EJAF December 2010 Grants
The Elton John AIDS Foundation (EJAF), which funds innovative HIV prevention, stigma reduction, and direct care and support programs for people living with HIV/AIDS in the Americas and the Caribbean, today announced its third round of grants for calendar year 2010. Thirty-three grants totaling $2,695,330 were awarded. From projects to restore HIV/AIDS services in earthquake-torn Haiti, to targeted HIV prevention public service messages for Black gay men, to innovative efforts to streamline HIV services for parolees, to peer education services for at-risk youth, these new awards reflect EJAF’s continuing national and international leadership to eliminate the stigma and discrimination that still prevent vulnerable people from receiving the prevention information, treatment and services they so urgently need.
Twelve awards totaling over $1.5 million will further enhance the Foundation’s continuing focus on its core targeted initiatives identified in 2006: marginalized populations (gay men, injection drug users, and incarcerated individuals), poorly-served geographic regions (the Southern United States, the Caribbean, and Latin America), and under-served groups such as African Americans and young people. The remaining 21 grants, totaling nearly $1.17 million are devoted to the Foundation’s new initiative addressing the rise in HIV incidence among gay and bisexual men in the United States. This brings EJAF’s grant-making total for calendar year 2010 to $6,501,729.
According to the U.S. Centers for Disease Control and Prevention (CDC), gay and bisexual men account for more than half of all new HIV infections in the U.S. each year (53%, or an estimated 28,700 infections) and are the only risk group in the U.S. experiencing an annual increase in the number of new HIV infections. The 21 grants selected for EJAF’s new intensified initiative addressing this issue focus on two specific areas: (1) health literacy programs and community-based media outreach targeted especially for gay men including condom/lubricant distribution campaigns, school-based sexual health programs for young people, and anti-homophobia and civil rights organizing focused on eliminating the types of stigma and discrimination that discourage or prevent gay men from seeking health services; and (2) scale-up and enhancement of gay-friendly health and social services including voluntary HIV counselling and testing, health care provider training about male-focused sexual health counselling; and gay-friendly social services, including mental health services, substance abuse and drug treatment services, legal services, and case management.
“EJAF has awarded community-based grants focused on the needs of gay men since its inception in 1992, and has invested over $3.8 million just since 2006 into HIV programs targeted specifically for gay men, both directly and through partners such as the National AIDS Fund Community Partners and the Syringe Access Fund and, for the Caribbean and Latin America, the amfAR MSM Initiative and the HIV Collaborative Fund,” said EJAF’s Executive Director Scott Campbell. “This new targeted initiative represents the next step in the evolution of EJAF’s core grant-making strategy to address the needs of this population.”
About EJAF: Established by Sir Elton John in 1992, the Elton John AIDS Foundation (EJAF) is one of the world’s leading nonprofit organizations supporting innovative HIV prevention programs, efforts to eliminate stigma and discrimination associated with HIV/AIDS, and direct care and support services for people living with HIV/AIDS. Since inception, EJAF has raised over $220 million for worthy programs across the US and in 55 countries around the globe.
EJAF reviews and awards grants to worthy projects in the Americas and the Caribbean. In addition, EJAF participates in a partnership with the National AIDS Fund (NAF) to provide challenge grants to NAF member community organizations domestically that must be matched two to one as an incentive to leverage additional local support for their work from other sources. Since 1993, Challenge Grants from EJAF have leveraged nearly $127 million in additional funding for local community organizations. EJAF also supports grants awarded through the Syringe Access Fund. Our sister organization in Great Britain, EJAF-UK, focuses its grant making on grassroots HIV prevention and care efforts in Africa, Asia, and Europe. Visit www.ejafuk.com for further information on EJAF-UK.
EJAF regularly evaluates its grant-making priorities within the context of the ever-changing challenges and needs of the evolving HIV/AIDS epidemic, targeting its grant awards where they will make the greatest impact. This approach has clearly resonated with our donors, and their generous response during 2007-2009 enabled us to increase EJAF’s grant making by 64%, according to Funders Concerned About AIDS. We have expanded not only the amount of money given but also strategically targeted key populations that are poorly served by current prevention efforts and most at risk of infection including: critically under-funded communities of the Southern United States, the Caribbean, and Latin America; highly marginalized populations such as injection drug users, men who have sex with men, and incarcerated individuals; and underserved populations such as African Americans and young people.
EJAF December 2010 Grant List
Targeted Grants (New and Renewal Requests)
Partners in Health, $500,000
amfAR MSM Initiative (Latin America), $250,000
The Collaborative Fund for HIV Treatment Preparedness, $275,000
Youth and Sexual Health
ACLU Reproductive Freedom Project, $50,000
ACLU National Prison Project, $150,000
Bailey House, Project First, $35,000
The Center for HIV Law and Policy Teen SENSE, $50,000
The Center for HIV Law and Policy Positive Justice Project, $50,000
Southern United States
Southwest Louisiana AIDS Council, $35,850
Association of Nurses in AIDS Care, $50,000
MSM Renewal Grants
Community AIDS Resource, Inc., dba Care Resource, $40,000
Positive Impact, Inc., $40,000
Addressing the Rise in HIV Infection Among Gay and Bisexual Men
HEAT Program/Research Foundation of SUNY, $75,000
Okaloosa AIDS Support and Informational Services, Inc., $75,000
Harlem United Community AIDS Center, Inc., $75,000
The Attic Youth Center, $45,000
Out Youth, $25,000
The Saban Free Clinic, $15,000
Health Outreach Prevention Education (H.O.P.E.), $60,000
Good Samaritan Project, $50,000
The Health Trust, $75,000
NYU School of Medicine/Men’s Sexual Health Project, $75,000
Youth Outlook, $20,000
New York-Presbyterian Hospital/Project STAY, $75,000
AIDS Care Center for Education and Support Services/Rainbow Bridge Connection, $75,000
AIDS/HIV Services Group, $32,000
Gay Men of African Descent, $50,000
Michael Reese Research and Education Foundation, $37,480
Fan Free Clinic, $75,000
Test Positive Aware Network/L.I.F.E. Program, $75,000
AIDS Resource Center of Ohio, $60,000
Gay and Lesbian Community Center of Greater Fort Lauderdale, $75,000
Trinity Lutheran Church/Trinity Place Shelter Harm Reduction Workshops, $25,000
Targeted Grants – Total $1,525,850
I. The Caribbean – Subtotal $500,000
Partners in Health, Boston, MA
Providing Comprehensive HIV Care in Haiti: Partners in Health serves HIV-positive and at-risk Haitians living in St. Marc, Verrettes, and four Internally Displaced People camps in Port-au-Prince. In St. Marc, EJAF funding will support HIV care and treatment at the district hospital, Hôpital Saint Nicolas, and a health center, Service de Santé de Premier Echelon. Partners In Health currently cares for 2,653 HIV-positive patients in this catchment area, including 1,040 HIV-positive patients who are currently on antiretroviral therapy. Support in St. Marc is particularly critical as the cholera outbreak there continues to threaten the health of HIV patients. Partners In Health also needs to expand HIV care to its Verrettes health center after the closure of a community health program left patients without care. In July, Partners In Health began providing this care via the public clinic in Verrettes by supporting additional staff and implementing its HIV care program for those patients. While Partners In Health does receive some funding from PEPFAR for this program, funding from EJAF will close the gap in funding, ensuring that the 967 HIV-positive patients – including 689 who are currently on antiretroviral therapy – continue to get care and that Partners In Health is able to enroll newly diagnosed patients into its HIV care program. EJAF funding will also support the delivery of voluntary counseling and testing and HIV diagnosis at four internally displaced persons camps in Port-au-Prince for the next 12 months. These posts are a critical entry point for HIV care as HIV testing is encouraged for all who seek care. As of September 30, Partners In Health tested 20,667 people in the camps, 851 of whom tested positive. Partners In Health refers those who are positive to its local partner, GHESKIO, for clinical treatment. Beyond providing voluntary counseling and testing, Partners In Health also conducts prevention activities that are critical to our objective, including community education sessions and home visits to the destitute sick. From July 1 to September 30, staff conducted 14 community education sessions and reached out to over 41,000 heads of households to disseminate prevention and awareness messages.
II. Latin America – Subtotal $525,000
amfAR, The Foundation for AIDS Research, New York, NY
amfAR’s MSM Initiative (Latin America) works to improve access to HIV prevention, treatment and care services for men who have sex with men (MSM) in Latin America and other regions of the world. The program provides financial, technical, and capacity-building support to MSM-focused community-based organizations to help them implement and expand HIV services for gay and bisexual men and transgendered individuals and to undertake structural interventions designed to reduce stigma and discrimination, increase service access, and promote human rights for MSM and other sexual minorities. The diversity of these groups—viewed by amfAR as community partners in the region—reflects the complex nature of the Latin American epidemic, and has resulted in HIV programming for sexual minorities that ranges from street outreach and prevention for transgender sex workers to landmark legal cases challenging long-standing homophobic laws. The MSM Initiative remains focused on its core strategy of providing community awards to support rights-based HIV services for gay, bisexual, and transgendered people in Latin America. amfAR will provide direct financial support to these groups—approximately $140,000 in community awards to 7 groups, as well as technical and capacity-building assistance to the 7 grantees via one-on-one mentoring relationships with regional experts and/or South-to-South exchange. Throughout the year, amfAR will utilize its technical assistance audit and planning mechanisms to continue implementation of a regional mentorship program. amfAR staff will conduct technical assistance audits (via Skype, telephone and/or site visits) with community award partners to prioritize technical assistance and/or capacity-building needs. Then, amfAR and the local grantee will develop a technical assistance plan and secure a mentor (e.g., a regional expert and/or another community organization) to provide South-to-South, targeted technical assistance based on identified needs. With an additional $100,000 from EJAF, amfAR will increase the total number of grants being offered in the 2011 award cycle (to be made in November 2011) and focus on increasing the ability of its community partners to document evidence-based outcomes. One deficit noted by the peer reviewers in 2010 was limited support to projects located in Central America, where capacity of community organizations is typically lower and governments are not as supportive of MSM/HIV programming. The additional funds would also allow amfAR to focus on Central America and help strengthen proposals from organizations in this area to be more competitive in amfAR’s awards process.
The Collaborative Fund for HIV Treatment Preparedness, Brooklyn, NY
Community-Based Advocacy and Education in Latin America: EJAF funding will support continued advocacy, treatment literacy and community mobilization by the International Coalition of Activists in Treatment In Latin America (The Coalition), which coordinates all Latin American-focused activities for the HIV Collaborative Fund and the International Treatment Preparedness Coalition. Over the course of the funding period, The Coalition will develop a core group of advocates to monitor the state of treatment access in their respective communities with an emphasis on tracking and reporting stock outages of antiretroviral medicines as well as monitoring the availability and outcomes from use of antiretroviral treatment among patients. The Coalition will organize a meeting of up to 17 advocates from across the region. These advocates will be Coalition members, especially those associated with previous and successful HIV Collaborative Fund grants. This group will meet along with other Coalition members, including those from the Regional Advisory Committee, to plan the monitoring project. Through this meeting, the group will: a) select indicators, b) develop methods for data collection, c) define the scope of analysis and development of a data base to collect the information, and d) identify training needs to support groups involved in the monitoring project. Data from the monitoring activities will be analyzed and reported through the Coalition web site. The results of the monitoring project will be used for advocacy activities to be conducted by Coalition staff and Regional Advisory Committee members. Advocacy work will also be conducted at local and national levels by community-based organizations through a small grants mechanism. The small grants will support local organizations to implement advocacy strategies to address shortfalls in HIV care and treatment provision as identified through the monitoring activities. All grantees will participate in capacity building activities including a Pre-Implementation Workshop held after grant selection and prior to project implementation. This workshop will provide an opportunity for grantees to improve their program plans and receive training in monitoring and evaluation activities. Through this monitoring and advocacy program, the Coalition will be able to track the consistency of antiretroviral therapy availability throughout Latin America. This monitoring will also provide a fast way of documenting and acting on drug stock outages. The advocacy efforts working in tandem with the monitoring project will ensure that stock outages are avoided. The initial meeting will take place in the first quarter of 2011. Monitoring activities will begin in the second quarter of the year. The process for selecting grantees for the advocacy work will also begin in the second quarter with grantees selected by Summer 2011. The grant projects will run for a one-year period.
