GAUDENZIA, INC

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GAUDENZIA, INC Non-Profit Substance Abuse
Treatment

NEW OPTIONS PROGRAM
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Project Setting and Goal

• Services to SAs with or high risk for HIV in a
  short
• term detox/stabilization program (28 days)
  long
• term treatment TC (90 days) an OP program
  (6 mo)
• and a long term CCC for offenders.
• Target population is SAs with or high risk for
  HIV/AIDS in residential and OP treatment and
  those re-entering Dauphin County from
  jails/prisons.
• The overarching goal is to reduce the incidence
  of HIV/ AIDS and Hep among minority SAs in
  Dauphin County and SA/HIV/Hep among family
  members/ SOs.

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FOUR PROGRAM COMPONENTS

• COMMUNITY OUTREACH
• TREATMENT AND REFERRALS
• HIV/HEP PREVENTION EDUCATION
• FAMILY SERVICES

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Community and Consumer Collaboration
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A. Implementing Evidence Based (EB)
Interventions1. Outreach, Recruitment, and
Retention of Offenders

• Consumers and Community Collaborators
• Steering Committee
• Planning retreat
• Daily Collaboration AIDS day, play at
  university, etc
• EBP in community e.g., Community Promise
• CJS Relationships (81 CJS involved!)
• Acceptance of their role and responsibility
  
• Steering Committee and Planning retreat get
  them invested
• Partners - daily collaboration, treatment
  planning, and case consults

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A. Implementing Evidence Based (EB)
Interventions1. Outreach, Recruitment, and
Retention of Offenders

• Contracts and Agreements but its people working
  together
• MET and CBT and Self Help - Again science but
  people making a difference

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Implementing Evidence Based (EB) Interventions
2. Integrating HIV and Hepatitis
Program/Curriculum into existing TC Treatment
Program

• Developing an EB Program/Curriculum for Diverse
  Residential and OP Substance Abusers
• Developing an EB Program/Curriculum for Diverse
  Family Members/SOs

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A. Implementing Evidence Based (EB)
Interventions

• 3. Implementing an HIV/Hepatitis Curriculum in
  Varying Length Residential and OP Programs
• a. A 28 day detox stabilization
• b. A 90 Day modified TC
• c. A 6 Month Residential Community Correction
  Center
• d. A 4-12 Month OP Program

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B. Evaluation

• 1. Key Challenges to Recruitment/Retention to
  Conduct Follow-Up
• Attract, Train, and Maintain Diverse (including
  Bi-Lingual/Bi-Cultural) Staff
• Get Staff Comfortable Probing into Intimate
  Personal Areas
• Approaches to Substance Abuser Re-Entry
  Populations Belief that their SA and Other
  Problems are Going to be Easy On The Outside
• Trained Staff to Address many Co-Occurring MH and
  Medial Disorders
• Increase Transportation Services
• Provide Family/Significant Other Services
• They Are Disaffiliated

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B. Evaluation

• 2. Collecting Follow-Up Data With Highly
  Transitional Offenders and Analyzing Data
• Recruit With Engagement and Client Commitment
  Not Incentives
• Follow-Up Requires a Designated Person
• Keep In Touch with Alumni Activities, Cards,
  Calls and Aftercare
• Evaluators Experienced in SA, Evaluation, and
  HIV/AIDS Attend Meetings And Activities

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C. Quality Assurance Community Linkages

• Confidentiality With Substance Abusers And HIV
• Females Engage in More Sex Risk Behaviors Than
  Men

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C. Quality Assurance Community Linkages

• Changing Unsafe Sexual Behaviors
• 1. Without recovery, will not work
• 2. Through Knowledge, Intentions, and
  Practice, and
• 3. Aftercare and Follow-Up

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Supplementary HIV Knowledge, Assessment of
Self-Risk, Intentions and Behaviors at Baseline

• Client knowledge about HIV was limited - with
  almost half (10 of 18) questions scoring less
  than 75 correct at intake
• Almost half of clients thought they were at no
  risk of contracting HIV
• The low assessment of self-risk was in contrast
  to their assessment of the seriousness of the
  AIDS problem - almost 80 worry to some degree
  about AIDS,
• A similar percentage reporting that they agreed
  that AIDS was a serious problem where they lived

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Risk Factors at Intake Alcohol and Other Drug
Use

• Participants at Intake
• Men and Women
• Intake (n103
• Alcohol Use past 30 days 36
• Illegal Drug 37
• Total 73
• IV Drug Use 15 (5 males and 15
  females)

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Risk Factors at Intake Sexual Behaviors

• Sexual Orientation at Intake
• 83 heterosexual
• 14 Bisexual (mostly women)
• 3 gay or Lesbian

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Risk Factors at Intake Criminal Activity and
Involvement

• n103
• Detention jail for more than 3 days 81
• Released in last year 56
• Released in last 30 days 15

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Risk Factors at Intake Sexual
Activity at Intake

• Intake n103
• Sexually Active in last 30 days 75
• 12 or more sex contacts 23
• Of those sexually active
• Unprotected vaginal sex - men 83
• Unprotected vaginal sex women 61
• Unprotected vaginal sex with IDU 14
• Sex while under the influence 100
• Likely to have safe or no sex in next 6 mo 47
• (36 safe sex and 11 abstain)

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Summary

• The program is particularly strong in
• Decreasing AOD abuse and increasing clients HIV
  knowledge
• Recruiting and Retaining African-American and
  Hispanic clients
• Increasing client well-being, and
• Helping the Criminal Justice Re-entry population
  become stable in the community i.e. recovery,
  reduce crime, and changing behaviors

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Opportunities for improvement

• Increase the clients ability to assess their own
  HIV risk and change their actual sexual behavior
• Focus on African American and Hispanic/Latino
  clients and how to make a greater impact
• Focus on skills development in groups and
  treatment plans.
• Focus on strengthening the Family Component
• Reach out more to high risk communities