Positively Negative - Increasing HIV/AIDS Awareness Among African American Teens

State: FL Type: Model Practice Year: 2011

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"The Florida Department of Health, Hernando County Health Department (HCHD) developed the Positively Negative program increase access to quality health care, health education, and HIV/AIDS disease prevention measures among African American teenagers residing in the 34601 zipcode area or Hernando County. The link between high rates of HIV/AIDS deaths and young African Americans is well established. This disparity is particularly glaring in Positively Negative's target population, African American teens in Hernando County’s 34601 zipcode area. Residents in the 34601 zipcode area are younger and represent the highest proportion of the county’s African American population. The death rate from HIV in the 34601 zipcode is 2.2 times higher than the rate for Hernando County. What’s more, the age-adjusted HIV death rate among non-whites in the county has climbed over three percent in just four years. HIV/AIDS awareness education and testing are imperative to reverse this tragic trend. Last year only 22% of teens aged 13-19 tested for HIV through the Hernando County Health Department’s Teen Clinic were African American. To complicate matters, a staggering 21% of those same African American teens - double the rate of white teens - were previously diagnosed with a sexually transmitted disease (STD).

Positively Negative was initially implemented in April 2010 to accomplish these objectives: 1. By June 30, 2010 seventy-five (75) African American teenagers aged 13-19 will participate in Video Opportunities for Innovative Condom Education and Safer Sex (VOICES). 2. By June 30, 2010 increase by 10% the proportion of African American teenagers aged 13-19 who participate in the Teen Clinic offered at the Hernando County Health Department. 3. By June 30, 2010 increase by 20% the proportion of African American teenagers aged 13-19 who are tested for HIV by the Hernando County Health Department. 4. By June 30, 2010 secure letters of commitment from 10 agencies stating that they agree to offer VOICES quarterly. To increase the capacity of the HCHD to implement Positively Negative, $7,300 of grant funding was received from the Florida Gulfcoast North Area Health Education Center. Funds were used to train staff and purchase equipment and supplies needed. Positively Negative was implemented in two phases:

Phase 1: Outreach marketing Contacts were made with local churches and community based organizations to establish the presentation schedule and plan a strategic marketing strategy to primarily reach area African American teens residing in the target area. Video Opportunities for Innovative Condom Education and Safer Sex (VOICES) materials were purchased. VOICES a video-based HIV/STD prevention program, is designed to encourage condom use and improve condom negotiation skills among African Americans. VOICES has demonstrated effectiveness in reducing risky behaviors and is recommended by the Center for Disease Control and Prevention (CDC). VOICES participants have a significantly lower rate of infection with new STDs; increased knowledge about the transmission of HIV and other STDs; and increased intentions to use condoms regularly.

Phase 2: Implementation/Evaluation VOICES was provided at organizations committed to playing a role in empowering youth to make a positive impact on the HIV/AIDS epidemic. As inroads were made within the target community, letters of commitment were secured from key agencies expressing their willingness to offer VOICES quarterly. HIV testing, the cornerstone of this project was offered to the target population, real time, on an ongoing basis. Teen Clinic, an entrée into health care services as well as HIV testing, was continually promoted through street corner/neighborhood outreach. By June 2010, Positively Negative had met or exceeded its objectives: 1. By June 30, 2010 eighty-five (target = 75) African American teenagers aged 13-19 participated in VOICES. 2. By June 30, 2010 the proportion of African American teenagers aged 13-19 who participate in the Teen Clinic offered at the HCHD increased by 45% (target = 10%). 3. By June 30, 2010 the proportion of African American teenagers aged 13-19 who are tested for HIV by the HCHD increased by 25% (target = 20%).