III. Youth and Sexual Health – Subtotal $50,000
ACLU Reproductive Freedom Project, New York, NY
Advancing Healthy Sexuality Education: The program objectives are to: 1) eliminate abstinence-only sex education programming in the nation’s public schools; 2) replace it with comprehensive sex education; and 3) encourage a vision of sexuality as a natural and healthy part of human personality. The program employs the following strategies: 1) State-Based Advocacy: With targeted grants, messaging and organizing assistance, and guidance with strategic planning, the ACLU will help its affiliates eliminate abstinence-only programming and ensure that comprehensive sex education is taught in state and local communities. 2) Sex Education State Summit: The ACLU will join with SIECUS, Advocates for Youth, and Planned Parenthood to hold the fifth State Summit on Sex Education, a conference aimed at sharing, improving, and coordinating state-based sex education advocacy strategies. The National Education Association is co-sponsoring the conference this year. 3) Roll-out of new Messages: After obtaining and assessing the results of the ACLU’s “Sexuality as Personality” research, the program will develop and implement a communications campaign using these messages in 1-2 communities. Both pre- and post-campaign testing will be conducted in order to further demonstrate that these new messages do at least as well as traditional comprehensive sex education messages. 4) Investigation and Litigation: Together with its affiliates, the ACLU will continue to investigate publicly-supported sex education programming to ensure compliance with state and federal law. For example, investigations of USAID-funded abstinence-only programs that include religious proselytizing in violation of the federal constitution will continue. The ACLU recently reviewed close to 12,000 documents received via its Freedom of Information Act lawsuit and will continue to press for more documents and to develop a plan of action. The threat of litigation will be used to enforce good sex education laws; for example, the ACLU’s Washington affiliate recently sent demand letters to three school districts to pressure them to comply with that state’s good sex education law.
IV. Incarcerated Populations – Subtotal $285,000
ACLU National Prison Project, New York, NY
Advancing Rights for Prisoners with HIV: With EJAF funding, the ACLU’s National Prison Project will continue to advance the rights of prisoners with HIV using litigation, advocacy, and public education, paying particular attention to the segregation of prisoners with HIV, which can have insidious effects on a prisoner’s well being. The National Prison Project will also seek equal access to jobs and to work release so that prisoners with HIV have the same opportunities as others to learn job skills that will help them reenter the community. In Alabama, investigations have revealed that prisoners with HIV are made to wear special armbands (making confidentiality of their status impossible), housed in separate quarters, and prevented from entering certain types of residential programs, such as faith-based or honor dorms and residential drug treatment or pre-release programs that are linked to support groups in the community. As recently as November 2009, the Alabama Department of Corrections website shockingly listed the names of prisoners with HIV assigned to special dorms, further reducing control over confidentiality of their status. The National Prison Project expects to file a lawsuit to reform these practices. In South Carolina, prisoners with HIV are made to eat separately from other prisoners, denied access to work release programs and a host of different prison jobs – including those earned for good behavior – and housed at a more expensive, more violent maximum-security facility called Broad River. Notably, the U.S. Department of Justice, prompted in part by the National Prison Project’s advocacy, has threatened to sue the state over the issue of HIV discrimination. If this does not promptly result in an end to South Carolina’s worst practices, they will consider further steps, including litigation. The National Prison Project will also continue litigation to get improved medical care in certain states. They recently reached favorable settlements for lawsuits in Wisconsin, Nevada, and Mississippi and monitor the implementation of agreed improvements in those states. The National Prison Project is also working in Arizona, where a federal judge was convinced that medical care at the Maricopa County Jail (the nation’s fourth largest) was so deficient as to violate the Constitution, a decision recently upheld on appeal to the Ninth Circuit. The National Prison Project anticipates a settlement soon in its California case concerning medical care for immigration detainees. In Mississippi, the National Prison Project is looking into reports of appalling medical care at a prison run by a private, for-profit corporation. In Arizona, as the state prison system moves to cut medical costs, the National Prison Project has received disturbing reports of deterioration in care for HIV and other chronic diseases.
Bailey House, Inc., New York, NY
Project FIRST: Project FIRST serves formerly incarcerated individuals living with HIV/AIDS who are homeless or at risk of homelessness in New York City. To achieve its goal of placing individuals living with HIV/AIDS and with a history of incarceration in permanent housing and connecting them to support services promoting housing stability while optimizing their health and wellbeing, Project FIRST conducts the following activities: 1) Outreach. Through presentations and outreach, Project FIRST has established referral networks with the New York State and New York City Departments of Correction, the New York City Department of Probation, the New York State Parole Board, and community-based organizations that provide services to former inmates and/or people living with HIV/AIDS. 2) Intake and Assessment. Intake occurs at the Rand Harlan Center for Housing, Community and Wellness in East Harlem. All prospective clients are assessed for immediate housing needs, health status, legal status, and other factors and are then referred to an appropriate program. For Project FIRST participants, within the first 30 days they are also assessed for mental illness, substance use, job history, and employment readiness. 3) Housing Placement. All participants meet with a Housing Specialist who will: develop a housing plan to identify housing needs and locate appropriate, permanent housing; set up appointments for apartment viewing and assisting participants with negotiating the lease; arrange move-ins and move-outs; place eligible participants in a transitional housing unit if needed until permanent housing is secured; provide financial assistance to eligible clients to pay for security deposits, first month’s rent, broker’s fees (if any), and moving costs; offer eviction prevention assistance as needed for those who face rental and/or utility arrears; and conduct follow-up to ensure housing stability. 4) Ongoing Support. All participants meet with an Independent Living Skills Specialist to develop a plan aimed at strengthening the skills they need to maintain their housing such as money management, accessing financial support, civic restoration, education on landlord/tenant rights and responsibilities, and vocational counseling. The Specialist also addresses their health-related needs by connecting them to services co-located with Project FIRST at the Rand Harlan Center including: medical care coordination in partnership with local healthcare providers; intensive case management combining accompaniment with healthcare navigation and advocacy; substance use pre-treatment through support groups and individual counseling; a Food Pantry with weekly grocery bags and nutrition education; and a peer education program that encourages leadership skills while teaching HIV prevention through risk reduction techniques. Bailey House has also established linkages with many reputable organizations to provide complementary services such as on-site psychiatric assessment and treatment, viral hepatitis education, testing and treatment and vocational/educational training.
The Center for HIV Law and Policy, New York, NY
Teen SENSE: The Center’s Teen SENSE program targets young people confined in detention and group foster care facilities. This population typically ranges in age from 13-19, is disproportionately at risk of sexual abuse and drug use, and disproportionately financially disadvantaged. Adolescents in juvenile justice facilities are overwhelmingly from the vulnerable communities and populations most affected by, and at risk for, HIV/AIDS, low-income, Black, Latino, and sexual minorities (lesbian, gay, bisexual, and transgendered persons). These youth, across the spectrum of sexual orientation and gender, are at very great risk of HIV and other sexually transmitted infections. A significant number of young people with or at risk of HIV pass through the juvenile detention and foster care systems. EJAF funding will support: 1) staffing for the continued piloting and expansion of Teen SENSE in New Jersey, Washington, DC and New York, and to support the active participation of lesbian, gay, bisexual, transgendered, and questioning youth; 2) development of an expanded national network, national policy advocacy campaign, and community organizing effort that includes an active youth advisory group; 3) an expanded bank of resources supporting this campaign; and 4) a national convening of diverse professionals, community leaders and affected youth to advance national policy prioritization of the HIV prevention and sexual health needs of sexual minority adolescents in state custody. Specific proposed activities include: 1) The Center will identify and enlist current and former detention and foster care youth, and additional sexual minority youth, to advise program expansion and to participate as Teen SENSE Youth Advisors. 2) The Center will organize and train Teen SENSE Youth Advisors to play a key role in a) securing input/feedback on sexual health programs for youth in state custody; b) public advocacy for the rights of youth in custody to comprehensive sexual health care. 3) The Center will draft and implement a broad distribution plan for the national Teen SENSE Legal Road Map and accessible “Know Your Rights” summaries that set forth the basis for the right of all youth in state custody to a safe environment that meet their sexual health and HIV prevention needs, to encourage advocates across the country to duplicate Teen SENSE locally. 4) The Center will publish, and secure broad endorsement of, Teen SENSE standards on sexual health care, sexual health education and staff training in youth detention and foster care facilities by a national network of organizations and advocates that work in youth rights, sexual minority issues, sexuality education, sexual health, and juvenile justice. 5) The Center will develop focused advocacy for adoption of Teen SENSE sexual health care standards in youth facilities based in Washington, DC, New York and New Jersey. 6) The Center will compile and post a comprehensive online library of resources on the sexual health needs and rights of sexual minority youth in state custody, and the elements of inclusive sexual health programs that address those needs. 7) The Center will convene a national meeting of experts and youth for strategy development, broader dissemination of HIV prevention policy proposals specifically targeting youth in state custody, and broader public awareness for the sexual health care and HIV prevention needs of youth in out-of-home care. The Center is also working with a broad coalition of community allies who have been organized to intercede with government policy makers to ensure that these standards and the services they outline become a reality for youth in detention and foster care facilities across the country.
The Center for HIV Law and Policy, New York, NY
Positive Justice Project: A particularly sinister manifestation of HIV stigma is the criminal prosecution of persons who test HIV positive for acts of consensual sex and for conduct, such as spitting or biting that poses no real risk of transmission. Criminalization of HIV legitimizes the ignorance about HIV, homophobia and racism that fuels inflated fears of HIV and those who have HIV. In the last two years alone, there have been more than 80 documented HIV-specific arrests and prosecutions against people who have tested positive for HIV, and the actual number is likely higher. Some defendants have been charged under HIV-specific criminal laws; others were charged under general criminal laws. There are very few cases involving actual intent to infect or harm a partner over the course of the epidemic. Rather, people are serving long sentences, or are subject to intrusive monitoring as “sex offenders,” in situations where there was no evidence even that the defendant transmitted HIV. Thirty-eight U.S. states and territories criminalize the conduct of HIV-positive people who allegedly expose others to HIV. Even when an HIV-positive person discloses her/his HIV status to a partner, or takes precautions to prevent transmission (such as using a condom during sex), the HIV-positive person can be prosecuted in many jurisdictions. To address the urgency created by the reference to criminalization in the National AIDS Strategy, The Center will accelerate its state organizing plan and engage the membership of the National Association of State and Territorial AIDS Directors on the issue of criminalization. State AIDS Directors are key players in state AIDS policy and, more than any other group, in direct contact with the public, the media, state legislators and law enforcement officials regarding perceived exposure incidents, potential prosecutions and proposed HIV laws. With EJAF funding, The Center will: 1) Convene each work group to create a community consensus statement of principles for the appropriate use of criminal and civil law to address potential HIV exposure. The goal is a set of principles which treat similar risks in the same manner (e.g., treating HIV like HPV is treated in legal settings) and call for an end to discriminatory treatment of HIV in laws, prosecutions and sentencing. 2) Convene work group representatives to endorse use of fact sheets and talking points on: HIV routes and actual transmission risks (including impact of antiretroviral therapy), public health reasons to oppose criminalization, and stories of individuals for whom criminalization has had a devastating impact. 3) In preparation for state-specific Project outreach and organizing, create: a) Fact sheets which outline relevant law, how it’s been applied, and how HIV+ people can best protect themselves from arrest and prosecution for alleged HIV exposure incidents; and b) Surveys to assess knowledge and attitudes about HIV risks and criminalization before community forums, and to measure change in knowledge and attitudes following these forums. 4) Plan and conduct a series of four to seven outreach and organizing meetings, focused on those jurisdictions with the most current prosecutions (Tennessee, Ohio, Illinois, Indiana, Michigan, Missouri and Pennsylvania) to assess and address common factors of public support of criminalization. Each meeting will include a community “town hall” forum at local AIDS service organizations and/or Lesbian-Gay-Bisexual-Transgender community centers that are likely to draw the best cross-representation of community, including at-risk and HIV positive women, who are the reference points and drivers of most pro-criminalization policies and rhetoric. If available, local attorney(s) who have defended individuals in criminalization cases will be included in panel discussion, as will state AIDS directors and state/local health officials.
