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Home > Demonstration Sites 
Harris County Government (Positive Outlook) 

Harris County Website
The purpose of this project, conducted through Harris County Public Health & Environmental Services, the City of Houston Health & Human Services Department (HDHHS) and Harris County Hospital District (HCHD), is to engage HIV seropositive YCMSM into care and link them to youth-focused medical case management services that support retention in primary medical care.  

                        

Charles Henley, LCSW 
2223 West Loop South, #417 South Houston, TX 77027
Telephone: (713) 439-6034
Fax: (713) 439-6338 chenley@hcphes.org/rwga

           


Major Goals
The major goals of this study are: 1) Increase HIV testing among YCMSM, 2) identify YCMSM who have known HIV infection but are not receiving care, and 3) increase retention in care among YCMSM. 

Accomplishments to Date
To date, over 40 HIV-positive YCMSM have been engaged in care and enrolled into the study. All participants have completed the baseline multi-site and local surveys; the majority of these participants have completed at least one follow-up survey. In addition, we have developed and implemented a standard protocol for the intensive medical case management program, as well as implemented in-reach testing at multiple HCHD clinic sites and trauma centers, follow-up testing among high-risk HIV negative youth, and social networking. 
 
Final Year Activities
During the final year of this program, we will continue enrolling study participants. We will continue to collect national and local survey data, as well as process and outcome data for our in-reach testing, follow-up testing among high-risk HIV negative youth, and social networking programs. Evaluation of local data will begin during this year. We will focus on dissemination activities, including abstract presentation at national meetings and authoring peer-reviewed manuscripts. 
 
Major Variables and Expected Utility of Evaluation
Major variables include: 1) number of HIV tests performed among YCMSM by HDHHS and HCHD; 2) number of YCMSM who are newly diagnosed with HIV; 3) number of YCMSM who are assigned to and meet with case manager; 4) time between testing and first physician or nurse practitioner appointment among YCMSM; 5) number of YCMSM who were previously out of care who are contacted and brought into care for at least one year; 6) utilization of HIV clinical resources; 7) number of CD4 cell counts and HIV viral load determinations; 8) utilization of social services resources and other resources (substance abuse, psychiatry); 9) change in health status; and 10) adherence to HAART. 
 
[click here to see Site Presentation given at January 2005 Grantee Meeting]

Intervention

  • Consolidated case management based on combination of existing services.
  • A multidisciplinary team will provide case management, outreach, peer counseling, medical care coordination, and health education risk reduction using a Client Management Team (CMT) approach
  • Outreach is not for testing individuals at large, but rather outreach to existing or newly diagnosed HIV+ YCMSM
  • During outreach clients come for services every week in 4-8 hours.
  • Counseling and testing as needed, and individual sessions on education, services, etc.

Outputs 

  • Enroll 10 to 15 HIV+ by 8/05; enroll 85 by end of project
  • A minimum of 50 to 80% of newly-identified HIV+ clients will enter primary care and/or case management
  • A minimum of 50/60/90% of HIV+ clients will use primary care during 6 month period per year

Short Term Outcomes

  • Increase proportion of HIV+ who know their serostatus
  • Increase knowledge of HIV risk reduction and practice of safer sex
  • Increase proportion of HIV+ that are identified, linked to care, and remain in care
  • Increase client use of primary care and support services
  • Improved or maintained CD4 counts
  • Improved or maintained viral loads
  • Increase knowledge of care system and how to use it
  • Increase adherence to treatment regimens

Long Term Outcomes 

  • Reduce new HIV cases among YCMSM
  • Slow and stabilize disease progression in HIV+

Proposed Local Evaluation Strategy 

  • Comparison group of those in system not enrolled in the program. ni=85; nc=30 
  • Client assessments from case management requirements (e.g., assessment form within ten working days of assessment and linked to service within 30 days). Centralized Patient Data Management System (CPCDMS) to collect data, with one face to face interview visit q30 days and at least one visit to natural environment every 90 days 
  • Comparison group is those clients enrolled into CPCDMS within two years of project start and those enrolled by other agencies meeting the inclusion criteria  


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