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Hernando County Health Department
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Positively Negative - Increasing HIV/AIDS Awareness Among African American Teens
"The Florida Department of Health, Hernando County Health Department (HCHD) developed the Positively Negative program increase access to quality health care, health education, and HIV/AIDS disease prevention measures among African American teenagers residing in the 34601 zipcode area or Hernando County. The link between high rates of HIV/AIDS deaths and young African Americans is well established. This disparity is particularly glaring in Positively Negative's target population, African American teens in Hernando County’s 34601 zipcode area. Residents in the 34601 zipcode area are younger and represent the highest proportion of the county’s African American population. The death rate from HIV in the 34601 zipcode is 2.2 times higher than the rate for Hernando County. What’s more, the age-adjusted HIV death rate among non-whites in the county has climbed over three percent in just four years. HIV/AIDS awareness education and testing are imperative to reverse this tragic trend. Last year only 22% of teens aged 13-19 tested for HIV through the Hernando County Health Department’s Teen Clinic were African American. To complicate matters, a staggering 21% of those same African American teens - double the rate of white teens - were previously diagnosed with a sexually transmitted disease (STD). Positively Negative was initially implemented in April 2010 to accomplish these objectives: 1. By June 30, 2010 seventy-five (75) African American teenagers aged 13-19 will participate in Video Opportunities for Innovative Condom Education and Safer Sex (VOICES). 2. By June 30, 2010 increase by 10% the proportion of African American teenagers aged 13-19 who participate in the Teen Clinic offered at the Hernando County Health Department. 3. By June 30, 2010 increase by 20% the proportion of African American teenagers aged 13-19 who are tested for HIV by the Hernando County Health Department. 4. By June 30, 2010 secure letters of commitment from 10 agencies stating that they agree to offer VOICES quarterly. To increase the capacity of the HCHD to implement Positively Negative, $7,300 of grant funding was received from the Florida Gulfcoast North Area Health Education Center. Funds were used to train staff and purchase equipment and supplies needed. Positively Negative was implemented in two phases: Phase 1: Outreach marketing Contacts were made with local churches and community based organizations to establish the presentation schedule and plan a strategic marketing strategy to primarily reach area African American teens residing in the target area. Video Opportunities for Innovative Condom Education and Safer Sex (VOICES) materials were purchased. VOICES a video-based HIV/STD prevention program, is designed to encourage condom use and improve condom negotiation skills among African Americans. VOICES has demonstrated effectiveness in reducing risky behaviors and is recommended by the Center for Disease Control and Prevention (CDC). VOICES participants have a significantly lower rate of infection with new STDs; increased knowledge about the transmission of HIV and other STDs; and increased intentions to use condoms regularly. Phase 2: Implementation/Evaluation VOICES was provided at organizations committed to playing a role in empowering youth to make a positive impact on the HIV/AIDS epidemic. As inroads were made within the target community, letters of commitment were secured from key agencies expressing their willingness to offer VOICES quarterly. HIV testing, the cornerstone of this project was offered to the target population, real time, on an ongoing basis. Teen Clinic, an entrée into health care services as well as HIV testing, was continually promoted through street corner/neighborhood outreach. By June 2010, Positively Negative had met or exceeded its objectives: 1. By June 30, 2010 eighty-five (target = 75) African American teenagers aged 13-19 participated in VOICES. 2. By June 30, 2010 the proportion of African American teenagers aged 13-19 who participate in the Teen Clinic offered at the HCHD increased by 45% (target = 10%). 3. By June 30, 2010 the proportion of African American teenagers aged 13-19 who are tested for HIV by the HCHD increased by 25% (target = 20%).
The HIV/AIDS epidemic remains a highly significant public health problem as HIV/AIDS continues to spread with ferocious speed. Virtually unknown 20 years ago, HIV has infected more than 60 million people worldwide. Each day, approximately 14,000 new infections occur, more than half of them among young people below age 25 - a group likely to have contracted HIV as adolescents. This underscores the need for advocating prevention to teens so they are equipped with the information/resources needed to protect themselves and each other from HIV. African American teens are a particularly vulnerable population. Tragically, African American teens compromise the single largest group of young people affected by HIV in the US. Although African American teens age 13-19 represent only 15% of the US population, they account for 66% of the AIDS cases in this age category. This same pattern can be seen in Florida where African Americans comprise 15% of Florida’s adult (13 ) population, but over half (53%) of the AIDS cases and 45% of the HIV cases reported in 2008. Of the 3,534 HIV/AIDS cases for ages 13-24 in Florida in 2008, 30% were of the age group 13-19 and 70% were African Americans.