V. Southern United States – Subtotal $85,850
Southwest Louisiana AIDS Council, Lake Charles, LA
Facilitating Access to Coordinated Treatment (FACT): FACT targets underserved and minority populations, particularly previously incarcerated, young men who have sex with men (MSM), persons with a history of substance abuse and/or mental health disorders, and people of color who live in or receive services in Louisiana Office of Public Health’s Region V, comprising five civil parishes (counties) in the southwest corner of Louisiana. The objectives of FACT are: 1) To identify HIV+ persons, both newly diagnosed and those not linked to primary medical care, and to provide information and referrals for medical and supportive services available within the region. The FACT System Navigator coordinates with the Region V Office of Public Health, the Comprehensive Care Clinic, and other HIV testing/prevention programs in the region to identify newly diagnosed persons. The system navigator is also certified to provide testing/counseling and partner elicitation services, facilitating partner notification and early entry to care. 2) To assist clients in identifying personal, family, and community support systems in order to assess barriers to care. The system navigator works with clients to identify issues which may be obstacles to care, such as lack of transportation, negative experiences with the health care system, and history of/active substance abuse or mental health disorders. With this information, the system navigator works with the client to develop an individualized plan of care which minimizes these barriers and maximizes active participation in medical and supportive services. 3) To provide linkages to medical and supportive services in order to facilitate access and retention in care. The system navigator and the client work together to identify necessary resources and to develop a clear plan of action, outlining responsibilities and targeting completion dates. The system navigator assists the client with completion of paperwork, with making and attending appointments, and even with “coaching” where needed to help clients make consistent progress with their care plan. The dual foci of the plan of care are, first, to help clients learn how to successfully identify and access medical and community resources on their own and, second, to help clients gain confidence in their abilities to navigate the health care and supportive services systems. FACT’s goal is to provide these services to 100 persons, 75% of whom will remain in medical care after one year.
Association of Nurses in AIDS Care (ANAC), Akron, OH
Train the Trainer HIV Nursing Workshops: The Train the Trainer HIV Nursing Workshops will train between ten and fifteen nurses at one time and focus on the rural south. Trainings will take place in Alabama, Georgia, Tennessee, Florida, and Louisiana, and the Association of Nurses in AIDS Care (ANAC) will market and register the nurses for the trainings from clinics, rural hospitals and doctors offices in the area. Particular emphasis will be given to communities that have disproportionately high incidence of HIV. ANAC chapters in these areas will help facilitate the necessary activities on the ground, while the National office will oversee the project. These workshops will assist nurses who are not trained specifically in HIV/AIDS Care to acquire the knowledge needed to care for patients who are HIV positive. The curriculum for this training was developed by an ANAC member and used for the previously funded trainings in the Mississippi Delta Region. The evaluations from these meetings showed an overwhelmingly positive response to the material presented. The presenter did a fabulous job of interacting and relating to the nurses because she is also a nurse working in the rural south area. The same nurse will be secured to do the proposed trainings, and ANAC is confident the same success will occur. After each nurse subsequently trains an additional 10-15 nurses, they will receive a copy of ANAC’s Core Curriculum for HIV/AIDS Nursing and the Scope and Standards of Practice on HIV/AIDS Nursing. These references are enduring resources that the nurses can utilize in clinical practice. The nurses that are trained will also have access to the presenter for one year through email. As they apply the training they received, they can ask for additional guidance or feedback. The nurses who are trained will be secured by approaching their employer and acquiring a signed document from the employer that accomplishes the following: 1) The employer will allow one nurse to attend the training during regular work hours at no cost to the employer. 2) The employer will allow the nurse who attended the training to conduct a four hour training with 10-15 other nurses from their facility. The employer will allow the nurse to use their copier to make copies for the training and have access to a room and LCD player to present the slide deck. 3) Each nurse trained will receive four Continuing Education Credits, a jump drive with the slide deck information, a complimentary one-year ANAC membership, and access by email to the ANAC member who originally presented for questions concerning HIV.
VI. MSM Renewal Grants – Subtotal $80,000
Community AIDS Resource (dba Care Resource), Miami, FL
Youth Health Intervention Project (YHIP): The purpose of YHIP is to reduce new HIV infections among young men who have sex with men (MSM) and to connect HIV-positive MSM to appropriate medical care, treatment and other support services. YHIP targets gay men in Broward County, FL, ages 17-39, including all racial and ethnic categories, low-income individuals, and drug users. YHIP disseminates culturally competent prevention messages and increases knowledge of HIV serostatus among this population, utilizing community outreach, counseling, testing and linkage to care. EJAF funds will be used to staff the program with two per diem Treatment Access Counselors who are responsible for conducting outreach to the target population and conducting HIV testing, pre/post-HIV test counseling and linkage to needed services. Testing is conducted at various sites using a mobile van equipped for confidential testing and at other sites made available by affiliated organizations. EJAF funds will also cover travel (mobile unit), supplies (prevention messages and safe-sex kits) and 15% of total personnel and benefits are included for overhead costs. The Treatment Access Counselors will go to various sites in targeted areas and engage individuals in conversations about sexually transmitted infections, HIV, and substance use risks; distribute educational materials and safe sex kits; and invite individuals to be screened for HIV. Individuals who accept testing receive pre-test counseling at the mobile unit followed by the HIV test and post-test counseling. HIV-positive individuals will be immediately linked to comprehensive HIV-related services at Care Resource or any other agency the client chooses. HIV-negative high-risk individuals will be referred for comprehensive risk counseling, sexually transmitted infections services, or other appropriate prevention services.
Positive Impact, Inc., Atlanta, GA
Sexual Transmitted Infection Screening in MSM Populations: Positive Impact provides multiple HIV prevention programs for gay, bisexual and other men who have sex with men (MSM), including free HIV rapid testing. EJAF funding will support the incorporation of screenings for sexually transmitted infections (STIs) to include syphilis, gonorrhea and Chlamydia into the Prevention Department programming. When a gay man participates in an agency prevention program, he is routinely referred to Positive Impact’s in-house Testing Center for an HIV test if the individual is not known to be HIV-positive. As well, the Outreach Specialists in the Prevention Department actively recruit gay men from bars, nightclubs, sex clubs and other high-risk venues to obtain an HIV test at the Testing Center. Men who then receive an HIV test and who also are identified to have had potential exposure to an STI or to describe symptoms of an STI are directly introduced to the Health Care Specialist for an STI screening at the same visit when the HIV test is obtained. The STI Clinic will offer screenings during hours when the HIV Testing Center is open. The Health Care Specialist will provide STI screenings four days a week, including evenings, to accommodate as many schedules as possible. It is planned to conduct a minimum of 300 STI screenings for syphilis, gonorrhea and Chlamydia annually. The State Laboratory in Decatur, Georgia will provide the swabs, syringes and tubes to collect blood specimen samples. The specimens are then returned to the State Lab, who charges $10 to run screenings for syphilis. The Emory Laboratory provides urine cups to collect urine specimens for gonorrhea and Chlamydia, and these are sent to Emory for processing at the rate of $50 per sample. Both the State Laboratory and Emory then send a results report back to the agency. Once the reports are back at the agency, the Health Care Specialist contacts the client to notify them of their test results. Anyone who receives a reactive (positive) test result for any STI will be referred to their primary healthcare provider or to their county public health department for immediate treatment. The Health Care Specialist will coordinate with the health departments to assist in ensuring the client accesses treatment. The Health Care Specialist will also report all positive results to the health department so that an attempt can be made to contact sex partners of the individual receiving a positive result. This contact is executed in such a way as to ensure that the positive client’s confidentiality is not breeched and the individual is not identified to any sex partners with whom the positive client might have had contact.
VII. MSM Initiative: Addressing the Rise in HIV Infection Among Gay and Bisexual Men –
HEAT Program/ Research Foundation of SUNY, Brooklyn, NY
Young MSM/Transgender Health Project: This project is an innovative model for outreach, identification, and specialized care services, including primary care, mental health care, case management, HIV treatment adherence education, and access to HIV clinical research, for HIV+ and at-risk young MSM and transgender youth of color, ages 13-24. The overarching goal of the project is to reach out to and effectively engage and retain high-risk and HIV+ young sexual minorities in care, which will improve their physical and mental health and extend their lives, by tapping into their social networks and offering HIV counseling and treatment at community-based organizations for lesbian, gay, bisexual, and trangender youth, foster care group homes, homeless youth drop-in centers, night clubs, churches, “House Balls,” Pride events, underground parties where sexual minority youth engage in unprotected sex, and juvenile justice facilities. Peer outreach workers help the program reach, engage and stay connected with sexual minority youth. EJAF funds will pay for an additional part-time medical provider to care for the growing client base of high-risk and HIV+ and will expand HEAT’s capacity to meet the increased demand for medical services and to continue to reach out to and engage new sexual minority youth in care. HEAT is an Article 28 licensed medical facility under SUNY Downstate Medical Center located in Central Brooklyn, one of the highest HIV/AIDS prevalence areas in NYC and the nation. HEAT’s “one-stop shopping” model eliminates barriers youth often face when trying to access health care. Our adolescent/young adult focused model puts the young person in the center of his/her care and treatment decisions. Clients see the same health practitioner each visit. Medical services for sexual minority youth include complete physicals, STD screening/treatment including Hepatitis A & B immunizations, anal PAP smears, antiretroviral and hormonal treatment. HEAT also provides services for HIV negative transgender youth including gender identity transformation and hormone therapy. Because of the challenges many young people face around HIV treatment compliance, practitioners provide intensive treatment adherence education and support. Referrals for dental care, specialty services and inpatient care are made to SUNY Downstate.
Okaloosa AIDS Support and Informational Services, Inc. (OASIS), Ft. Walton Beach, FL
Equality House: EJAF support will be used to provide a year’s operating expenses as foundation for the Equality House project to develop and implement sustaining initiatives that have as a primary focus the health and rights of gay men and other sexual minorities. OASIS believes that in order to maximize the chances for a lasting advance of this project in the community, it will require a strong program coordinator as its hallmark. The program coordinator will pursue three main goals: the development and provision of their own professional services, the development of MSM prevention interventions, and the development of many initiatives that establish new linkages with the greater professional community beyond the HIV/AIDS and Gay-Lesbian-Bisexual-Transgender-Questioning populations. OASIS believes in the impact and reach of its prevention work and is eager to replace, at least in part, programming for these high-risk populations. The agency has been working diligently with West Florida University staff and the Red Ribbon Charitable Foundation to build its own evidenced-based prevention curriculum for the gay community. Examples of new linkages might include work to provide affordable legal services and education, continuing education related to gay issues for the medical, academic, and business communities, and work to develop substantive leadership development opportunities that will help build the next generation of HIV/AIDS and/or sexual minority leaders. While the goals identified above fall into efforts to strengthen gay-friendly health and social services, OASIS also envisions Equality House as an ideal foundation for the community mobilization for health and rights, particularly in conjunction with its work as a two-year National AIDS Fund Southern REACH grantee. As producer/host of the regionally-acclaimed Positive Living conferences, OASIS is highly skilled when it comes to curriculum development and training. The agency’s popular Activate U workshops provide consumers with the basics of HIV grassroots advocacy and guide local efforts to address critical health and rights issues such as the AIDS Drug Assistance Program and housing as healthcare. The Equality House project would make a likely venue for this kind of mobilization and help to unify and strengthen common effort among stakeholders and allies such as the ACLU and Equality Florida.
Harlem United Community AIDS Center, Inc., New York, NY
HOME (Helping Our Men Evolve): A service for gay, bisexual, and questioning at-risk youth of color: HOME reaches minority men who have sex with men (MSM) ages 15 to 29 who may or may not identify as gay or bisexual. At present, HOME serves 130 youth, half of whom are homeless. HOME is tailored to the specific needs of gay youth; as a result, it has taken the form of an empowering community instead of a traditional prevention program to address the root causes of youth HIV prevention issues such as harmful social norms and self-image problems. Not only does HOME provide a continuum of social programs, group therapy, mental health interventions, and primary care referrals (all based on a comprehensive intake process), it also empowers clients to grow over the course of their involvement. HOME “visitors” are referred by peers, may attend events without undergoing an intake process, and may move on to become “members” and “peer leaders.” After visitors undergo an intake process (which includes a Comprehensive Risk Counseling and Services assessment), they get expanded access to the HOME facility, access to support groups, and referrals to primary and mental health care. Members of 3 months or more can become Peer Leaders and receive stipends to intern with Harlem United or to spread prevention messages in the community (by “tabling” in areas MSM frequent, planning daily HOME-sponsored social events and support groups, conducting outreach over Internet forums and social media, and providing sensitivity training to community establishments). HOME clients on the job development track (Harlem United interns) receive $400/month and HOME clients on the prevention track receive $100/month. HOME pays stipends via gift cards and leaders are enrolled in stipend programs for 6 months. EJAF funding supports expanded peer leader and prevention track stipends.
