered. In addition to pharmacies, there are 101 other providers enrolled including 12 hospitals, 9 nursing homes, 29 clinics (Diagnostic and Treatment Centers), and 46 private practitioners.

It is estimated that in 2006, 133,500 syringes were furnished and 20,200 fitpacks were given out to clients for proper disposal of syringes. Another important component of ESAP is the promotion of safe sharps disposal. In New York State, all hospitals and nursing homes (930) are required by law to accept household sharps, but not all are convenient to customers. Pharmacies, clinics and health care practitioners that wish to accept household sharps for safe disposal must register separately with the New York State Safe Sharps Collection Program (NYSSSCP). There are over 115 agencies/facilities hosting kiosks or wall mounted sharps collection units in 20 counties. With the addition of 7 mobile van programs, the number of sites increased to over 135 sites. Venues for disposal include, landfills, waste transfer stations, community based organizations mobile vans, housing projects, a community college, a bus depot, an airport, federal hospitals and a police station. Extrapolation from data reported by collection sites yielded an estimated 23,612 pounds of syringes and other sharps collected during 2006.

A listing of registered ESAP providers by county, as well as sharps collection sites, is available online.

The website provides ESAP-related material including an overview of the law and regulations, information on ESAP for providers and consumers, guidelines to sell or furnish syringes without prescription, guidelines for health care facilities, and the application to register for ESAP. It also contains information on how to dispose of household sharps properly, the application for sites interested in accepting syringes for disposal outside a health care setting, and additional resources.

Contact:

Wesley E. Badillo, MD, MPH
Coordinator
Expanded Syringe Access Program
(212) 417-4746
web03@health.state.ny.us

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Peer Delivered Services

Program Description

Peer education and support are highly effective means of providing HIV prevention education and personal empowerment to individuals at high risk of HIV infection and those who may not be engaged by traditional methods of outreach and education. Peer-delivered services recognize that prevention messages and service delivery are strengthened when delivered by those who share common characteristics with the priority population. These characteristics may include race/ethnicity, cultural background, language, age, gender, HIV status, risk behavior, or similar histories (e.g., individuals who have a history of substance use). The AIDS Institute supports peer-delivered services through the Peer Initiative as well as through other initiatives serving hard-to-reach and underserved populations. The AIDS Institute's Peer Initiative was first funded in 1994 and is supported by both state and federal funding.

Peer Initiative providers recruit members of target communities and provide them with training to become peer educators. Peer training activities vary by provider agency, but in general include: basic information on HIV/AIDS, sexually transmitted diseases (STDs), hepatitis and tuberculosis (TB); and HIV transmission prevention, and treatment. In addition, programs work closely with peers to continue the development of techniques to engage individuals at risk. Many programs also work with peers on presentation skills so that the material presented is accurate, culturally sensitive, and keeps the audience engaged and actively listening. All programs provide ongoing support and training for peers to reinforce healthy behaviors and programs ensure that they continue to feel comfortable in their role as peer educators.

Once trained, peer educators conduct outreach, education interventions, and on-going support in a variety of settings and to a variety of priority populations. Examples of Peer Initiative programs funded by the AIDS Institute include: a theater project that has adolescent peers conduct street outreach and interactive theater as a method to deliver HIV prevention education; a Hispanic agency that has adolescents, women and substance users provide HIV prevention education; a multi-service AIDS-specific agency that employs gay men who were former substance users to reach those actively using; a peer program for those within the correctional system; a prevention program that recruits Caribbean-born women to provide HIV prevention workshops; and a program that has peers who find and educate injection substance users.

In addition to agencies funded under the Peer Initiative, many other providers incorporate the use of peer models in service delivery.

Contact:

Bethsabet Justiniano
Director, Bureau of Community Based Services
Division of HIV Prevention
(518) 486-1412
bxj03@health.state.ny.us

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Specialty Targeted Contracts

Program Description

Specialty contractors are funded through a variety of initiatives and are categorized under the umbrella group ‘Specialty Targeted Contracts.’ These contracts are limited in scope and support the design and implementation of specialized services for designated populations and/or within specific geographic areas. Populations reached through these contracts include women, adolescents, persons living with HIV/AIDS, and select racial or ethnic minorities.

The intent of all specialty targeted contracts is to implement programs designed to reduce the spread of HIV/AIDS through the delivery of interventions that increase HIV/AIDS awareness, support long-term behavior change, and assist with effective service coordination.

Programs funded include a statewide Spanish language hotline, and a program to support community development for African Americans.

Contact:

Bethsabet Justiniano
Director, Bureau of Community Based Services
Division of HIV Prevention
(518) 486-1412
bxj03@health.state.ny.us

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Prevention Services for Adolescents and Young Adults

Program Description

New York State leads the nation in AIDS cases among adolescents and young adults. As of December 31, 2007, more than 4,600 young people (age 13-24) in New York State were living with HIV/AIDS; many were infected as teenagers. During 2007 alone, 697 young people received an initial HIV diagnosis. The impact of HIV on young people, along with the complex challenges confronting them, requires a vigorous and comprehensive strategy to assist young people in reducing their risk for HIV infection.

