El Paso SPNS Update January, 2002

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El Paso SPNS UpdateJanuary, 2002

• Centro de Salud Familiar La Fe
• CARE Center
• Community Advocacy, Resources, and Education

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SUMMARY OF CARE MANAGEMENT INTERVENTIONS
Jan.-Dec. 2001

• Total client population at the CARE Center is
  currently 355.
• 481 people were tested for HIV, with a
  return-for-result rate of 83 (or 399 persons)
  and a positivity rate of 14 (or 66 persons).
• Clinic services were expanded from 8-13 days per
  month.
• Care managers were trained in nutrition
  counseling.

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Clinical Challenges Addressed

• Unanticipated growth of client load
• Expansion of services
• Personnel retention/recruitment
• Hiring of additional staff, role clarification
• Border crossing difficulties
• Flexibility of scheduling and service provision
• Specialized training needs
• Coordination with AETC
• Exploration of local training options

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Evaluation Challenges Addressed

• Parallel database evolution
• Database coordination
• Planned move to QSI for patient tracking
• Appointment tracking
• New software planned for patient tracking
• Client recruitment for assessment
• Exploration of home visit option
• Shift of recruitment responsibilities

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Dissemination Activities

• US Conference on AIDS, Miami Beach, FL (abstract
  only)
• US/Mexico Border Health Association, Las Cruces,
  NM
• Texas-Mexico Border Health Coordination Office,
  El Paso, TX
• Society of Behavioral Medicine, Washington, DC

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Demographic Characteristics

• N177
• 87 male
• mean age 38 years
• mean time since diagnosis 8 years
• 95 White, 90 Hispanic
• 58 preferred to answer in Spanish
• mean annual border crossings 48
• mean time spent in Mexico annually 1.6 months

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Sexual Orientation
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Education
Of the years of education reported, more than
half took place in Mexico and less than half took
place in the U.S.
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Most Likely Exposure Category
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Employment Status
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More on Employment

• About half had been employed during the past
  year.
• 59 of those who were not employed were out of
  work for health reasons.
• Those who were employed missed an average of 18
  days in the last year due to poor health.
• 72 reported having no health insurance.
• 23 of those unemployed said they were looking
  for work.
• 17 of those who were not looking for work said
  that they were concerned about losing their
  benefits if they got a job.
• Average household income was 11,799

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Inferred Treatment Issues
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Emergency Room Utilization

• 38 reported using the ER for care in the last
  year, for an average of 2 visits.
• Very few of those visits were initiated by clinic
  staff.

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Depressive Symptomology

• Mean score on the BDI-II was 12.9 (Standard
  Deviation 11.1)
• Note a score of 20 or above would indicate Major
  Depressive Disorder (Dozois, Dobson, Ahnberg,
  1998)

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Adherence

• Of clients currently taking HIV medications, 75
  reported that they had not missed a dose in the
  past 3 days.
• For those clients that did miss a dose in the
  past 3 days, mean number of reported doses missed
  was 4.4 (Std. dev. 4.5)
• That is, they reported not taking their
  medication 27 of the time.