The Attic Youth Center, Philadelphia, PA
HIV Prevention Services for At Risk Young MSM in Philadelphia: The Attic serves approximately 1,000 Lesbian-Gay-Bisexual-Transgender-Questioning youth each year between the ages of 14 and 23, the majority of who live in the City of Philadelphia. Eighty percent of the youth who participate in Attic programming are African American and Latino young men who have sex with men. The Attic will provide the following services with support from EJAF: 1) Mpowerment — Mpowerment is a HIV prevention intervention for young gay men that promotes the use of peer to peer outreach and education to reduce sexual risk behavior. The Attic’s Mpowerment program is run by 3 youth staff (a peer leader and two peer educators) with the support of Attic professional staff. The peer educators organize a core group of gay youth from the community who receive ongoing training and who promote strategies to create a culture where safer sex is the practiced norm. 2) Comprehensive Risk Counseling Services — The Attic provides voluntary and confidential counseling to address personal, psychosocial, and environmental challenges that influence risk behaviors. Youth work with a counselor to identify goals and to discuss strategies related to reducing risky behaviors. 3) Mental Health Programming and Supportive Services — Mental health counseling and support groups are available to gay youth who participate in Attic HIV prevention services, either by self referral, or referred by program staff. 4) HIV prevention services are part of a continuum of care offered at The Attic. Sexual minority youth also participate in case management services as well as The Attic’s Life Skills Center, where youth take part in programming designed to improve academic and job skills, develop leadership capacities, and promote community involvement. Based on The Attic’s experience, these services also contribute to a decrease in risk behaviors for sexual minority youth.
Out Youth, Austin, TX
HIV Prevention, Testing and Counseling Program: Out Youth is the only agency in Central Texas that specifically serves Lesbian-Gay-Bisexual-Transgender youth locally and statewide. EJAF funding will support: 1) Sexual health curriculum and counseling: Out Youth’s sexual health curriculum is designed to increase awareness of sexually transmitted diseases. To that end, it uses a variety of formats (e.g., group activities, games, movies) to provide youth (age 14 to 20 years) with prevention information. All youth have the option to meet individually where counselors assess the individual’s risk for sexually transmitted diseases and provide additional information on HIV/AIDS, including specific information on exposure, the “window period” (i.e., the time between exposure and when the virus can be detected via testing), and testing and retesting options. 2) Rapid HIV testing: Youth who are interested in the rapid HIV test will be asked to sign consent forms. Counselors obtain information on how to contact the youth if needed (e.g., school name, home address, phone number). Youth interested in testing will be screened for their readiness to test. Youth who are intoxicated, at risk for suicide, or who exhibit serious mental health symptoms are not tested. Youth who are tested will engage in additional educational activities after the test until the results become available. 3) Retest and post-test counseling and follow-up: Youth who initially test positive will be immediately retested using the Orasure test (the results of which are typically not known for a week). Those who test positive on the rapid test will be counseled by a master’s-level social worker and screened for risk of suicide. A social worker will provide the youth with an emergency number in case support is needed while awaiting results of confirmatory testing. These results will be given at the Out Youth drop-in center approximately 1 week later where individuals who test HIV-positive are immediately linked to youth-specific, comprehensive HIV care.
The Saban Free Clinic, Los Angeles, CA
Increased HIV/AIDS Outreach, Testing and Counseling to MSM in L.A. County: Founded in 1967 as The Los Angeles Free Clinic, the clinic accommodates nearly 90,000 visits to 21,000 unique individuals for medical, dental, mental health and educational services through its network of five clinical sites. The clinic’s HIV program provides the following services: 1) Rapid and Standard HIV testing; 2) Interactive, bilingual presentations and workshops to the community; 3) Lateenhealth.org, which includes teen friendly info about HIV and the clinic’s services; 4) Distribution of condoms, female condoms, lubricant, pamphlets and other materials; 5) Referrals to specialized medical or psychosocial services for people with HIV. The Clinic provides youth-tailored comprehensive sexual health education in classes at local high schools and runs a High-Risk Youth Program for homeless/runaway youth, ages 12-24. This program addresses safe sex, informed decision making, and enrolls HIV-positive clients into specialized programs. The Clinic also runs a newly-implemented School Based Health Center at Hollywood High School, which offers HIV services, education and supplies to students. EJAF funding will support: 1) Increased Outreach to Sexual Minority Populations: The Clinic will distribute targeted information about HIV services to social service agencies, bathhouses and sex clubs, schools and through Internet outreach such as our website Lateenhealth.org, postings on Craigslist’s “Men seeking Men” category, and social networking sites like Facebook, Myspace and Twitter. 2) Increased Rapid HIV testing: Currently our HIV Tester and Counselor positions only offer Rapid HIV tests, which does not require a blood draw and results are obtained in only 20 minutes. To increase access and ease of obtaining an HIV test, medical assistants and other clinicians at the clinic will be able to offer Rapid HIV tests. Thus, patients coming in for other medical reasons may be more inclined to take an HIV test because of the convenience; also individuals unwilling to meet with an HIV counselor may accept the test from another clinician. Physicians at the Hollywood High School Center feel this will be particularly conducive and convenient for students visiting this Clinic. 3) Health Provider Training: The Clinic’s Rapid HIV Coordinator will provide trainings to perform Rapid HIV tests and also trainings to Clinic health care providers for gay-focused topics for testing and counseling, which will enable them to better relate to gay clients and give better care in regards to HIV services. Trainings provided will include topics such as the Importance of HIV Perceptions Across Different Cultures, Stigmas and Other Barriers to Care, and Client-Centered Counseling for HIV/AIDS.
Health Outreach Prevention Education (H.O.P.E.), Tulsa, OK
IMPACT: In the rural areas in Oklahoma, there are very few services available for testing or prevention education for HIV, especially for gay men and other sexual minorities. H.O.P.E. currently answers the Statewide HIV/STD hotline and receives at least 50% of the calls from rural areas in Oklahoma requesting access to HIV testing and prevention information. With EJAF funding, this project hire an additional full-time outreach worker and enhance the following services: 1) Rural Outreach: H.O.P.E. will increase rapid HIV testing availability to rural areas outside of Tulsa through relationships with rural drug courts, clinics, health departments, drug treatment centers, and other agencies that would like to provide HIV testing, counseling, and prevention. H.O.P.E. will also increase the distribution of condoms, condom packets and other prevention materials in rural areas. 2) Internet Outreach: H.O.P.E. currently conducts very limited internet outreach on Manhunt.com, but will significantly enhance this to include other sites and provide a staff member to answer questions, encourage testing, and provide risk reduction and prevention messages. 3) Condom Distribution: H.O.P.E. provides a limited amount of condom packets (two condoms, lubrication pillow, and H.O.P.E. business card) and loose condoms to each local gay establishment around Tulsa. Distribution will be expanded to include rural areas, as well as alternative spots in Tulsa. H.O.P.E. will significantly grow this distribution program to provide safer sex supplies and information to existing partners as well as more mainstream locations and special events in hopes of reaching men who may not identify as gay. 4) Advocacy Work: It is the philosophy at H.O.P.E. that there are many complicated factors making gay men at higher risk for HIV and other infections. Stigma plays a key role, particularly in a more conservative environment like Oklahoma. H.O.P.E., along with collaborative partners, will increase its efforts to provide advocacy, support, and education to gay and questioning youth, so that they are better prepared to make health decisions around sex and sexuality. 5) Marketing campaign: H.O.P.E. has conducted several formal and informal focus groups to determine the most appropriate HIV prevention messages for the gay community, as well as the most appropriate venue to disseminate these messages. The program will develop high quality promotional materials (postcards, posters, bathroom posters, billboards) based on the messaging feedback received from the target population to be distributed at partner organizations, bars, adult book stores, social gatherings, and special events. The billboards will target the MSM and the African American community. H.O.P.E. will also increase the distribution of role-model stories that encourage behavior change to increase condom use in gay men and other sexual minorities.
Good Samaritan Project, Kansas City, MO
Let’s Talk Man to Man: The target population for Good Samaritan Project’s Many Men Many Voices program, “Let’s Talk Man to Man,” is men who have sex with men (MSM) of all ethnicities in the Kansas City Transitional Grant Area. The program is a group-level intervention delivered over six interactive sessions. Because gay men are struggling with a minority identity of homosexual in a heterosexual majority culture, the key characteristics of the intervention focus upon exploring how minority identity can be enhanced to become a protective factor against HIV infection. This intervention is adaptable to the needs of all MSM, HIV-negative and HIV-positive. The focus of the delivery of this intervention is on interaction and observation of peers rather than on didactic experiences. HIV-positive men learn secondary prevention skills and HIV-negative men learn from the experiences of HIV-positive men about how to remain negative. Gay men will be recruited into the program from counseling, testing, and referral conducted in a variety of venues, such as bars, public sex environments, sex parties, etc. Group facilitators will attend these events and be on hand to speak with potential participants and assess client suitability for inclusion in the intervention. Previous participants will be enlisted to assist facilitators, safer sex kits with program promotions will be distributed, press releases will be distributed to local media, other area agencies providing MSM services will be alerted to and given information regarding the program, and social marketing will be conducted with outreach efforts. Incentives will be used to retain participants, such as refreshments and gas or grocery cards at meetings. Participants will be interviewed in advance for placement in appropriate groups such as ethnic-specific. “Let’s Talk Man to Man” will be offered in two session increments over three consecutive Saturdays with each session covering a different topic. In previous implementations of similar programs, this schedule of delivery had a retention rate greater than 90%. Sessions will be offered at the Good Samaritan Project’s main office located centrally and on major bus lines in Kansas City, Missouri. Bus passes will be given or rides arranged for participants lacking adequate transportation. The main office is located one block from two major thoroughfares insuring privacy. Facilitators will be knowledgeable about other Good Samaritan Project services and community resources, and will be able to make referrals to other services to support client expressed needs and goals for safer behavior. Many prevention supportive services will be available on-site. HIV testing as well as gonorrhea and Chlamydia testing will be offered by group facilitators trained in testing protocols. Representatives from local health departments will be invited to program sessions to offer tuberculosis testing as well as hepatitis testing and vaccinations.
The Health Trust, Campbell, CA
The Health Trust AIDS Services: The target population for this project is males who have sex with males (MSM) residing in Santa Clara County, including males of all ages and of any sexual orientation who have sex with other males. The Health Trust is committed to reducing health disparities in HIV prevention, detection, and care/treatment and eliminating barriers to care that include: lack of health insurance; chronic mental illness or substance abuse; recent incarceration; poverty; homelessness; and competing needs such as food and shelter. Over the past two years, The Health Trust has expanded its existing AIDS services to include a focus on health education and prevention, advocacy and social support interventions to increase awareness among gay men and other sexual minorities, service providers and the larger public sphere; mobilize a movement towards reduction of discrimination and stigma; and enhance successful integrated/self-sufficient living options for gay men and other MSM. Together with the coordinated efforts of community partners, The Health Trust is committed to advancing a gay men’s health agenda while lowering disproportionate percentages of new HIV infections and AIDS diagnoses in our county through the following activities: 1) Gay-friendly social services and skill development activities that advance health, independence and self-sufficiency that takes into account an economic assessment of an individual’s situation as well as less quantifiable aspects of a person’s life, including education, housing stability, life skills, mental health, etc., including: 100 social events, support groups and workshops on the following topics: income and spending/credit repair/financial literacy; employment and resume writing; legal issues and compliance with probation/parole; mental health and stress reduction; HIV meds and substance use; HIV education and management; positive socialization; and healthy nutrition/cooking that impact 500-1,500 individuals. The Health Trust will also draw from the expertise of clinical staff, and the local HAP and Planning Council to provide training to 15 “peer advocates” to implement a peer support program. 2) Implementation of two large-scale annual service provider and public education and awareness events, reaching approximately 500 participants, developed in conjunction with diverse organizations whose work focuses on reducing stigma, increasing awareness and addressing disparities from within the framework of a gay men’s health agenda. These events will also highlight relevant issues and offer a public face to the wider population willing to advance a gay men’s health agenda in Santa Clara County. 3) Advancement of an advocacy and policy agenda to improve the health and wellness of gay men in Santa Clara County, including addressing the need to restore sexually transmitted disease testing in Santa Clara County and advocating for public funding to support the implementation of peer support prevention and advocacy programs to reach gay men throughout the county.
