HRSA
awarded grants under its Special
Projects of National Significance
program to the applicants listed
below.
Camino
de Vida Center for HIV Services
New Mexico Border Health Initiative
P. O. Drawer 2827
Las Cruces, NM 88004
Funding
Period: 2001-2005
Description:
The New Mexico-Mexico border region
is one of the fastest growing
and poorest areas in the United
States. The rural nature of the
area, inadequate transportation,
limited resources, low income
and low formal education levels
of the border population are notable
limitations on access to health
care. Given the lack of access
to medical care, Latino clients
infected with HIV are often diagnosed
late. Most Latino clients are
also late to begin care, and as
a result, their treatment regimens
are not as effective.
This
project has three major goals:
1) determining the patterns of
unmet HIV care among Latinos living
in the border area, 2) developing
culturally appropriate, early
HIV detection and referral services
for Latinos, 3) improving the
system of care to provide better
continuity and quality in care
for HIV-infected Latinos. To achieve
these goals, the New Mexico Border
Health initiative is engaging
in the following activities: a)
conducting a needs assessment
to examine the patterns of access
and utilization of health care
among border Latinos, b) using
a promoters program to conduct
outreach to specific segments
of the Latino population: specifically
men who have sex with men, injection
drug users, and women at risk
of becoming infected with HIV;
and c) enhancing and monitoring
the current system for continuity
and quality of care for HIV infected
Latino clients. The project hopes
to increase the number of underserved
Latinos who are tested for HIV,
enrolled in early intervention
HIV primary care and are provided
with a seamless referral to a
full range of HIV treatment and
services.
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Centro
de Salud Familiar La Fe, Inc.
Border HIV Disease Management
Model
608 S. St. Vrain
El Paso, TX 79901
Funding
Period: 2001-2005
Description:
The HIV service continuum
of care in this region is being
seriously challenged at this time.
The area’s sole comprehensive
AIDS service organization closed
in December 1998. The increases
in the complexity and costs of
diagnostic and treatment modalities
put additional burdens of service
delivery on budgets and staff
to provide quality care to growing
caseloads of clients with greater
level of acuity. Consequently,
the traditional system of case
management, with its mainly social
service functions, is proving
less than adequate to meet the
changing healthcare needs of HIV/AIDS
clients.
This
project is creating multidisciplinary
care teams composed of nurses,
positive peer advocates, and a
nutritionist to offer combined
social and medical case management
in the form of a disease management
approach. A major component of
this model is treatment adherence
assessment, education and counseling
which is being performed by all
team members according to detailed
job Descriptions and project protocols.
This study is formally document
differences in patient outcomes
that are found with the existing
case management method as compared
with this enhanced version of
disease management.
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El
Rio Santa Cruz Community Health
Center, Inc.
The Arizona Border HIV Project
839 West Congress
Tucson, AZ 85749
Funding
Period: 2001-2005
Description:
The Arizona Border HIV/AIDS Care
Project is the collaboration of
agencies developing and implementing
innovative, seamless service capacities
for early intervention and sustained
primary medical care for those
affected by HIV within the Arizona/Mexico
border region. Barriers to care
are many, including economic,
travel hardships, concerns over
lack of confidentiality and the
resultant stigmatization, cultural
and linguistic differences, and
a scarcity of physicians knowledgeable
in care for HIV infection. The
goals for this project include
improving capacity to provide
targeted outreach and counseling
for testing and identifying those
infected with HIV; engaging those
who test positive with primary
health care services; and enhancing
localized capacity of accessible
primary care providers skilled
in the care of individuals diagnosed
with HIV/AIDS.
Evaluation
strategies have been developed
that will provide quantitative
and qualitative components that
will, in conjunction with the
regional evaluation center, effectively
measure the project’s impact
on both individuals and systems
along the Arizona/Sonora border.
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San
Ysidro Health Center
4004 Beyer Boulevard
San Ysidro CA 92173
Funding Period: 2001-2005
Description:
This program is improving HIV/’AIDS
outreach, primary care services
and cross-border linkages for
people who live or work in San
Diego or Imperial counties. The
number of new AIDS cases for Latinos
is disproportionately high relative
to their total population nationwide
and in the border region. Latinos
face barriers to care such as
lack of knowledge about service,
language barriers, and lack of
culturally competent services.
The underserved sub-populations
that will be targeted in this
program are 1) newly immigrated
Latinos; 2) migrant and permanent
farm workers; 3) Latinas; and
4) Latino youth survival sex workers.
Three
major goals of this program are
to 1) increase early detection
of the underserved HIV-positive
Latino/a population; 2) increase
access to comprehensive HIV/AIDS
primary care services and 3) enhance
the capacity of community health
centers to provide culturally
sensitive care. The model is utilizing
five community health centers
(CHC) as service delivery hubs
to conduct outreach and coordinate
systems of care. Border competent
outreach workers and case managers
arel assuring that underserved
high-risk Latino populations are
reached and linked into primary
care services. A binational program
has been established to connect
a Latino/a diagnosed as HIV-positive
in San Diego or Imperial counties
with a provider in Tijuana or
Mexicali if needed, and vice versa.
The lead agency is coordinating
activities to support all CHCs
such as social marketing campaign,
a cross-border HIV/AIDS resource
guide, and a quality cultural
competency training curriculum.
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University
of Oklahoma
Centro
De Evaluacion: HIV/AIDS Evaluation
& Technical Assistance Center
Department of Anthropology
3200 Marshall Avenue
Norman, OK 73069
Funding
Period: 2001-2005
Description:
Due to the effects of poverty
and oppression, border populations
are at high-risk for social morbidities.
Other important issues for border
regions include: unemployment,
a general lack of health insurance,
fluidity of US/Mexico population
movements, language barriers,
cultural dynamics about sexual
behavior and dramatic population
growth. University of Oklahoma
is serving as the evaluation center
for a multi-site program involving
5 grantees located in the border
region. A multi-site evaluation
for issues that cross-cut the
five sites will be conducted that
develop outcome, lessons learned,
and best practices findings. The
Center is providing sites with
technical assistance. This includes,
but is not limited to assessment
of health care networks, model
development, variable selection,
instrument creation, and data
analysis. Evaluation activities
are being derived from the HRSA
Ryan White CARE Act evaluation
questions, but are primarily focusing
on removing barriers to HIV primary
care access.
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Valley
AIDS Council
Proyecto Juntos/Project
Together
418 East Tyle
Harlingen TX 78550
Funding
Period: 2001-2005
Description:
The Juntos Project goals are designed
to increase access to HIV primary
health care, to increase the capacity
of the primary health care system
to effectively meet the HIV health
care needs of poor, under served
populations living with HIV and
residing along the Texas-Mexico
Border. Juntos also seeks to better
organize health care networks
by linking the lead AIDS service
organization in the target area
with community health centers
providing primary care in the
target area. These agencies are
the Valley AIDS Council and Brownsville
Community Health Center, La Fe
del Valle, and United Medical
Centers of Eagle Pass. The centers
are major providers of primary
health care to indigent populations
in the target area.
The
Juntos Project Model include a
rotating HIV primary health care
component designed to move HIV/AIDS
care closer to where persons with
HIV live and into the three health
centers where capacity to provide
this care has been limited. Nurses
are located at each center to
coordinate care and referrals
across the partner agencies. The
project works on strengthening
the capacity of the area network
of health and human service agencies
to provide a comprehensive and
coordinated array of care and
services to the Target Population.
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