Agency Community RolesThe Hernando County Health Department spearheaded this project by: (1) securing the funding (2) training staff in VOICES (3) ordering materials (4) identifying and soliciting support from community partners (5) supplying community partners with promotional materials (6) conducting and evaluating the VOICES sessions (7) performing HIV testing (8) writing required reports (9) maintaining ongoing collaborative relationships with partners Costs and ExpendituresThe Florida Department of Health, Hernando County Health Department (HCHD) developed the Positively Negative program increase access to quality health care, health education, and HIV/AIDS disease prevention measures among African American teenagers residing in the 34601 zipcode area or Hernando County. The link between high rates of HIV/AIDS deaths and young African Americans is well established. This disparity is particularly glaring in Positively Negative's target population, African American teens in Hernando County’s 34601 zipcode area. Residents in the 34601 zipcode area are younger and represent the highest proportion of the county’s African American population. The death rate from HIV in the 34601 zipcode is 2.2 times higher than the rate for Hernando County. What’s more, the age-adjusted HIV death rate among non-whites in the county has climbed over three percent in just four years. HIV/AIDS awareness education and testing are imperative to reverse this tragic trend. Last year only 22% of teens aged 13-19 tested for HIV through the Hernando County Health Department’s Teen Clinic were African American. To complicate matters, a staggering 21% of those same African American teens - double the rate of white teens - were previously diagnosed with a sexually transmitted disease (STD). Positively Negative was initially implemented in April 2010 to accomplish these objectives: 1. By June 30, 2010 seventy-five (75) African American teenagers aged 13-19 will participate in Video Opportunities for Innovative Condom Education and Safer Sex (VOICES). 2. By June 30, 2010 increase by 10% the proportion of African American teenagers aged 13-19 who participate in the Teen Clinic offered at the Hernando County Health Department. 3. By June 30, 2010 increase by 20% the proportion of African American teenagers aged 13-19 who are tested for HIV by the Hernando County Health Department. 4. By June 30, 2010 secure letters of commitment from 10 agencies stating that they agree to offer VOICES quarterly. Positively Negative was implemented in two phases: Phase 1: Outreach marketing Contacts were made with local churches and community based organizations to establish the presentation schedule and plan a strategic marketing strategy to primarily reach area African American teens residing in the target area. Video Opportunities for Innovative Condom Education and Safer Sex (VOICES) materials were purchased. VOICES a video-based HIV/STD prevention program, is designed to encourage condom use and improve condom negotiation skills among African Americans. VOICES has demonstrated effectiveness in reducing risky behaviors and is recommended by the Center for Disease Control and Prevention (CDC). VOICES participants have a significantly lower rate of infection with new STDs; increased knowledge about the transmission of HIV and other STDs; and increased intentions to use condoms regularly. Phase 2: Implementation/Evaluation VOICES was provided at organizations committed to playing a role in empowering youth to make a positive impact on the HIV/AIDS epidemic. As inroads were made within the target community, letters of commitment were secured from key agencies expressing their willingness to offer VOICES quarterly. HIV testing, the cornerstone of this project was offered to the target population, real time, on an ongoing basis. Teen Clinic, an entrée into health care services as well as HIV testing, was continually promoted through street corner/neighborhood outreach. By June 2010, Positively Negative had met or exceeded its objectives: 1. By June 30, 2010 eighty-five (target = 75) African American teenagers aged 13-19 participated in VOICES. 2. By June 30, 2010 the proportion of African American teenagers aged 13-19 who participate in the Teen Clinic offered at the HCHD increased by 45% (target = 10%). 3. By June 30, 2010 the proportion of African American teenagers aged 13-19 who are tested for HIV by the HCHD increased by 25% (target = 20%). ImplementationObjective #1: By June 30, 2010 seventy-five (75) African American teenagers aged 13-19 will participate in Video Opportunities for Innovative Condom Education and Safer Sex (VOICES). VOICES was strategically marketed and offered at organizations that committed to playing a role in empowering the youth of their community to make a positive impact on the HIV/AIDS epidemic. Having the grassroots support of community stakeholders and key leaders allowed the intervention to be marketed and provided in culturally friendly and supportive environments. Guerilla marketing techniques were utilized to reach teens and saturate the target area with educational brochures about STDs and HIV. This laid the foundation for 85 teens to complete the intervention. OBJECTIVE #2: By June 30, 2010, increase by 10% the proportion of African American teenagers aged 13-19 who participate in the Teen Clinic offered at the Hernando County Health Department. Through word of mouth and strategically marketing services at minority events, the rate of minority attendance at Teen Clinic soared over 40%. Another strategic step was providing a centrally located clinic location that is within walking distance of the target population. This successfully addressed the barrier of transportation. Once teens attended the clinic, the word spread to other teens, and attendance began to increase. OBJECTIVE #3: By June 30, 2010, increase by 20% the proportion of African American teenagers aged 13-19 who are tested for HIV by the Hernando County Health Department. The success of surpassing the target goal was directly related to Teen Clinic attendance, and support from community stakeholders that allowed for HIV testing in environments that are easily accessible, and peer friendly. The completion of VOICES also played a vital role in the number of minority teens tested. VOICES created a sense of awareness and teens began to internalize the importance and need of HIV/AID testing. OBJECTIVE #4: By June 30, 2010, secure letters of commitment from 10 agencies stating that they agree to offer VOICES quarterly. Informing key community stakeholders, leaders, and organizations of the negative impact of HIV/AIDs to minority teens in their own neighborhoods and the positive impact of VOICES motivated these leaders to commit to program sustainability. As inroads were made within the target community, letters of commitment were secured from key agencies expressing their willingness to offer VOICES quarterly.. Positively