NYU School of Medicine, New York, NY
The NYU Men’s Sexual Health Project (M*SHP): M*SHP, which initiated as a pilot in 2006, has conducted nearly 3,000 HIV tests in clinical satellites located in two bathhouses, one sex club, and a recently added sex party. Building on the clinical service created by M*SHP HIV and sexually transmitted infection testing, EJAF grant funds will be used to expand prevention services from testing and referral to provision of non-occupational post-exposure prophylaxis (nPEP). The objectives of the program are: 1) To expand knowledge of nPEP among highly-sexually active gay men, who are at enhanced risk of HIV exposure and seroconversion; and 2) To create a program based at the commercial sex venues serviced by M*SHP to provide nPEP in a way dictated by a needs assessment of our clients. The clear need to make nPEP provision both accessible and transparent to at-risk gay men on their own terms will require significant innovation to “de-medicalize” an intervention that requires laboratory testing and pharmacy support. In the tradition of M*SHP, both traditional and non-traditional approaches will be used to create a venue-based nPEP program. Objective 1 will occur simultaneously to objective 2, the establishment of the nPEP program. Significant outreach and press will be needed to promote the expansion of services at M*SHP to include nPEP. Several approaches that will require staff supported by EJAF funds will be used. Previous men testing with M*SHP (nearly 3000) will be contacted through emails and social networking media, through which the program interacts with its clients. Additionally web and print advertising, funded by EJAF, will be used to promote this service expansion. M*SHP will also use its significant ties with nightlife promoters and event organizers to further enhance visibility and knowledge of nPEP. Objective 2, to establish a venue-based nPEP program, will involve the use of existing clinical infrastructure at sex clubs and staff partially funded through EJAF, to identify men who have met criteria for nPEP. Rather than going through the emergency room, men requiring nPEP, as dictated by NY State and CDC guidelines, will have baseline rapid HIV testing and medication monitoring labs drawn in the field. If HIV uninfected and deemed by clinical criteria to merit nPEP, a prescription will be called in by Dr. Daskalakis to a 24 hour pharmacy for an appropriate nPEP regimen. An account at this pharmacy will be used to charge 3 days worth of nPEP to M*SHP, a cost budgeted for EJAF funds, and the nPEP client will be directed to pick up these preventive medications at no charge to them. This partial prescription or “starter pack” will be distributed rather than a complete 28 day course of nPEP medications, to guarantee follow up and minimize cost in the case of non-adherence to follow up. Staff will then function as case managers to set up a visit by the nPEP initiating client during normal office hours with Dr. Daskalakis to review baseline labs and receive the remaining 25 days of nPEP drugs to complete their course, free of charge through Bellevue Hospital. Further monitoring and adherence support will be done in the field or in the hospital as decided by the client.
Youth Outlook, Naperville, IL
HIV/AIDS Education Among Lesbian-Gay-Bisexual-Trangender-Questioning Youth: Youth Outlook serves approximately 150 sexual minority youth ages 14-21 per year who reside in Dosage, Kane, and DeKalb Counties of Illinois; this area corresponds to the far western suburbs of Chicago and rural northern Illinois. Youth Outlook provides specific HIV prevention education one to two times per month, as well as risk-reduction supplies every week. HIV and AIDS prevention is inherent in all of its programming: by engaging youth in activities that foster self-esteem, healthy choices, and goals for the future, Youth Outlook offers positive alternatives to risky sexual behavior that could lead to contracting HIV and AIDS. Drop-in center meetings are held weekly at each site. Topics relating to HIV are either scheduled, or otherwise brought up by youth in discussion, once or twice a month. HIV education and prevention program topics include HIV and sexually transmitted disease transmission risks and routes; living with HIV (how it can change a young person’s goals and hopes for the future); dealing with power and control in a relationship; and alternatives to becoming sexually active. Youth repeatedly state that Youth Outlook is the only place they feel comfortable discussing these issues. EJAF funding will support HIV prevention activities at the drop-in centers and the re-launch of the Popular Opinion Leader (POL) program. POL enlists the help of key opinion leaders in the gay community to change risky sexual norms and behaviors. Although the program was originally targeted to adult men who frequent gay bars, Youth Outlook successfully adapted the program for youth. In order to become a Popular Opinion Leader, youth must attend a full-day training session. With POL, youth endorse safer sexual behaviors in casual one-on-one conversations with friends, acquaintances, and other youth they meet. These conversations may take place at school, coffee shops, parties, or anywhere youth interact with each other. After training, and in order to practice their communication skills, the POLs will lead a Safe Sex Olympics at each of Youth Outlook’s four drop-in centers. The Safe Sex Olympics are a fun way for youth to discuss sensitive subjects and to learn safe sexual behaviors. When Youth Outlook first conducted POL in 2006-07, the program saw great success in recruiting additional levels of volunteers, increasing the number of Popular Opinion Leaders from 5 to 26 in just six months. The youth who participated in POL saw the impact on their own attitudes and in their discussions with friends.
New York-Presbyterian Hospital, New York, NY
Project STAY (Services to Assist Youth): Project STAY provides comprehensive medical and psychosocial services for youth living with HIV/AIDS, and works to prevent the spread of the disease among high-risk youth through innovative health education and outreach strategies. When homeless, substance using, depressed gay youth are seen in a typical medical clinic or emergency department, they are commonly referred to other providers, making follow-through less likely. Programs that provide comprehensive services at one site or have staff that accompany clients to other needed providers have shown greater success for vulnerable populations, including young HIV-infected gay men. Project STAY social workers and nurse practitioners often provide these services on an ad-hoc basis. However, given the influx of new and often complicated cases to its clinic, Project STAY has been unable to keep pace with the multiple demands unique to its gay clients due to lack of staffing infrastructure and capacity. Through the implementation of the STAY Connected Initiative (SCI), Project STAY aims to significantly enhance its existing “one-stop shopping” medical home for HIV-positive and at-risk sexual minority youth, and thereby help prevent the spread of HIV. EJAF will enable Project STAY to realize this goal, and will be used to hire a patient navigator to provide support and guidance to these young people in accessing care despite a multitude of barriers and helping to engage and motivate them towards healthier behaviors. Specifically, the patient navigator will maintain contact with HIV positive and at-risk gay clients regarding appointments; accompany clients to substance abuse, mental health, specialty medical and surgery clinics, and dental appointments; and assist clients with overcoming barriers to accessing care and services, including transportation, literacy, and language. The patient navigator will also assist with expansion of Project STAY’s health education and outreach activities to educate, screen and counsel at-risk sexual minority youth for HIV; facilitate linkage to Project STAY’s primary care clinic; identify and forge new partnerships with community organizations that provide services to at-risk gay youth; oversee development, production and distribution of health educational materials targeting at-risk sexual minority youth; and recruit and supervise two peer educators to assist in outreach and educational activities.
AIDS Care Center for Education & Support Services, Norfolk, VA
Rainbow Bridge Connection (RBC): RBC will serve the Lesbian-Gay-Bisexual-Transgender-Questioning community in the eastern region of Virginia which has a population of 1.6 million and consists of seven major cities including the Norfolk-Virginia Beach-Newport News Metropolitan Statistical Area. Since general estimates suggest sexual minorities represent 10% of the U.S. population, this region may be home to 160,000 sexual minority individuals, yet there is no Lesbian-Gay-Bisexual-Transgender-Questioning Center in the region. A key stakeholder described RBC as the local “Callen-Lorde,” referencing the sexual minority health center in New York City after which RBC services are modeled. RBC includes a transgender medical clinic but enhances those services with more comprehensive mental health services for all sexual minorities. Local survey data and recent stakeholder meetings indicated that the most critical need for the community was the creation of a “gathering place.” This gathering place needed to house support services for sexual minorities and their significant others (eg. parents, partners) as well as educational programs around legal issues, intimate partner violence, and suicide prevention, especially for youth. Transgender medical services will be housed at a separate community health center, but funding through EJAF will allow for the rental of project space to create the first and only Lesbian-Gay-Bisexual-Transgender service center in the region. It will serve persons at any point along the life cycle to improve quality of life and assist in empowering individuals and their families. Both peer-led and counselor-led psychosocial/education groups will be offered. Initial groups will include those to address gender identity issues and social support; a non-transitioning spouse/partner group; and an HIV+ gay support group. Because there is no local Parents & Friends of Lesbians and Gays chapter, RBC intends to develop parent support services. Partnerships with high school Gay-Straight Student Alliances will allow for the development of youth services. Offering groups is important to combat the isolation that many face as a member of a minority culture. RBC expects the groups to serve as a primary referral source for individual counseling. Counseling will be provided by licensed clinicians. Existing partnerships with local colleges will provide for recruitment of Masters-level students for field placements. Although individual counseling will be available at no cost to the uninsured, the development of fee-based services for those with insurance will help to generate a future revenue stream for the center. Initial educational services will include seminars on topics of interest. Medical services will include those offered by the transgender clinic as well as free, rapid HIV testing and syphilis testing within the RBC center. Testing will be available by walk-in and appointment. Additional medical services are in the “discussion” stage with other community health centers. Part of the long-term vision of this project is to expand medical services to the larger sexual minority community creating more options for finding a medical home. An advisory board of key stakeholders will provide input on other support services and activities. RBC is an effort to scale up services that do not pathologize the sexual minority community while creating a safe, welcoming space for services and “free community space” for its partners. A part-time center coordinator will manage all services at RBC.
AIDS/HIV Services Group (ASG), Charlottesville, VA
Improving Access to HIV Prevention and Care for Gay and Bisexual Men: AIDS/HIV Services Group (ASG), located in the city of Charlottesville, provides medical services to persons living with HIV/AIDS in the Thomas Jefferson Health District and prevention services extending beyond the TJHD to include the 24 primarily rural counties in the Northwest Health Region of Virginia. As the medical community begins to recognize HIV as a chronic condition and service providers respond with models of care addressing the needs of individuals and families preparing for managing a life of illness, ASG recognizes that for HIV-negative gay and bisexual men, remaining negative requires many of the same self-management efforts. The changes needed in the healthcare system and in individual and family lives outlined in the Chronic Care Model apply to gay men no matter their HIV status. ASG proposes a systemic engagement of gay men and the organizations that serve them based on self-management support, community involvement, delivery system design and decision support for both gay men and providers. ASG’s self-management support program will be developed for both Positive and Negative gay men based on goal-setting, problem-solving skills, peer mentoring and adherence and prevention programs. The program will be implemented through a 10 session curriculum: 1) Goal-setting and problem-solving strategies; 2) Health literacy and HIV/AIDS and STI-related knowledge; 3) Navigating the health care system; 4) Understanding the relationship between STIs, physical and mental health; 5) Managing negative emotions; 6) Finding and building networks of social support; 7) Strategies to increase medication adherence and side effects; Cognitive techniques for symptom management; 9) Communicating effectively with one’s health care provider; and 10) Nutrition and exercise. For HIV-positive gay men, the curriculum will be integrated into the medical case management process provided at ASG. For negative gay men, the classes will be held during the evenings at a local night club in Charlottesville, VA, called Club 216. Club 216, managed by a non-profit organization “The Piedmont Triangle Society” only operates on Friday and Saturday evenings. During the week, the space is available for ASG staff and volunteers to run sessions. As the only explicitly Lesbian-Gay-Bisexual-Transgender-Questioning venue in Charlottesville, the space is comfortable and familiar to the local gay population. During the first three months of the grant period, two series of the curriculum will be implemented; one series for Positive gay men and one for Negative gay men. The first series will serve as a “train-the-trainer” model targeting ASG volunteers who can then run the sessions for specific populations which may include: young gay men; bisexual men; same gender-loving brothers; active substance users; substance users in recovery; re-entry populations; affected populations; gay men over 55; treatment-experienced and long-term survivors; and newly identified Positives. Through active promotion of the series, ASG will engage community stakeholders to not only refer clients but to also participate in the sessions mostly closely aligned with their services. By offering these group sessions, ASG can address community stigma and myths and engage the healthcare community in a conversation regarding necessary engagement of sexual minorities and capacity for addressing their health needs.
