Transcript Outreach Strategies to Recruit Pregnant Substance Users

Organizing Drug
Users for
Public Health
Policy Changes
17th International Conference on the Reduction of Drug Related Harm
Jason Farrell, Executive Director - Positive Health Project, Inc.
301 West 37th Street, New York, NY 10018 USA
PHP History and Mission
• Founded in 1993
• Primary mission is to reduce HIV/HCV infection among
IDU’s and substance users by providing a range of
health, education and prevention services.
• Services are provided based on clients needs, trends in
drug use, and upon participant advisory committee
recommendations.
• One Stop Shop Harm Reduction Model
HIV Infections in NYC
• New York City has 20% of the nation's HIV cases and
AIDS deaths, highest rates in the US.
• PHP is located, in the Chelsea/Clinton community,
where cumulative AIDS case rates are 3.3 times higher
than all of NYC; 413 times the national rate.
Milestones
•
1999: Designed HBV vaccination study for IDU’s with Don Des
Jarlais.
•
2001: Developed safe injection equipment and study with Yale
School of Public Health.
•
2002: First medical center for IDU’s in a needle exchange
program.
•
2003: Free HIV/HCV Testing and Hepatitis A & B vaccination
program.
•
2003: Published first utilization study of a Safe Injection Room
in New York City
•
2004: Hired physician to distribute syringes in neighborhoods
with high HIV/HCV infection rates via ESAP law
Integrated Services
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Outreach Services
Client Intake/Triage
Needle Exchange
Medical Care/Dental
Prevention Case Management
Prevention with Positives
Group Level Interventions
Mental Health Services
HIV Among IDU’s in NYC
50
45
40
35
30
25
20
15
10
5
0
1990-92
1993-95
1996-98
1998-2002
Outcomes and Success
• There has been an 80% reduction in HIV transmission.
• NYC 1992: 50% of IDUs were HIV positive, 4% infected
per year
• NYC 2002: as few as 18% of IDUs are HIV positive, 1%
infected per year
User Unions
• Dutch Model
• Australian Model
• Canadian Model
Mission and Purpose
• The purpose of the New York User Union now known as
Voices of Community Advocates and Leaders (VOCAL)
is to increase the scope of consumer input by involving
IDU’s from all New York syringe exchange programs in
the development of policies and services that directly
affect their lives.
• VOCAL addresses the current lack of meaningful input
that drug injectors mono and co-infected have in the
formation, accountability, and implementation of
services.
• Although harm reduction has become widely accepted
as an approach to preventing the transmission of blood
borne infections, drug users continue to be excluded
from policy debates and program implementation, in
contrast to consumers of traditional AIDS prevention
programs.
Advisory Committees
National
• HCAP
• National Viral Hepatitis
Round Table
• National HIV/HCV CoInfection Coalition
• Care Coalition
• Pharmaceutical
Community Meetings
State/City
• HIV Prevention Planning
Group – City and State
• New York City Ryan
White Planning Council
• New York Hepatitis
Network
• New York State Viral
Hepatitis Planning
Committee
• IDUHA
Advisory Committees
National
• HCAP
• National Viral Hepatitis
Round Table
• National HIV/HCV CoInfection Coalition
• Care Coalition
• Pharmaceutical
Community Meetings
State/City
• HIV Prevention Planning
Group – City and State
• New York City Ryan
White Planning Council
• New York Hepatitis
Network
• New York State Viral
Hepatitis Planning
Committee
• IDUHA
User Organizing
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Trusting relationship with consumers/drug injectors
Involvement with other advisory and planning bodies
Network with other agencies that serve drug injectors
Resources for transportation and food
Facilitate IDU leadership
Flexibility in meeting days and times
Provision of advocacy training
Access to current HCV/HIV medical information
User Organizing
• 22 members from all of New York City syringe exchange
programs
• Committees: Housing; Health Care Access; and Prison
Health
• Full member meetings monthly 4th Friday of every month
• User organizing meetings are held every 2nd and 4th of
the month
• HCV user support group every 1st and 3rd Thursday
• First user ESAP every Thursday 1pm to 4 pm
• Monday, Wednesday and Friday drop in lounge
Desired Outcomes
• Changes to medical procedures which encourage IDU's
to access biopsies
• HCV care network to ensure citywide continuum of care
• Policy and service delivery changes to accommodate
IDU needs regarding treatment care, adherence and
support services
• Training for IDU's to become better advocates
• Participation and placement on committees that allow
IDU's to monitor and develop prevention messages and
service provision
Desired Outcomes
• Have an User Union committee member on the PPG and
HIV Planning Council to monitor city funded prevention,
support and medical care services and reviewing funding
applications
• The New York User Union represents drug injectors
living with HIV/HCV who are organized to facilitate
change according to the needs of this population.
• The resulting effects for member of this committee
includes a redeemed self-esteem, a found self respect
and an inherent sense of self improvement.
PHP Contact Info
For more information about
New York User Union/VOCAL or
Positive Health Project, Inc.
please contact:
Louis Jones, Lead Organizer & Director
(917) 734-2963
Jason Farrell, Executive Director
(212) 465-8304 extension 32
[email protected]
www.positivehealthproject.org