Abstracts Vol. 1 [International Conference on AIDS (11th: 1996: Vancouver, Canada)]

Mo.D.1908 - Mo.D.1912

Monday, July 8, 1996

should pay for their care. No such relationships exist among AAs. Among Hs, more English
spoken predicts less support for government involvement and federal government clinics.
Conclusions: Ws, AAs, and Hs vary in their knowledge of HIV transmission and prevention,
as well as in their attitudes about where responsibility should be placed. Community planning and program evaluation must be based on a recognition of these differences, in order
to ensure culturally competent programs.
J. David Kennamer; Ph.D.;VA Commonwealth University, Survey Research Lab;
VCU Box 3016; RichmondVA 23284-3016 Tel: [phone] Fax: [phone]
email: jkenna(dhibbs.vcu.edu
Mo.D. 1908
ASIANS & PACIFIC ISLANDERS LIVING WITH HIV/AIDS IN NEWYORK CITY:
IN SEARCH OF CULTURAL COMPETENCE
Yoshioka MRM*, Chin J**, Manzon, John A**. *Columbia University School of Social Work,
New York City New York, USA; * 'Asian & Pacific Islander Coalition on HIV/AIDS, New York
City New York, USA
Issue: Asians and Pacific Islanders (A&PIs) living with HIV/AIDS in the U.S. face both selfimposed and externally-imposed barriers when attempting to access social and institutional
suppcort.These barriers are related to their cultural training and their status as racial/cultural
minorities in the U.S.
Project: From March I1995 through December I1995 twenty open-ended tape-recorded
interviews were conducted in New York City with A&PIs who are living with HIV/AIDS.
Interviews examined the sources of social and institutional support accessed by participants barriers to and facilitators of access to such support, and the perceived quality of the
support received.
Results: Content analysis of the interviews showed that participants use several criteria to
decide which sources of social and institutional support to access, and when to reveal HIVpositive status. In g eneral, participants were first concerned with the perceived quality of
support in very practical terms (i.e., financial assistance). In assessing sources of social support, participants also considered whether disclosure of HIV status would cause emotional
pain to friends and family, as well as their degree of AIDS-phobia. In assessing sources of
institutional support, participants also considered language accessibility and cultural competence of staff. Interestingly, participants who began seeking services earlier in the epidemic
before A&PI-specific services were offered tended to de-prioritize language accessibility and cultural competence ais criteria.
Lessons Learned: A&PIs living with HIV/AIDS make rational assessments of sources of
social and institutional support using a range of criteria and the information available to
them In many cases. A&PIs living with HIV/AIDS may benefit from receiving information on
available A&PI-specific services, particularly as the range of culturally competent and language accessible services increases.
John A. Manzon, APICHA, 275 Seventh Avenue, I 2th floor; New York, NY 1000 1I
Telephone: [phone], ext. 309 Fax: [phone]
Mo.D. 1909
CLINICAL SERVICE DELIVERY STRATEGIES TO REACH AFRICAN-AMERICANS WITH
HIV DISEASE:THE IMPACT OF THE RYAN WHITE C.A.R.E.ACT IN FOUR CITIES
Jones, Billy*, Pounds, M**,Thomas, S*. Macro International, Inc.*, HRSA, U.S. Public Health
Service**
Issue: The disproportionate impact of HIV disease on African-Americans remains cause for
alarm even as the epidemic declines among gay white men.The National Cancer Institute
estimated that I out of every 33 black men, ages 27-39 may be infected with HIV Since
198 1, among reported cases of AIDS in women, 53% are black. Additionally black children
constitute 53% of AIDS cases reported among children. Research demonstrates that
African-Americans present for clinical treatment late in their disease stage and have higher
mortality rates compared to whites.The Ryan White Care Act was designed to expedite
delivery of AIDS clinical services to persons living with HIV disease. Among Black
Americans, social class, gender sexual orientation and HIV risk category must be considered
as factors that influence the response to HIV medical care.
Project: The specific aim of this study was to gain a better understanding of the extent to
which the Ryan White Care Act fiacilitated access to HIV services for African-Americans in
Atlanta, GA; Houston,TX; Philadelphia, PA; and Los Angeles, CA. A secondary aim was to
apply qualitative research methods to a problem made more complex by race, gender, sexual orientation and social class issues.The in-depth interview research method was used as
the primary qualitative research strategy for this study.
Results: I. Centralized and de-centralized case management models were both described
as strategies to serve African-Americans with HIV disease; 2.The allocation of Ryan White
financial resources emerged as a theme in each city; and 3. Identification, cultivation, establishment, and maintenance and growth of a constituent base emerged as an important
theme in each cty
Lessons Learned: The fact that a significant number of Afiican-Americans with HIV disease
lack private insurance is a major barriet.n Additionally. black physicians are part of the middle
class and may share attitudes generated by the stigma associated with AIDS.
Billy.Jones; Macro International Inc., 1I785 Beltsville Drive, Calverton, MD 20705;
Telephone [phone] Fax: 30 I -572-0999; email: jones(cmacroint.com
Mo.D. 1910
CAL-PEP STREET OUTREACH AND MOBILE CLINIC: SERVICES TARGETING
HIGH-RISK INDIVIDUALS
Ryan, Lisa Lockett, Gloria, Richey Sonya. California Prevention & Education Project (Cal-PEP),
Oakland, CA
Issue: Effectively reaching prostitutes, injection drug users, crack users and other high-risk
individuals who many believe are not receptive' to prevention and education services.
Project: Cal-PEP Street Outreach and comprehensive clinic services targets individuals for
HIV/AIDS and STD testing, care, education and prevention services. Staff are trained
Community Health Outreach Workers. Many have a history as former prostitutes, IDUs,
crack users or homeless persons. Working in conjunction with state and local health
departments, CHOWs identify highrisk communities and conduct intensive outreach and
mobile testing over a period of 4-6 weeks. All activity occurs at times and locations to best