Gay Men of African Descent (GMAD), Brooklyn, NY
Intensive Prevention Project: Gay Men of African Descent (GMAD) is a not-for-profit community-based organization that serves more than 12,000 residents each year with services and programs that touch people who are living with HIV/AIDS, people who think they might have been exposed to HIV, and those who are at high risk of exposure to the virus. These services include: HIV/sexually transmitted infection screening, mental health counseling, brief psychotherapy sessions, support groups, supplemental food pantry, initial medical screenings, substance abuse pre-services and HIV prevention services. The proposed activities for this project are: recruitment and program promotion to identify, attract, enroll and retain individuals who reflect the population of focus in the places where they congregate, especially from the Ballroom scene. The Ballroom scene is a social subculture of the Lesbian-Gay-Bisexual-Transgender-Questioning community (ages 13-28 and predominantly African American and Hispanic/Latino males) involving staged, competitive drag fashion performances, historically connected to 1920’s drag balls in Harlem. This program will have a target of 250 HIV tests. These screenings create a platform for referral for individual and group psychotherapy. GMAD has a cadre of staff and volunteers to provide recruitment and screening services. The Project’s strengths-based case management approach ameliorates feelings of isolation, abandonment and diminishes the psychological impact of homelessness at a critical point in the lives of program participants and promotes entry into HIV medical care through focusing on successes each participant defines. This strengths assessment is leveraged to engage clients into care and related social services. This is a five-session intervention delivered over 90 days. The core elements are: 1) assessment; 2) care/services plan development; 3) linking/coordination of services; 4) reassessment/follow-up; and 5) case closure/transfer. As part of the initial assessment, a qualified mental health professional determines the need for psychotherapy. This decision will be based on such things as current problems, history, level of development, ability to cooperate with treatment, and what interventions are most likely to help with the presenting concerns. Young sexual minorities receive emotional support, resolve conflicts with people, understand feelings and problems, and try out new solutions to old problems. The proposed expansion will complement existing services and activities such as GMAD’s Drop-In Center where clients are provided a safe and affirming space, access to computers, transportation assistance, nutritional incentives, coalition development and community mobilization, a supplemental food pantry, and referrals for medical and related social needs.
Michael Reese Research and Education Foundation, Chicago, IL
Integrated HIV Care for African American MSM on the South Side of Chicago: Established in 1989, the HIV Care Program was the first clinic on Chicago’s south side dedicated to serving people living with HIV. The Program re-located to Mercy Hospital to continue serving this highly impacted community after Michael Reese Hospital closed. No one is turned away, regardless of ability to pay. The core of the Program is a twice-weekly clinic that provides a seamless system of care to 300 patients in all stages of HIV disease by an expert, dedicated team. Due to stigma and the reluctance of some gay men to identify with a program for men who have sex with men, the clinic was intentionally integrated into a Family Health Center where no one is identified as gay or HIV positive by their attendance. Many patients choose the Program because it is NOT a large identifiable HIV or Lesbian-Gay-Bisexual-Transgender treatment center. To address the need for prevention, mental health care, and substance abuse services in its patient population, the Program successfully adapted the Partnership for Health model to include mental health and substance abuse counseling during the clinic visit, with clinicians reinforcing prevention messages. This approach decreases the perceived stigma of obtaining mental health care. Clinical staff meet patients “where they are,” which has resulted in increased numbers of patients ready to reduce their drug use, begin recovery and engage in healthier behaviors. Objective 1: Provide 150 integrated mental health and substance abuse counseling sessions to 50 sexual minority individuals with HIV in the context of medical clinic visits. In this integrated care model, a psychologist will see patients whose mental health and/or substance abuse issues impede their ability to set goals or decrease risk behaviors during the clinic session for assessment and counseling/therapy. On-going, more intensive counseling sessions will be held outside of clinic hours in the Program’s counseling and education center across the street from the hospital. Clients receiving prevention services will also be invited to attend a weekly support group, in which they may receive not only information, but peer support for positive behavioral change. Therapy will be individualized to each patient, depending upon psychopathology, coping style, severity and stage of illness. Various therapeutic modalities and counseling approaches may be utilized. Patients are encouraged to invite partners to counseling sessions. Objective 2: Provide 200 prevention counseling sessions using the Partnership for Health model adapted and tailored to the African-American sexual minority population to 100 HIV+ gay adults (and their partners) to reduce transmission of HIV. The Partnership for Health Model, originally developed by Jean Richardson and colleagues, resulted in a 38% reduction in unprotected anal or vaginal sex among patients with multiple and casual partners after the implementation of “consequence frame messaging” in the context of a clinic-wide program.
Fan Free Clinic Richmond, VA
Hispanic/Latino Men Who Have Sex With Men (MSM) Outreach Project: Despite great need, there are no HIV/AIDS outreach programs in the Greater Richmond area focused on connecting with Hispanic/Latino men who have sex with men. Compelled to support this underserved population, the Fan Free Clinic created this Outreach Project to target Latino gay men who are likely engaging in high-risk sexual activity or injection drug use. With EJAF funding, The Outreach Project will create a “street team” tasked with reaching out to the Hispanic/Latino MSM community in the Greater Richmond area. During the initial phase of the project, the Street Team will consist of two part-time outreach workers (20 hours/week). The Clinic’s work with other marginalized populations has revealed that among the greatest challenges to building trust and establishing meaningful relationships in a particular community is overcoming cultural barriers. To enhance the Project’s ability to break through such barriers, The Clinic seeks to assemble a street team composed solely of Latino gay men who are native Spanish speakers. Short-Term Objectives: 1) Connect with Latino gay men: Working in a team of two, the outreach workers will work to establish a presence in areas of the Greater Richmond community that local Hispanic/Latino MSM contacts identify as gathering spots for Latino gay men (both traditional and nontraditional settings). While in these areas, the Street Team will make educational materials and condoms available, offer HIV testing events and simply be accessible for counseling and referral purposes. A portion of each outreach worker’s time will also be devoted to intensive outreach with small numbers of Latino gay men considered to be at very high risk for contracting HIV. 2) Conduct Needs Assessment: Throughout the grant period, the Street Team will also be tasked with conducting a hands-on, comprehensive needs assessment of the local Hispanic/Latino MSM community, gathering information in order to better address the needs of this community going forward. Long-Term Objectives: In future years, The Clinic anticipates using the data it gathers through this initial phase of the Hispanic/Latino MSM Outreach Project to determine the best next steps for enhancing the outreach it provides to the Latino MSM community going forward. The Clinic also hopes to strengthen the services provided to this population throughout Central Virginia by sharing lessons learned with other organizations serving Hispanics/Latinos and MSM populations.
Test Positive Aware Network (TPAN), Chicago, IL
L.I.F.E Program: Test Positive Aware Network (The Network) serves individuals throughout the city of Chicago and surrounding neighborhoods. The L.I.F.E. Program at The Network will target high-risk men who have sex with men (MSM). The majority of The Network’s clients are uninsured, HIV+ African-American gay men ages 45 to 64 living at or below federal poverty level who are also co-impacted with substance abuse issues. During 13 weekly sessions, participants gain the knowledge, motivation, skills, and support necessary to manage biological, psychological, and social life issues that can impact immune functioning and overall health. With EJAF funding, The Network will provide: 1) Four peer-led presentations on HIV, stigma, and identity; 2) Outreach/testing; 3) One 1-day HIV self-management 101 seminar for providers, focusing on reducing HIV stigma and promoting holistic care based in self-management and the chronic disease care model; 4) Four 1-day HIV Self-Management 101 seminars to newly HIV-diagnosed individuals; and 5) Two 13-week L.I.F.E. Health Workshops, and four 1-day L.I.F.E. Seminars (topics include: grief and loss, eating and nutrition, trusted support, self-assertiveness). L.I.F.E.is based on scientific research that connects human performance on certain biological, psychological, and social cofactors to immune system functioning, disease progression, and overall health. These cofactors have been shown in HIV disease and other life-threatening illnesses to trigger symptom onset, speed up or slow down disease progression, and impact survival time. Cofactors have also been shown to impact physical, social, and psychological aspects of quality of life. When people living with HIV/AIDS or other illnesses understand the dynamic relationship between mind and body, and improve their performance on certain cofactors, then they may benefit from improved physical and psychological health and well-being. By increasing health-supporting cofactor performance and reducing or eliminating health-risking cofactor performance, participants can greatly increase their potential to develop and maintain wellness.
AIDS Resource Center Ohio (ARC Ohio), Dayton, OH
Healthy Gay Men Ohio Project: The Project will advocate for local, state and federal HIV prevention funding and allocations that accurately reflect prevention needs and HIV incidence for the State of Ohio. The Project also seeks to increase HIV outreach, education and testing to gay men across Ohio, especially in rural and underserved areas of the state. Specific outcomes include: 1) AIDS Resource Center Ohio (ARC Ohio) will mobilize gay, bisexual, and transgendered men and their allies to encourage state and local health departments, as well as all relevant planning and priority-setting groups, to “Be Fair” in making allocations that truly reflect HIUV epidemiology. That mobilization will include a) the creation and growth of a social media/internet based network of at least 2,000 sexual minorities across the state who are willing to “join that cause” and receive messages encouraging e-mail, letter, and phone messaging to public officials; b) training of highly-engaged sexual minorities to attend local and state planning groups, to “watchdog” decision-making and encourage fairness; and c) training of sexual minorities and their allies to schedule and carry out visits with state and local public officials, in which advocates press the case for fairness in allocations and funding levels. Ohio HIV advocates have successfully employed such strategies to change policies in other key areas, such as pressing the state school board to reject Lesbian-Gay-Bisexual-Transgender-excluding abstinence-only-until-marriage sex ed curricula, and encouraging that same body to apply for federal DASH funding to support HIV prevention infrastructure development. 2) ARC Ohio will increase media education to raise the topic of sexual-minority-excluding funding disparities in both mainstream media, and targeted sexual minority and allied-community media. Specifically, ARC Ohio will place letters to the editor and opinion pieces, and encourage educative reporting on the aforementioned disparities, in Ohio’s major dailies (minimally, the Dayton Daily News, the Cincinnati Enquirer, the Columbus Dispatch, the Toledo Blade, the Cleveland Plain Dealer, and the Akron Beacon Journal), as well as Ohio’s three largest sexual minority media outlets (the Gay People’s Chronicle, Spangle Magazine, and Outlook Weekly). 3) ARC Ohio will increase HIV prevention among gay, bisexual, transgender and questioning men through maintenance of core funding for current critical services in this area, thus serving over 5,000 sexual minority individuals across Ohio with culturally competent, evidence-based HIV prevention programming. 4) Linked to advocacy efforts, but also following from the visibility that such advocacy efforts will create, ARC Ohio will provide HIV testing to 1,000 sexual minorities across Ohio.
Gay and Lesbian Community Center of Greater Fort Lauderdale, Inc., Wilton Manors, FL
LIFE GOES ON: The Gay and Lesbian Community Center’s PALS Project (Positive Action for Living Safely) helps the nearly 9,500 gay and bisexual men living with HIV in Broward County lead safer, richer lives. The Center proposes to scale-up its health and prevention services for gay men through the PALS Project with a new LIFE GOES ON initiative. Activities will include: 1) PALS Partners. Provision of a ground-breaking, structured program where HIV-positive peer educators will be certified, supervised and mentored to coach wellness, behavioral interventions and service linkages. Partners will: a) Develop a formal certified curriculum that will include: An introduction to holistic health and wellness; HIV/sexually transmitted disease prevention; risk reduction; values and ethics; overview of linkage to local medical, sexually transmitted disease, substance abuse, mental health and case management providers; and coaching, facilitation and presentation skills; b) Conduct regular capacity-building and training with volunteer peer educators. Sessions will provide teaching, modeling and role-playing to address gaps in knowledge, encourage skill development and professional abilities; c) Establish ongoing Personal Improvement Plans through individualized coaching; d) Empower peer educators to provide prevention and health activities. 2) Peer-led HIV Prevention: Provision of 4 peer-led community presentations on HIV, stigma and identity. Utilize personal narratives from men living with HIV to educate the community on risk reduction, and reduce stigma related to HIV/sexually transmitted disease testing and HIV health care and self-management. 3) Provider Education: Coordination of 2 HIV self-management seminars for providers, focusing on reducing HIV stigma, promoting holistic care based on self-management and the chronic disease care and wellness models. 4) Newly Diagnosed Services: Provision of 4 one-day HIV Self-Management seminars to newly HIV-diagnosed gay men. Topics will include: a) HIV facts and myths; b) What is good primary health care and what are available resources? c) Shame and stigma prevention through self empowerment; and d) Next steps, including linkage to behavioral health resources. In addition, the Center will offer ongoing peer coaching and service linkage to newly diagnosed individuals, enhancing access to primary medical care, sexually transmitted disease treatment and substance abuse and mental health services. 5) Wellness Self-Management Seminar Series: Offering 6 large, community dinner/education opportunities focused on gay men’s health and prevention. Seminar topics will include: “Happy Hiney” (anal health concerns for the gay man); Bug Chasers, Condom Cops, Sero-sorters and Bare Backers (an HIV prevention community forum); Understanding HIV/Hep C Coinfection; and Get Connected: a Community Case Management services overview. 6) Drop-In Center. Establishing a PALS Drop-In Center for gay men to encourage positive social support and increase access to health education information, HIV/STD testing and treatment; and linkage to behavioral and social services.