Adolescent HIV Prevention Services (AHPS) was created in 1994 to expand and strengthen HIV/AIDS prevention services for young people and to support these services with a comprehensive statewide strategy for program planning, development, delivery, and evaluation. Currently, AHPS funds 33 community and school-based programs that serve a broad spectrum of young people.

The providers funded by AHPS serve a diverse cross-section of adolescents and young adults (ages 13 to 24) including heterosexual youth; young people who are lesbian, gay, bisexual or transgender; young men of color who have sex with men; and young people from various socio-economic, racial, and ethnic groups. The primary target population is youth who are at risk for HIV infection, including young people who are homeless and out-of-school. The challenge for providers is to deliver prevention services tailored to the various populations to provide them with the knowledge, skills, and motivation to change behaviors that put them at risk for HIV infection.

Program Models

AHPS supports three primary HIV prevention program areas: community-based prevention; school-based prevention (from elementary through college); and a lesbian, gay, bisexual, transgender initiative. The prevention services provided in these program areas are delivered through a variety of methods and strategies including peer-delivered education and outreach interventions, intensive outreach and early intervention services targeting young men of color who have sex with men, the performing arts, adventure-based learning, parent education, positive youth asset development, service learning, social marketing, and interactive educational activities. Programs are located in urban, suburban, and rural communities in New York State. AHPS staff provide program oversight and technical assistance to the service providers and work with them to explore methods to improve service delivery. This initiative will be re-solicited in early 2009.

Positive Youth Development and HIV Prevention

The AHPS programs incorporate the principles and practices of positive youth development into their HIV prevention programming. The programs strive to identify the strengths and internal and external assets of the young people they serve instead of focusing only on young people’s deficits and problems.
This strength-based approach requires programs to provide opportunities for young people to explore and develop a full range of capacities and skills. The combination of youth development opportunities and individualized multi-session, behavior-based harm reduction interventions enhance the ability of the programs to provide effective HIV prevention and risk reduction services for young people. The programs are also required to facilitate young people's access to sexually transmitted disease screening and treatment, HIV counseling and testing, and health care services.

School-based HIV Prevention Education

The AIDS Institute, through a memorandum of understanding with the New York State Education Department, supports the delivery of HIV/AIDS prevention education to students in public schools in the State. Funding supports the provision of training and technical assistance to school personnel through the operation of a web-based distance learning project. By accessing the web-based program and/or attending face-to-face trainings, school staff can receive training and relevant information on resources available to provide HIV/AIDS prevention education to their students in the context of a comprehensive health education program. The AIDS Institute and the State Education Department also collaborate to ensure that updated and accurate HIV prevention information and resources are made available to school districts throughout the State.

Assets Coming Together for Youth

The AIDS Institute, in conjunction with the New York State Department of Health, Center for Community Health, manages an initiative designed to build community organizations’ capacity to improve the health and well being of young people. The goal of the Assets Coming Together (ACT) for Youth initiative is to promote the use of youth development strategies to assist young people to lead healthy and productive lives. The initiative supports a Center of Excellence at Cornell University, which includes collaboration with the University of Rochester, Division of Adolescent Medicine, the New York State Center for School Safety and Cornell Cooperative Extension in New York City. The Center of Excellence provides training and technical assistance to youth-serving programs funded by the New York State Department of Health, as well as serving as a clearinghouse for the collection and dissemination of youth development resources and best practices.

New York State Prevention Planning Group

The Young People's Committee of the New York State HIV Prevention Planning Group has been actively involved in gathering information and reviewing the HIV prevention needs of the State's young people. AHPS and the Young People's Committee work collaboratively to identify the specific HIV prevention interventions and services that effectively prevent and reduce the risk of HIV infection for young people.

Contact:

Barbara Leo
Director, Adolescent HIV Prevention Services
Bureau of Special Populations
Division of HIV Prevention
(518) 486-6066
bjl03@health.state.ny.us

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Prevention Services for Women

Program Description

As of December 31, 2007, 37,485 women with HIV/AIDS were living in New York State. Data from the New York State Department of Health indicates that 88% of all females living with HIV/AIDS are women of color: 56.6% Black, 29.3% Hispanic, and 2.1% Asian/Pacific Islander, Native American/Alaskan Native, and women of two or more races. The concentration of the HIV epidemic among women of color is dramatic. Heterosexual contact and injection drug use are the most frequently reported HIV transmission categories among women living with HIV/AIDS in New York State: 35.6% and 21.2% respectively. However, epidemiologists estimate that approximately 60% of women initially placed in the unknown risk category will be reclassified as heterosexual cases. It is important to note that sexual transmission continues to account for an increasing proportion of new infections, and that sexually transmitted infections (STIs) are a major factor fueling the epidemic particularly among persons of color.

The HIV/AIDS epidemic presents unique social, economic and public health challenges. Significant progress has been made in understanding the virus and in developing treatments to manage HIV disease and opportunistic infections. With individuals living longer, the challenge for providing prevention services to those infected and supportive services to continue in health care and receive other needed services to improve quality of life have increased. Women of color and who are poor are particularly in need of comprehensive services that will help them to access a full range of clinical, mental, health and social services which will improve their well being and the overall quality of life for them and their families.

