9th - Harm Reduction Coalition

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9th National Harm Reduction Conference FROM PUBLIC HEALTH TO SOCIAL JUSTICE California, Davis, and the Executive Director of Safer Alternatives thru Networking & Education (SANE), a community-based organization providing syringe exchange and other harm reduction services to drug users. Rachel has provided technical and political assistance to emergent syringe exchange programs (SEP) as well as guidance on addressing women’s issues to harm reduction service providers in many Eastern European countries. Rachel advocates a harm reduction approach in addressing issues related to HIV, gender, and drug use. Antunez, Erin, San Francisco Department of Public Health, San Francisco, CA erin.antunez@sfdph.org Public Health Follow up as Harm Reduction: Using Harm Reduction while working with HIV+patients in San Francisco Department of Public Health Public Health Follow up as Harm Reduction: Using Harm Reduction while working with HIV+patients in San Francisco Department of Public Health. LINCS (Linkage Integration Navigation Comprehensive Services) is a new program for integrated linkage to care, partner services, and re-engagement in care in the San Francisco Department of Public Health (SFDPH). LINCS helps people living with HIV link to and remain in HIV care and provides partner services to newly diagnosed individuals in order to identify other infected persons who are not in care. We consider this “public health follow up” of local HIV testing programs. LINCS is a safety net under other support services at SFDPH medical clinics and community-based HIV test sites. LINCS works with SFDPH medical providers and community testing staff to ensure that HIV+ persons are offered partner services and are engaged in medical care in a compassionate and non-judgmental way. The mission of LINCS is to both improve HIV health outcomes and reduce the rate of new HIV infections by increasing the number of people living with HIV accessing antiretroviral therapy in San Francisco. LINCS provides a safety-net to catch patients “falling through the cracks” of the public health system by: identifying persons with unmet needs (e.g. new diagnosis, unsuppressed HIV viral load, not in care); assisting newly diagnosed HIV+ patients with communication needs and other partner services; providing navigation services to re-engage individuals who have dropped out of care; and coordinating linkage and re-engagement services to ensure that all clients are provided with the appropriate care. LINCS staff meet patients where they are at and provide warm handoff linkage to care, partner services, and active referrals to ancillary service providers at clinical and community based organizations. Navigators arrange and escort patients to appointments, as well as provide direct counseling and problem-solving assistance to patients to overcome barriers to engagement in care. Erin Antunez has worked in public health for the past 14 years as an outreach worker, HIV test counselor, an underground needle exchange worker, a harm reduction based risk reduction counselor, a research assistant for studies working with active substance users, and as a trainer of other counselors. Her current work at the San Francisco Department of Public Health is as a Linkage to Care and Navigation Coordinator for HIV+ patients in the DPH system. Armata, Aimee, Larkin Street Youth Services, San Francisco, CA aarmata@larkinstreetyouth.org Low Threshold, High Regard: Housing as Harm Reduction and Cultural Humility Larkin Street Youth Services is a nonprofit organization in San Francisco that serves runaway and homeless youth ages 12-24. The agency’s continuum of care, designed to help youth permanently exit street life, includes: outreach and drop-in center services; emergency, transitional, and permanent housing programs; case management; mental health, substance abuse and medical services; education and employment services; and support services for HIV-positive youth. Larkin Street employs a harm reduction approach throughout all of its programming. This philosophy is relevant not only to substance use, but generally aims to remove barriers to entry for youth seeking services and “meet youth where they are,” focusing on the impact of behaviors in a non-judgmental setting. Strategies for engaging youth include multiple points of entry/reentry, housing as an intervention, and motivational interviewing techniques. This workshop will examine how harm reduction principles can be effectively implemented in different ways across programs. Larkin Street Youth Services have developed an integrated framework for providing drop-in and low threshold housing programs implemented with high regard for youth and 4
9th National Harm Reduction Conference FROM PUBLIC HEALTH TO SOCIAL JUSTICE community resiliencies. The dialectics of low threshold/high regard is foundational in providing culturally responsive harm reduction counseling in the context of housing programs for youth. Matching program intervention with the sociocultural context of choice is a community based practice that integrates harm reduction counseling with cultural humility and builds a youth culture (service culture) that sustains clients’ changes over time. The presenters will share their experiences implementing harm reduction approaches in a variety of housing settings which serve unaccompanied, homeless and runaway youth. Participants will engage in an exchange of ideas, and learn new strategies to integrate harm reduction in programs. The session will consist of a presentation and small group activities. Aimee Armata is the Clinical Director at Larkin Street Youth Services. Aimee has worked in gender specific, co-occurring treatment contexts, with adolescent girls involved in the juvenile justice system and in innovative community clinics providing “treatment on the margins.” Aimee has worked in forensic and low threshold community mental health settings from a wellness and recovery perspective. Aimee works as both a cultural anthropologist and a clinician engaged in social and psychological transformation and situates her work as an intervention in socially sanctioned forms of violence affecting youth, marginalized communities and youth with mental illness. Baca, Brandon, New Mexico AIDS Services, Albuquerque, New Mexico bbaca@nmas.net Integrating Harm Reduction in Rapid HIV Testing This presentation discusses harm reduction oriented rapid HIV testing and shares innovative tools to assist providers in developing and maintaining effective programs. Rapid HIV testing presents unique challenges to the counselor and potential to do harm is increased compared to non-rapid HIV testing due to limited preparation time the counselor has to deliver results and provide additional services such as blood-work and additional counseling. Establishing protocols before testing can prevent and reduce any physical/mental harm associated with rapid HIV testing in any population or setting. Methods: Preventative measures, such as a client readiness assessment can prepare the counselor for physical or psychological complications that may arise. For HIV preliminary positive cases, resources must be initiated before offering testing, such as; immediate confirmatory blood draws, linkage to care systems, mental health services, scheduled follow-ups, partner notification services and referrals to easily accessible resources to meet the needs of the client outside counselor care. Lastly, protocols for responding to emergencies such as violence, suicide ideation, fainting, etc., can reduce the harm associated with rapid HIV testing. Results and Conclusion: Our planning and evaluation has reduced harm in rapid HIV testing while increasing counselor-client safety and satisfaction. Extensive preparation increases response times and improves harm reduction services. Brandon Baca has a B.S. in Psychology from the University of New Mexico with honors, four years of HIV/STD/Hepatitis prevention experience in New Mexico & Rwanda, Africa. State of New Mexico Evaluation and Planning Committee Co-Chair, Decision Making Member of NMCPAG. Certified in, HIV Counseling & Testing (Rapid & Oral), STI & Hepatitis Integration, Syringe Exchange/ Harm Reduction, Overdose Prevention, Motivational Interviewing, Mental Health First Aid, Personalized Cognitive Counseling, and Sexual Assault Advocacy Backes, Glenn, Public Policy Research & Consulting, Sacramento, CA glennbackes@mac.com Syringe Access Laws in California: They Keep A’Changin New laws went into effect in California in 2011. The ones that allows purchase and possession of syringes from pharmacies is supposed to sunset the last day of 2014. What happens after that, and more importantly perhaps, what happens before that to keep the law alive after 2014 Another bill and set of laws that allows the California Department of Public Health to authorize new syringe exchange programs anywhere in the state is in effect, but the regulations hadn’t been published (as of June 5
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