Trinity Lutheran Church, New York, NY
Trinity Place Shelter Harm Reduction Workshops: Trinity Place Shelter serves an average of 40 homeless Lesbian-Gay-Bisexual-Transgender-Questioning youth and young adults aged 18 to 24 per year. While some come from other parts of the U.S., most are African-American and Latino youth from the outlying boroughs of New York City. Many tend to be transgender, a cohort that continues to encounter abuse even on the Upper West Side of Manhattan. The average resident is 19-21 years old, has a spotty education, a history of alcohol abuse and hospitalization, and has been bouncing between temporary shelters or the apartments of friends. He or she has a high level of anxiety, due, in some cases, to post-traumatic stress syndrome from previous experiences as a sex worker, and may also have a drug problem. With EJAF funding, Trinity Place will inaugurate a regular series of on-site Saturday morning workshops to provide culturally-sensitive harm reduction services to better engage Trinity Place residents in group therapy, peer education, and other social supports to help them adopt life-long risk-elimination strategies. The workshops will be conducted by leaders assigned by Trinity’s partner organization, Harlem United Community AIDS Center. Since young men who are at an alarmingly high risk of contracting HIV/AIDS and other sexually transmitted diseases will not attend traditional prevention programs, Harlem United successfully established a new empowerment model based on a theory suggesting that people are most likely to adopt new behaviors that have already been accepted by similar individuals they respect. Harlem United’s trained, experienced workshop leaders consequently become role models for the youth they reach. Employing short-term and long-term harm reduction counseling, the leaders provide all the tools necessary not only to avoid HIV, but to escape the cycle of poverty, disease, abuse, and low self-esteem. In so doing, the leaders refer clients to specialized primary care physicians, mental health specialists, and substance abuse treatment sources. Harlem United will accordingly supply workshop leaders to offer educational presentations based on knowledge of and respect for the harm reduction model, rapid HIV testing, and substance use and sexually transmitted infection screenings, assessments, and referrals. The new Trinity workshop series will focus on gender/sexual identity, sexual health, and the negative consequences of drug use. Since at any given time Trinity may have residents who are newly admitted, as well as longer-term residents who are approaching discharge, the workshops will be designed so that newcomers may feel welcome to “start in the middle” without having to “catch up” to those who have been attending regularly. As participants become increasingly responsive to harm reduction education, training will be offered to empower participants as volunteer peer leaders. By using the power of peer relationships to spread prevention messages, participants will become instruments of transformative change within the sexual minority community.
EJAF August 2010 Grants
The Elton John AIDS Foundation (EJAF) is proud to announce its second round of grants for calendar year 2010, totaling over $2.3 million. This new funding brings EJAF’s total grant investments for 2010 to more than $3.8 million.
These grants represent EJAF’s continuing commitment to funding demographics and geographic regions that are seriously impacted by HIV/AIDS and under-served by traditional funders. The 15 grants awarded through this funding cycle are distributed over all of the Foundation’s targeted areas: The Southern United States; Latin America and the Caribbean; incarcerated populations; men who have sex with men (MSM); harm reduction; African Americans; and young people. Several of these grants have overlapping areas of focus, i.e., the Caribbean and MSM, Latin American youth, African American gay men, etc.
EJAF’s strategic approach allows us to respond adroitly as the global AIDS epidemic evolves, investing donor dollars where they are most needed and will have the greatest impact. Many of these grants are requests for renewed funding for organizations EJAF has partnered with in the past, and we have been very gratified to learn about important new issues that have arisen during the course of their work, resulting in funding requests for programs that have evolved to address these issues.
A new grant to the Kaiser Family Foundation will invest $325,000 to enhance the national Greater Than AIDS Campaign with additional targeted messages focusing on Black gay and bisexual men. In the U.S., black gay men constitute a disproportionately high proportion of gay men who are becoming infected. According to the U.S. Centers for Disease Control and Prevention, the leading cause of HIV infection among African American men is sexual contact with other men. This project will create and disseminate targeted public messaging to help combat the debilitating stigma that undermines HIV prevention and treatment efforts particularly in the South and among gay and bisexual black men. This new grant also helps to launch EJAF’s new national grant-making initiative focused on further intensifying the promotion of health and rights for gay and bisexual men in the U.S. Through this initiative, EJAF will invest over $1 million in grants for projects that: (1) expand community mobilization for the health and rights of gay men and (2) strengthen gay-friendly clinical and social services.
During these uncertain financial times, all of us at EJAF are particularly pleased to be able to continue to offer support to organizations serving populations most affected by HIV/AIDS. As always, we are deeply grateful for your interest in and support of EJAF and its life-sustaining work.
amfAR, The Foundation for AIDS Research, New York, NY, $150,000 — The MSM Initiative (Caribbean): This grant support the continued work of amfAR’s MSM Initiative in the Caribbean, where it currently supports 7 projects that provide HIV/AIDS services to and advocacy for men who have sex with men (MSM) in the region. Launched in 2007, amfAR’s MSM Initiative works to significantly improve access to HIV prevention, treatment and care for MSM populations in countries across Africa, Asia and the Pacific, the Caribbean, Eastern Europe and Central Asia, and Latin America through three core strategies: 1) Supporting grassroots efforts in low- and middle-income countries to create and sustain peer-driven HIV programs for MSM; 2) Building awareness and understanding of HIV epidemics among MSM communities and other stakeholders; and 3) Developing strong policies and increasing public funding for HIV-related services to MSM in low- and middle-income countries amfAR is now in its third year of delivering urgently needed community awards and technical assistance in the Caribbean.
Clinton Health Access Initiative (CHAI), New York, NY, $476,399 — Increasing Access to High-Quality HIV/AIDS Treatment in the Caribbean: CHAI has been engaged in the Caribbean since its inception in 2002, and has worked in partnership with EJAF in the region since 2007. To date, this partnership has achieved notable results: millions of dollars saved on antiretroviral (ARV) drugs in the English Caribbean, launch of a pilot to reduce patient wait times at clinics in Jamaica’s Western Region, and the roll out of more cost effective ARV regimens in Haiti. Since 2002, CHAI has focused upon building strategic relationships with the Ministry of Health using data and analytical evidence in order to help answer important questions around planning, program execution, and budgeting. Because of CHAI’s approach, the Initiative commands a unique position within the donor and NGO community. One important way CHAI works with partners is to leverage their resources, often providing the analytical argument for funding.
The Collaborative Fund for HIV Treatment Preparedness, Brooklyn, NY, $75,000 — International Treatment Preparedness Coalition’s (ITPC) Caribbean Treatment Action Group: EJAF funding supports HIV community mobilization, education and advocacy activities in the Caribbean, including a sixth round of grant making. The International Treatment Preparedness Coalition (ITPC)’s work in the region focuses on: 1) Developing a supportive infrastructure for people living with HIV and AIDS and/or supporting a process driven by people living with HIV/AIDS; 2) Developing and strengthening PLWHA communities for implementation of treatment preparedness and access; 3) Advocating for universal access to HIV/AIDS treatment especially among sex workers and people who use crack-cocaine and heroin; 4) Promoting programs that place positive persons at the center of prevention efforts; 5) Supporting anti- stigma and discrimination strategies; 6) Promoting harm reduction policies, strategies and interventions; 7) Addressing issues of adherence and resistance; and Addressing psychosocial issues, including denial, among persons living with HIV/AIDS. The Collaborative Fund provides four methods of funding to community-based organizations: 1) Small grants to community-based organizations; 2) Regional network support to build communications infrastructure and engage in advocacy activities to promote access to comprehensive and equitable HIV care, treatment and prevention; and 3) Monitoring and evaluation.
Kaiser Family Foundation, Menlo Park, CA, $350,000 — Caribbean Broadcast Media Partnership on HIV/AIDS (CBMP): Since its launch in May 2006, the Caribbean Broadcast Media Partnership on HIV/AIDS (CBMP) has grown to include 100 leading broadcasters from 25 Caribbean countries and territories, committed to expanding public awareness about HIV/AIDS and related issues. By sharing information and resources among broadcasters, and building their own capacity to develop and deliver HIV-themed programming content, CBMP broadcasters have established new, coordinated media initiatives that deliver lifesaving messages to help stem the spread of HIV/AIDS and fight AIDS-related stigma and discrimination. CBMP broadcasters cover a total estimated population of some 30 million people in the second most highly impacted region of the world by HIV/AIDS. This represents, by far, the single largest mobilization of media in response to any social issue in the region. Their annual airtime commitment to HIV messaging is modestly estimated at US $6 million. The goal of the CBMP is to significantly leverage broadcast media in response to HIV/AIDS in the Caribbean. This goal is achieved through the following key objectives: 1) Build media leadership and member development through local capacity; 2) Dedicate substantial financial and/or human resources to HIV across program platforms; 3) Increase access to and demand for HIV Information Resources; 4) Forge strategic alliances locally, regionally and internationally to extend reach and impact; and 5) Strengthen connections between media, national AIDS agencies, PLHIV organizations and stakeholders.
Aid for AIDS International, New York, NY, $250,000 — Cuanto Sabes de VIH y AIDS? (How Much Do You Know about HIV and AIDS?): This is an HIV primary-prevention effort developed and implemented by Aid for AIDS International (AFAI). This initiative, based on a peer-as-educator model, targets teenagers in the developing world training them to teach their peers safe healthcare behaviors. The fundamental goal of ¿Cuanto Sabes? is to reduce HIV transmission rates in particular geographic regions in Latin America by empowering young people to become leaders in the fight against HIV and AIDS. ¿Cuanto Sabes? is aimed at educating individuals at the community level about HIV prevention, testing and care, and also addresses the stigma that surrounds the virus and often impedes individuals from getting tested and treated for HIV. Equally important, the program addresses the ways in which governments, schools, corporations, NGOs, the media, and individuals within Spanish-speaking societies discuss HIV and AIDS issues. Specifically, AFAI assists these different groups in adopting a more comprehensive and coordinated approach to addressing HIV and AID issues. As demonstrated during the past two years partnering with the EJAF, Cuanto Sabes? is an effective strategy to engage youth in this process. Not only do these teenagers become educated about HIV and communicate this information to their peers, but the initiative also conveys the value of associated life skills and NLP (neurolinguistic programming) that assists youth in learning to incorporate these skills into their daily lives. In this way, they are empowered to benefit from basic education, achieve a better quality of life and appreciate the importance of life-long learning and a healthy lifestyle.
Youth and Sexual Health
Advocates for Youth, Washington, DC, $75,000 — Protecting the Rights of Youth to Access HIV and AIDS Services and Information: Advocates for Youth works to ensure young people’s access to the information and services they need to prevent HIV/AIDS, including comprehensive sex education, condoms, and culturally competent community-based services. Society’s negative and confused attitudes about youth and sex, along with systemic homophobia and racism, further fuels the epidemic, contributing to the disproportionate rates of HIV and AIDS among young women of color and young men who have sex with men. To address these issues, in the year ahead, Advocates will: 1) Work with filmmaker James Houston to finalize and market the film Let’s Talk About Sex. Materials will promote the idea that sexual development is healthy and normal and that young people need access to accurate and honest reproductive and sexual health information and services. Staff expects to reach 35 million Americans with information about the film and provide one million Americans with campaign materials challenging current U.S. thinking about youth and sex. More than 40,000 people will view the film. 2) Provide assistance and materials to its 35,000-member Youth Activist Network (YAN), helping them to advocate for comprehensive sex education and other HIV prevention policies by continuing broad outreach through its Amplify website (700,000 visitors this year), recruiting another 10,000 YAN members to write over 30,000 letters to policymakers and launch at least five issue-specific campaigns; work with young women of color at historically black colleges and universities to educate their peers and improve HIV prevention services on their campuses; and assist 2,000 college-age YAN members to distribute one million condoms and safer sex information through the Great American Condom Campaign. 3) Through its Anti-Homophobia/Transphobia Initiative, disseminate materials to 10,000 organizations serving youth of color and provide intensive training on GLBT youth issues to 10 organizations serving youth of color so that they can make concrete changes to their HIV prevention programming and redress homophobia/transphobia within their organizations and communities.