Funding to support HIV prevention services for women is awarded to contractors located throughout the State, including community-based organizations, hospitals, and community health centers. The target populations for the initiative are women, particularly women of color who are at high risk for HIV and/or STI and women who are already infected. The Women's Services Unit provides program oversight, contract management and technical assistance to the providers participating in this initiative. Agencies selected to participate in this initiative are required to develop or enhance comprehensive HIV prevention and support programs for women, their partners and families.

Key components/service areas of this initiative include: HIV counseling and testing in clinical, community-based, and outreach settings; targeted and enhanced outreach to recruit and engage at-risk and HIV infected women who are not engaged in ongoing prevention, care and/or supportive services; multi-session individual and group behavioral interventions targeted to women at-risk and women living with HIV to minimize future transmission or acquisition of HIV; and strong referrals, linkages and follow-up to needed services for both at-risk and women identified as HIV positive.

Programs funded to provide HIV prevention services for women through this initiative will:

  • promote HIV behavioral interventions to initiate and to sustain behavior change over time and reduce the risk of HIV transmission or acquisition;
  • promote interventions to increase the motivation of women to know their HIV status;
  • increase access to voluntary testing at community-based organizations and health care settings utilizing the latest testing technologies available and approved for use by the New York State Department of Health;
  • reduce perinatal HIV transmission by providing early access to primary prevention and HIV counseling and testing recommended for pregnant women and women of childbearing age;
  • increase awareness among women at risk for HIV and women living with HIV of how STIs increase the risk of HIV transmission and facilitate access to STI prevention, screening and treatment; and
  • recruit and engage women into comprehensive systems of HIV prevention, support and health care services.

Contact:

Nkechi Oguagha
Assistant Director
Bureau of Special Populations
Division of HIV Prevention
(212) 417-4697
noo01@health.state.ny.us

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HIV Supportive Services for HIV-Infected Women and Their Families

Program Description

The HIV Supportive Services for HIV-Infected Women and their Families Initiative strengthens and expands referral linkages between HIV counseling and testing programs and community-based health and social services for women and their families. The initiative represents a unique, jointly funded, public-private partnership with the United Way of New York City. The AIDS Institute provides programmatic oversight for this partnership and the United Way provides technical assistance and fiscal administration.

Community-based organizations are funded to provide family-centered case management, community follow-up, and support services to HIV-infected women and their families. In addition, a range of supportive services are provided including: HIV prevention interventions for HIV-infected women; child care; 24-hour crisis intervention; emergency financial assistance; housing placement assistance; transportation; individual and group counseling; peer support; and HIV prevention education.

  • The first five (5) funded projects became fully operational providers of HIV case management and supportive services for HIV-infected women and their families in 1992 and have continued to expand their programs. In 1994, five (5) additional projects were funded and a case management program in Central Harlem became operational in 1995.
  • By 2000, most projects were reaching their caseload capacity, providing case management and supportive services to approximately 965 index clients and approximately 1,131 family members. Supportive services are provided to all clients receiving case management, as well as to clients receiving case management through the COBRA Community Follow-Up Program. Six (6) of the eleven (11) agencies are COBRA Community Follow-Up Programs.
  • The initiative was re-solicited in 2001 and again in 2008. Thirteen (13) organizations were funded in the most recent re-solicitation, and new contracts are scheduled to begin in early spring of 2009.
  • In addition to the supportive services listed above, agencies also provide mental health, family therapy, and legal services on site, via consultants, or through linkage agreements.

Contact:

Barbara Agatstein
Director, Bureau of Special Populations
Division of HIV Prevention
(212) 417-4668
bfa01@health.state.ny.us

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Communities of Color Initiative

Program Description

The Communities of Color initiative supports and seeks to effectively integrate the participation of HIV-infected and/or at risk individuals from communities of color in prevention interventions, health care and supportive services. Contractors funded under this initiative provide direct client services or referral to services such as case management, primary care, counseling, support groups, crisis intervention, transportation, meals/nutrition, legal services, counseling and testing, and information and referral. Fundable interventions also include outreach and the provision of evidenced-based prevention interventions.

The intent of this initiative is to strengthen evidence-based culturally competent and linguistically appropriate prevention interventions that meet the needs of persons from communities of color in New York State, through the provision of technical assistance and training to community-based organizations that address HIV/AIDS related issues for individuals at highest risk. This initiative also seeks to enhance HIV/STD integration efforts by recognizing the importance of STDs in HIV transmission and progression of HIV infection, and the disproportionate rates of STDs in communities of color and provide targeted prevention interventions and messages for HIV-infected/at risk individuals and/or groups.

Contact:

Barbara Agatstein
Director, Bureau of Special Populations
Division of HIV Prevention
(212) 417-4668
bfa01@health.state.ny.us

or

Bethsabet Justiniano
Director, Bureau of Community Based Services
Division of HIV Prevention
(518) 486-1412
bxj03@health.state.ny.us