25.1 HIV on the USMexico Border: The USMexico Border AETC Steering Team UMBAST Part I: Programs on t

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25.1 HIV on the US/Mexico Border The US/Mexico
Border AETC Steering Team (UMBAST) Part I
Programs on the U.S. Side of the Border
US/Mexico Border Institute All Grantees
Meeting Washington, D.C. Wednesday, August 30,
2006

• TX/OK AETC Border Project
• Oscar Gonzalez, MS
• TX/OK AETC Border Coordinator

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Mission Texas/Mexico Border Project

• To provide training, education, consultation and
  technical assistance along the US/Mexico Border
  in order to improve treatment and care for people
  living with HIV/AIDS

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TX/OK AETC Border Activities

• Design training events, education and products to
  address unmet training needs identified in the
  region
• Coordinate activities throughout the Texas/Mexico
  Border region
• Provide Technical Assistance to build HIV/AIDS
  clinical capacity

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Border Coordinating Centers

• Local Performance Sites
• Valley AIDS Council (Harlingen-McAllen-Brownsville
  , TX)
• La Fe CARE Center (El Paso, TX)
• Texas/Oklahoma AETC Central Office
• Border Project (Dallas, TX)

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Coordinating Centers Locations

• 20 Programs
• 627 Participants
• 66 Clinical Consultations
• 8 Technical Assistance

Central Office (Dallas)
La Fe CARE Center (El Paso)
Valley AIDS Council (Harlingen)
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Training Events Most Common Topics

• Prevention is the most common topic for Border
  training events.

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Training Events Program Titles

• Post Exposure Prophylaxis
• HIV 101
• Treatment Management of HIV (for Experienced
  Patients)
• Treatment Methods, Drug Combinations, Reactions
• Case Discussions Transmission, Prevention
  Medications
• U.S./Mexico Border HIV Case Management
  Mini-Conference
• Prevention with Positives Train-the-Trainer
  Workshop
• 2006 U.S./Mexico Border HIV Mental Health
  Conference
• 2005 Border Summit HIV Clinical Update
• HIV Overview Case Detection Common
  Manifestations

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Participant Professions
Other category includes Case managers
Outreach workers Promotor/as Client
advocates
Combination of La Fe C.A.R.E. Center (El Paso)
and Valley AIDS Council (Harlingen) Level I,
Level II, and Level III training programs
Source2005-2006 PIF/PR data
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Participant Ethnicity
Total Participants (n627)

• Hispanic Origin 74.5
• White 67.5
• African American 6.2
• Asian 1.1
• Native American .3
• American Indian/Alaska Native 1.6

Multiple responses per participant contribute
to a total greater than 100
.
Source2005-2006 PIF/PR data
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Specials Events- Border Summit and Clinical
Updates

• Border Summit 2005, HIV/AIDS Clinical Update
  Conference, La Fe CARE Center, El Paso, TX.
• 13th Annual HIV/AIDS Update Conference, Valley
  AIDS Council, South Padre Island, TX
• PWP ToT workshop, La Fe CARE Center, El Paso, TX

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Border Summit 2005, HIV/AIDS Clinical Update
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Additional Border Activities

• Conducted HIV/AIDS Case Management
  Mini-conferences in El Paso and McAllen with our
  Local Performance Sites
• Conducted one day HIV/AIDS and Mental Health
  Conference in El Paso, and similar workshops in
  McAllen
• Coordinated training, technical and capacity
  building efforts

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U.S./Mexico HIV/AIDS Case Management Conferences
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TX/Mexico Border Training Capacity Building

• Qualitative and Quantitative HIV/AIDS Case
  Management Capacity Building Models
• Developed a bilingual needs assessment and key
  informant questionnaire to identify learning
  preferences, knowledge inventory and training
  needs
• 120 providers and 12 agencies completed the
  assessments and surveys
• Training sessions based upon identified needs

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TX/Mexico Border Training Capacity Building

• Case Managers Conferences -
• McAllen, TX
• El Paso, TX
• Topics
• McAllen - documentation, rapid testing, domestic
  violence and treatment adherence counseling
• El Paso - outreach to Latinas, risk counseling,
  family violence and HIV/STD