reach the population. Clients are recruited, counseled, tested, given results and referred to
more extensive services when appropriate. In-home testing, community forums and referral
follow-up and client advocacy are other components. Long-term relationships are established with many clients.
Results: Over a period of 2 years the program records 4500 Outreach intervention, distributed I 3,500 condoms and 6600 bleach kits, conducted 100 educational workshops and
counselled and tested 1200 clients.
Lessons learned: Staff who are trained Community Health Outreach Workers as well as
former prostitutes, crack and injection drug users or homeless persons can form strong
bonds of trust with clients because of a shared background, thereby making the client more
receptive to prevention and education information.
Cal-PEP 630-20th St., Oakland, CA 946 I 2, USA Phone: [phone]
Fax: [phone] Email: [email protected]
Mo.D. 1912
MINO-WAAKAA'IGUN:A NEEDS ASSESSMENT REGARDING SUPPORTIVE
HOUSING FOR ABORIGINAL PEOPLE LIVING WITH HIV/AIDS
Albert, Darcy*, Deschamps, G*,Thoms M. X2-Spirited People of the I st Nations,Toronto,
Ontario, Canada.
Issue: Affordable and adequate housing is becoming an increasing need for people living
with HIV/AIDS (PHAs). Housing has become an AIDS issue because PHAs are living longer
lives as more effective treatments are being developed. Already, Aboriginal people and disabled people are the two most disadvantaged groups in Canada when it comes to accessing adequate and affordable housing. Aboriginal people living with HIV/AIDS fall into both of
these categories.
Project: In order to better understand and communicate the housing needs of Aboriginal
people living with HIV/AIDS, 2-Spirited People of the Ist Notions has conducted a needs
assessment among its HIV+ membership.The needs assessment is designed to identify the
housing needs of this Aboriginal community the extent of the these needs. and the services
and programs required to meet these housing needs.
Results: The needs assessment found that 70% of the sample community is unemployed,
30% of the community does not have stable housing, 52% of the community lives in unaffordable housing, and that 58% of the homes presently occupied by Aboriginal PHAs are
not suitable for people living with HIV/AIDS.The survey has also been designed to determine if a social housing facility for Aboriginal PHAs was in the interest of the affected community and if so, what type of home would Aboriginal PHAs prefer: 63% of the survey sample said they would live in a home for Aboriginal People Living with HIV/AIDS. In terms of
design, the respondents indicated that they would prefer a large building with independent,
self-contained apartments, located downtown (Toronto), close to HIV clinics and doctors,
with some in-house medical and psycho-social support services.
Lessons Learned: The needs assessment has found that there is an urgent need for a supportive home in Toronto for Aboriginal people living with HIV/AIDS.The Aboriginal PHAs surveyed
have expressed a real interest in this project and imagine Mirno- Wokao'igun to a be place
where Aboriginal people can live together and cmreate a culturally appropriate, supportive, and
caring environment for themselves and other Aboriginal people living with HIV and AIDS.
Darcy Albert, 2 Carlton Street, Suite 1419,Toronto, Ontario, M5B IJ3, Canada.
Tel: (4 I 6) 944-9300 Fax: (4 I16) 944-838 I

207