Native American Health Center Circle of Healing

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Native American Health Center Circle of Healing

• HIV HIV Prevention Services
• Presentation by Maritza Penagos

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Native American Health Center

• A CBO founded in 1972
• Provides a full range of primary medical, dental,
  substance abuse, mental health and HIV/AIDS care.
• One of the largest urban Indian clinics in the
  nation
• We have clinics in Oakland, Sacramento, Santa
  Barbara and San Francisco
• HIV Department located in SF clinic

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Circle of Healing

• HIV HIV Prevention Services in a caring,
  supportive, culturally rich and community focused
  environment
• Derives from the Native American indigenous
  cosmologies which reverend the healing power of
  the Sacred Hoop when all things are connected in
  the Sacred Hoop, balance and harmony can be
  attained.

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HIV Services Native American Center of
Excellence

• Primary Medical Care
• Nurse Case Management
• Substance Use Services assessments, counseling,
  case management, referrals/linkage
• Psychiatric Services (collaboration with SFCCC)
• Subcontract with Native American AIDS Project
• Peer Advocacy
• Mental Health Services

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HIV ServicesHolistic Native Network

• Collaboration with Friendship House
• SPNS initiative looking at the health outcomes of
  HIV Native Americans receiving comprehensive HIV
  services
• HIV Education/CTR to high risk Native Americans
• Streamlined access to residential treatment
  services for HIV Native Americans

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Holistic Native Network

• 55 clients enrolled
• 48 describe active substance abuse
• 44 have CDC defined AIDS
• 55 fit HUDs homelessness definition
• 56 identify as AI/AN 37 as multi-racial AI/AN

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HIV Prevention Services Cultural Medicine

• Sweat lodges
• Weekly beading classes
• Traditional healers
• Talking circles
• Community outreach/cultural events
• Working closely with other Native organizations
• Weekly Massage Acupuncture from IEP

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HIV Prevention Services CDC funded interventions

• Prevention case management (Wellness Support
  Counseling)
• HIV CTR using Oraquick Rapid Test
• Partnership for Health

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HIV Prevention Services Target Populations

• MSM, MSM/IDU, IDU and high-risk Heterosexual
  Native Americans who are HIV negative, or of
  unknown status
• High risk Non-Natives
• HIV Native Americans their partners

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Outreach for Prevention Services
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Conventional Outreach

• Shelters Mayors Project Connect
• SFCCC Mobile Van (CTR/RT eventually)
• Friendship House (CTR PCM)
• Forensic AIDS Project/County Jail (PCM)

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Drop In Center

• Implemented January, 2005
• Holding open space/Cultural Center
• Weekly beading class
• Community Events

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Community Events

• Monthly Workshops that blend cultural traditions
  with HIV Prevention
• Loving Our Community
• Weaving Our Traditions
• Celebration of Life
• Voices of Bravery

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Voices of Bravery
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Prevention Case Management

• Implemented February, 2005
• Difficulties
• In-house referrals
• Poor (sustained) Retention
• Ambiguity of PCM

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Wellness Support Counseling

• Accomplishments
• Risk Reduction Assessments at Friendship House
• MOU with Forensic AIDS Project
• Caseload is growing
• Linking HIV CTR with WSC

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HIV Counseling, Testing Referral/Linkage

• Implemented March, 2005
• Offered at NAHC off-site at NAAP
• Expansion 2006
• Friendship House
• Sacramento Oakland clinics
• SAGE SafeHouse

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HIV Testing

• Weve provided HIV testing since 1991
• In the last 5 years
• 246 increase in testing
• 45 of individuals receiving tests are AI/AN
• 50 of all confirmed positives were to AI/AN
• Risk Factors for individuals testing positive
  MSM, MSM/IDU, IDU

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Partnership for Health

• Implemented January, 2005
• At time of audit, June 30, 2005
• 45 UDC
• Average of 5 visits per UDC
• 42 had received at least one PfH prevention
  message
• Average of 2 prevention messages per UDC in the
  first six months of the intervention

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Partnership for Health

• Are we missing the target?
• Critical care/drop ins least likely to receive
  the message
• Critical care/drop ins are they the individuals
  that have lowest adherence to meds and more
  psychosocial issues that may make them most
  at-risk of transmission?

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Capacity Building Assistance

• BSSV Program (Dr. Amanda Houston)
• Evaluation tool for community events
• NNAAPC
• Team building strategic planning
• Motivational Interviewing