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US/Mexico Border Training
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HIV/AIDS CASE MANAGEMENT TRAINING CAPACITY
BUILDING MODELS ON THE U.S./MEXICO
BORDER González O., Emanuele T., Jones A., Smith
C., Armas L., Phillips D., Fehler A., Pacheco
H. Texas/Oklahoma AIDS Education and Training
Center - Parkland Health Hospital System,
Dallas, Texas RWCA Grantees Meeting, Washington,
August 28-31, 2006
Background Case Management plays a critical
role in the provision of HIV/AIDS care in the
U.S./Mexico Border. Case managers coordinate
psycho-social and medical services for people
living with HIV/AIDS in a region where systems of
care are fragmented and clients are typically
bi-national and bi-cultural, highly mobile,
uninsured and with limited English
proficiency. The Role of the Local Performance
Sites During the Fall of 2004, the US./Mexico
Border Local Performance Sites - La Fe CARE
Center and Valley AIDS Council - held their
annual Border Summits. The need to develop,
design and deliver site-specific case management
training and capacity building was documented
during the annual Border Summits. The Border
Program of the Texas/Oklahoma AIDS Education and
Training Center (TX/OK AETC) is committed to the
development of models for providing HIV/AIDS case
management training and capacity building for the
US/Mexico Border. The Role of the TX/OK AETC
Central Office The TX/OK AETC Border Coordinator
provides leadership and coordination to
activities in the U.S./Mexico Border. The Border
Coordinator is an anthropologist by training and
conducted much of the ethnographic techniques
used in the qualitative model for US/Mexico
HIV/AIDS case management training, education
capacity building. The needs assessment and key
informant instruments were developed and analyzed
by central office staff. The central office
staff was also instrumental in encouraging
collaboration with Border agencies and their
staff during this process. Summary The Border
Project of the TX/OK AETC developed two models
for providing HIV/AIDS case management training
and capacity building for the US/Mexico Border.
The qualitative model relied on data, literature,
ethnographic techniques and epidemiological data,
while the quantitative model was based primarily
on needs assessment surveys and key informant
interviews. Data obtained from both models was
used to inform the curriculum development,
training delivery and capacity building provided
in specific areas on the US/Mexico Border - El
Paso and Harlingen-Brownsville-McAllen area.
TX/OK AETC Models
Needs Assessment
Data
US/Mexico Border
US/Mexico Border
Literature
Training and Capacity Building
Training and Capacity Building
Ethnographic Techniques
HIV/AIDS Case Management
HIV/AIDS Case Management
Key Informant Questionnaire
Epidemiological Data
Harlingen-McAllen-Brownsville Area Conference
Topics Case management principles Rapid
testing Case note documentation Mental
health Outreach Treatment adherence
education Substance abuse Rapid testing
counseling and results Mobile border
population HIV 101 Comunicado con los pacientes
(en Espanol)
El Paso Area Conference Topics Psychosocial
assessment Case note documentation Outreach to
Latino women Case management motivation CRCS HIV/S
TD overview Family violence on the Border
Quantitative Model Survey instruments were
administered to 120 providers and 12 agencies in
the Harlingen-Brownsville-McAllen area and El
Paso region. Needs identified via quantitative
methods include case/note documentation, risk
reduction, mental health, and access to care for
the mobile border population. Qualitative
Model Available data, literature review,
epidemiological data and ethnographic techniques
were conducted during the Spring of 2006. Needs
and capacity building areas identified via
qualitative methods include family violence on
the Border, outreach to Latino women,
psychosocial assessment, the need to train case
managers to talk to clients in Spanish, and the
preference for local experts as speakers..
Training Participants
El Paso
Other
McAllen
Case Managers
Physicians
Mental Health Professionals
Substance Abuse Professionals
Nurses
Social Workers
Community Health Workers
Preliminary Results Given our experience
providing site-specific training, the TX/OK AETC
can successfully 1) encourage change in the way
case managers provide services to individuals
living with HIV/AIDS on the Border (87 Strongly
agree/Agree Harlingen-Brownsville-McAllen 93
Strongly agree/Agree - El Paso), 2) build the
knowledge and capacity of case managers to
facilitate the clinical management of individuals
living with HIV/AIDS along the U.S./Mexico
Border, 3) develop, update and disseminate
HIV/AIDS training resources to front line
minority providers or those who serve minorities,
and 4) strengthen partnerships between TX/OK
AETC, Local Performance Sites, primary care
providers, and support service organizations.
Based on strongly agree/agree responses to I
am very interested in learning more about the
following topics as they relate to case
management.
For additional information, please email Oscar
Gonzalez at o1gonz_at_parknet.pmh.org [phone]
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Technical Assistance

• We also provide TA providing information
  resources and guidance to improve HIV clinical
  services and continue of care for patients that
  go back and forth in US and Mexico.