Negative was designed as a two-phase project Phase 1: Outreach marketing March 1, 2010 – March 15, 2010 Phase one of Positively Negative took place with local organizations. Contacts were made with local churches and community based organizations to establish the presentation schedule and plan a strategic marketing strategy to primarily reach area African American teens residing in the 34601 zipcode area. Guerilla marketing techniques were utilized to reach teens and saturate the target area with educational brochures about STDs and HIV. Video Opportunities for Innovative Condom Education and Safer Sex (VOICES) materials were purchased during Phase One. Phase 2: Implementation/Evaluation March 15, 2010 - June 30, 2010 VOICES was provided at organizations that committed to playing a role in empowering the youth of their community to make a positive impact on the HIV/AIDS epidemic. As inroads were made within the target community, letters of commitment were secured from key agencies expressing their willingness to offer VOICES quarterly. HIV testing was offered to the target population, real time, on an ongoing basis. Teen Clinic was continually promoted through street corner/neighborhood outreach.
1. By June 30, 2010 seventy-five (75) African American teenagers aged 13-19 will participate in Video Opportunities for Innovative Condom Education and Safer Sex (VOICES). Baseline = 0 Target = 75 Attendance records indicate that 86 teens have completed the VOICES intervention. Not only was the participation greater than expected (target participation exceeded by 15%), but VOICES staff were pleased with the candor of teen participants in offering their feedback. In particular, teens who were never sexually active or were not currently sexually active expressed their struggles with practicing abstinence. Furthermore, they indicated that they needed to develop skills beyond condom negotiation and safe sex. This provided HCHD staff with an opportunity to implement Medical Cessation. Medical Cessation, designed to empower and train teens to return to a healthy lifestyle and to assist in the behavior change process (student becoming abstinent) was provided by certified HCHD staff. 2. By June 30, 2010 increase by 10% the proportion of African American teenagers aged 13-19 who participate in the Teen Clinic offered at the Hernando County Health Department. Baseline = 10% Target = 20% Prior to the implementation of Positively Negative, minority participation in Teen Clinic hovered at approximately 10%. Subsequent to the implementation of Positively Negative, Teen Clinic logs indicated that minority teens accounted for 45% of Teen Clinic participation. Again, Positively Negative exceeded expectations by 25%. Since many teens came to the clinic immediately after school and after walking from a nearby bus stop, they indicated that snacks would be a great incentive to keep them returning and inviting their friends. An HCHD staff member donated snacks and it bolstered attendance. The Positively Negative coordinator is now asking area partners to donate snack items to continue this positive momentum. Additionally, teens have begun to see the clinic as a safe “hang out” where they can come, interact with peers, receive education, and discuss healthy sexual behaviors. Teens have repeatedly expressed their interest in the information provided and their positive feelings about obtaining accurate information from a reliable source. 3. By June 30, 2010 increase by 20% the proportion of African American teenagers aged 13-19 who are tested for HIV by the Hernando County Health Department. Baseline = 22% Target = 42% Between March 2010 and June 2010 Positively Negative records indicate that there was a 5% increase (to 47%) in rates for minority teens tested for HIV. A report summarizing the successes of Positively Negative have been shared with community partners, the Florida Department of Health HIV/AIDS program office, and Gulfcoast North Area Health Education Center (funding source). Collaborating with area partners on the Positively Negative project reinforced the HCHD’s previous learning experience that a community intervention truly “takes a village” of committed stakeholders working together to accomplish their common objectives. Add to that, the understanding that timing of a community intervention is a critical factor in it success. The fact that funding became available for this project was fortunate and added momentum to the accomplishment of its objectives. All involved community partners consider Positively Negative a success and have committed their resources to hosting it quarterly. This not only insures sustainability, but long-term success in reducing HIV/AIDS health disparities in Hernando County.
The new community partners that have been secured through Positively Negative serve as the backbone of the project’s sustainability. Letters of Commitment have been received from community stakeholders expressing their willingness to support the project by: o acting as a point of contact o providing space and volunteers for educational events o promoting the project within their organization as well as among community members o offering VOICES or HIV/AIDS education quarterly at their facility The community has recognized the need for the project and its ability to increase HIV/AIDS awareness and testing among the area’s most vulnerable population. Outreach efforts will continue and, as they do, more letters of commitment will be obtained to ensure program sustainability. The HCHD has already witnessed local stakeholders providing more and more resources to ensure that Positively Negative remains a regular event within their respective organizations. In keeping with the mission of the Florida Department of Health, the HCHD will continue to provide HIV/AIDS testing as a core public health service. The availability of such testing, coupled with HIV/AIDS awareness/prevention efforts and the impact of the VOICES intervention, will keep Positively Negative on the local forefront and contribute to program sustainability. Continuous marketing at minority focused events will continue to saturate the community and will allow for project expansion and sustainability.
 
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