Black AIDS Institute, Los Angeles, CA, $200,000 — National Black AIDS Mobilization (NBAM) Campaign: This grant supports efforts to sustain, scale up and evaluate the Black AIDS Institute’s (BAI) National Black AIDS Mobilization (NBAM) campaign model. BAI has 5 goals for NBAM: 1) To intensify its technical support to national traditional Black institutions, assisting in effectively institutionalizing and expanding their newly developed AIDS capacity, leveraging this capacity to galvanize an AIDS movement throughout Black America, mainstreaming AIDS across their program and policy work, and taking concrete steps to build AIDS capacity in their chapters and affiliates. 2) To build on the early accomplishments of its “Test 1 Million” initiative to scale up testing promotion efforts in Black America, including conducting 3-5 statewide testing tours in the next year. 3) To undertake extensive community education and mobilization activities, including 3-6 community forums to encourage robust community ownership, and develop a National Black Implementation plan. BAI will produce user-friendly, action-oriented guidance to help Black Americans support implementation of the new strategy and to advocate for Black accountability for results in a national AIDS response. 4) To produce a report on the National AIDS Strategy, specifically analyzing the strategy from a Black point of view. 5) To plan retrospective projects for 2011, the 30th anniversary of the first HIV diagnosis in the United States, to draw attention to the epidemic and advocate for commitment of Black Institutions.
Men Who Have Sex With Men (MSM)
Kaiser Family Foundation, Menlo Park, CA, $325,000 — Greater Than AIDS: Targeted MSM Community Mobilization Campaign: The Greater Than AIDS movement responds to the AIDS crisis in the United States with a focus on the most heavily-affected populations, notably Black Americans and MSM. Through a national media campaign and targeted community outreach, Greater Than AIDS aims to elevate knowledge and understanding of HIV/AIDS and confront the stigma surrounding the disease. Greater Than AIDS is about the power of individuals acting together to achieve a greater goal – reducing the spread of HIV and the stigma associated with the disease. By stressing unity, hope and empowerment, Greater Than AIDS seeks to inspire each and every one of us – in our relationships, families, and communities – to do our part to stem HIV/AIDS by: being informed; acting with respect; speaking openly; using condoms; getting tested – and treated; and, getting involved. Major media companies are working together to distribute Greater Than AIDS public service ads and related content. Special promotions provide more in-depth coverage. Greater Than AIDS media partners include: Clear Channel Radio & Outdoor, CBS Radio & Outdoor, American Urban Radio Networks, the National Newspaper Publishers’ Association, BET, ESSENCE Communications, and AOL Black Voices. Targeted media partners with reach into MSM communities include Logo Networks (a subsidiary of MTV Networks) and HERE Media. Corporate partners – including Walgreen’s, the National Basketball Association, and Trojan – are helping to extend the reach.
Southern United States
AIDS Community Research Initiative of America (ACRIA), New York, NY, $200,000 — National Technical Assistance and Capacity Building (NTA) Program: ACRIA will provide technical assistance and capacity building assistance (TA/CBA) to HIV service providers at three new sites and continuation TA/CBA to the three sites served during the project’s first year. Each new package will include four days of intensive training/TA/CBA related to HIV and the provision of services, conducted by staff of ACRIA’s HIV Health Literacy Program (HHLP). Group trainings will utilize ACRIA’s comprehensive Training Manual, and all curriculum and training materials will be individually tailored to each site’s needs. ACRIA’s trainers/TA/CBA specialists will work individually with each participating agency to develop a service integration plan to incorporate HIV health literacy and treatment information into its service menu. Ongoing TA/CBA will help each agency implement its integration plan and keep participants abreast of new developments. Two trainees from each new location will spend a week at ACRIA’s NYC offices to receive coaching from HHLP staff. Continuation packages will each consist of two days of tailored and enhanced TA/CBA based on local needs that emerged during the first year, with special attention to complete implementation of service plans. Development and implementation of service integration plans will follow a case management model, with each organization treated as a “client,” and special attention will be paid to building and strengthening a collaborative network of southern HIV service providers.
amfAR, The Foundation for AIDS Research, $80,000 — Advancing HIV Prevention through Syringe Exchange in a Changing Domestic Policy Environment: The December 2009 removal of the ban on federal funding for syringe exchange programs (SEPs) marked an important advance in U.S. HIV prevention policy as numerous studies have demonstrated that SEPs can reduce HIV infection rates among injection drug users (IDUs) while not increasing crime or drug use. The Centers for Disease Control and Prevention (CDC) has recognized a sizeable decrease in HIV incidence among IDUs over the last 15 years due, in part, to the availability of SEPs. SEPs are currently funded by state and local governments and private funding, but with deepening fiscal pressures on these government entities, it has become increasingly important to enable jurisdictions to draw on federal funds to deliver these critical HIV prevention services. Following the SEPs victory last year, amfAR, The Foundation for AIDS Research, refocused its advocacy in this area to both protect the advance in Congress and ensure appropriate implementation of federal SEPs funding by federal agencies. We ask that the Elton John AIDS Foundation (EJAF) continue its generous support of amfAR’s SEPs advocacy efforts by funding two research projects whose results will be valuable advocacy tools for amfAR and other public health advocates and policy makers. The SEP project includes the annual National Syringe Exchange Survey and a new study examining the utilization of federal SEP funding. Both projects will provide valuable information we can use toward the goal of ensuring that the removal of the SEP ban is not overturned and federal funding for SEPs is administered in a manner maximizing public health impact. Activities will include monitoring and utilizing results of both SEP research projects to inform advocacy and develop and update publications; tracking SEPs programs to determine if state fiscal pressures have resulted in a reduction in services and closures; tracking jurisdictions’ ability to receive federal SEP; and meeting with Congressional members and staff to promote SEP effectiveness and the need for additional HIV prevention funding to support SEPs.
AEGiS, San Juan Capistrano, CA, $50,000 — AEGiS is an open access, Internet based living HIV/AIDS library. The website provides current research information, human resources, treatment, prevention, product, and policy information, with worldwide news and event coverage. The documents contained in the living library chronicle the history of HIV/AIDS. Information is organized in sections by publication type, with clearly stated sources, authors and publication dates. AEGiS’ broad scope of information elucidates the human experiences and reactions related to HIV/AIDS. AEGiS’ objectives are to 1) Provide access to a wealth of HIV/AIDS history and knowledge; 2) Broadcast and distribute HIV/AIDS information; 3) Perpetually include the latest information on all aspects of HIV/AIDS in chronological order with the highest set of Internet standards to ensure clarity for site visitors; 4) Present data from the most recent scientific meetings and those from the past to improve the general public’s access to this information and data; 5) Maintain our computer equipment-the gateway to our database; 6) Offer services by facilitating access to HIV specialists to assure competent care and accurate health information; 7) Connect site visitors to specific on-line resources, local walk-in AIDS services, and related organizations for support; and Provide individual answers to site visitors’ queries requesting information. All services are conducted with the purpose of providing educational information regarding HIV/AIDS.
AIDS Foundation of Chicago, Chicago, IL, $25,000 — International Rectal Microbicide Advocates (IRMA): Created in 2005, IRMA is comprised of over 1,000 advocates, policymakers and leading scientists from 6 continents working together to advance a robust rectal microbicide research and development agenda – with the goal of creating safe, effective, acceptable and accessible rectal microbicides for the women and men around the world who engage in anal intercourse. IRMA works to confront the institutional, socio-cultural and political stigma around the public health need for rectal microbicide research, and to increase funding and commitment within this field of inquiry. AIDS Foundation of Chicago is the group’s secretariat, providing coordination and support for IRMA.
Treatment Action Group, New York, NY, $50,000 — Cure Advocacy and Universal Access to Antiretroviral Therapy by 2015: Treatment Action Group’s cure project will accelerate research and funding by working with researchers, policymakers, funders, and activist groups to create a newly unified, focused effort to discover and develop a cure for HIV infection. TAG will lead science-based research and treatment activist community efforts to raise funding, awareness, and create an enabling environment for HIV cure research. This AIDS Cure Advocacy work builds on the joint amfAR-Project Inform-TAG workshop in November 2008 on HIV latency, persistence, and eradication. The workshop led to new and expanded funding initiatives by amfAR and the U.S. National Institutes of Health (NIH) focusing on HIV latency, persistence, and the way toward HIV eradication. Based on new insights into how HIV enters the body and evades drug elimination, researchers are beginning to develop approaches directed at reducing latent HIV reservoirs and either eliminating them from the body or enabling people to live in a state of drug-free remission. Universal Access to ART by 2015: According to UNAIDS over 5.2 million people with HIV worldwide are currently receiving antiretroviral therapy (ART), yet the world is still far from achieving universal access. Nonetheless at the XVIII International AIDS Conference in Vienna, Austria, on 19-23 July 2010, a clear consensus emerged that we must press forward with the goal of universal access despite the obstacles which are impeding progress. Therefore TAG will continue to work for universal access in the United States and around the world, not only to ART but to treatments for the deadliest coinfections which affect people with HIV including hepatitis B virus (HBV), hepatitis C virus (HCV), and tuberculosis (TB).
EJAF May 2010 Grants
The Elton John AIDS Foundation (EJAF), which funds innovative HIV prevention, stigma reduction, and direct care and support programs for people living with HIV/AIDS in the Americas and the Caribbean, today announced its first round of grants for calendar year 2010 – a comprehensive award of $1.3 million to the National AIDS Fund (NAF).
This significant award supports EJAF’s long-standing Challenge and Leadership Grant collaboration with NAF. These Challenge Grants must be matched $2 for every $1 by locally-raised funds, thereby at least tripling the impact of EJAF’s investments. During 2009, total NAF and Community Partnership grant making, including locally raised funds, amounted to $8,640,393 – a sum over six times EJAF’s investment.
NAF currently supports 39 Community Partnerships across the U.S. that help local communities and grassroots organizations develop HIV prevention and service programs specific to their unique needs. NAF’s Community Partnerships provide an infrastructure for channeling national resources to local programs across the country that can best utilize that support. Community Partnerships serve not only as collaborative fund-raising and grant-making bodies, but also often as conveners, technical assistance providers, community builders, and policy advocates.
According to NAF’s President and CEO Kandy Ferree, “We regard NAF’s partnership with EJAF as an excellent model for how two complementary organizations can work together to maximize each other’s strengths.” EJAF’s Executive Director Scott Campbell added, “Over the years, NAF has demonstrated extraordinary leadership in support of grassroots, community-based responses to the HIV/AIDS epidemic. All of us at EJAF are extremely proud to have played an integral part in the growth and expansion of NAF’s Community Partnership Network, and we look forward to partnering with NAF in their effort to extend the network into uncovered areas of the country.”
National AIDS Fund (NAF), New York, NY, $1.3 million – This grant will support the National AIDS Fund’s core grant-making in 2010. NAF aims to create a total Challenge Grant funding pool of at least $1.6 million, which will be used to leverage approximately an additional $6 million in local funding. NAF will focus EJAF’s entire $1.3 million Community Partnership Program investment on the Challenge Grants Program, which will emphasize the following population and geographic priorities: (1) Highly impacted populations prioritized by NAF, specifically men who have sex with men, injection drug users, communities of color, women, and those affected by incarceration; and (2) Highly impacted geographic areas prioritized by NAF, specifically large epicenters (i.e. Washington, DC, Chicago, New York City, San Francisco, Los Angeles, Atlanta), the Southern United States, and Puerto Rico. Programmatically, NAF will be emphasizing programs that fall into one or more of the following categories: (1) Evidence-based HIV prevention; (2) Community innovations; and (3) Structural interventions.