Examples for Webinar

  1. Individual-level: Case Management & Care Navigation
  2. Group-level: Education Sessions
  3. Community-level: Social Marketing/Outreach

1. CASE MANAGEMENT & CARE NAVIGATION

Case ManagementBecause of the transnational factors faced by this population, including high levels of homelessness (as described above we may see unusual levels of homelessness due to the airbridge), poverty, a lack of insurance, lower levels of acculturation, and language barriers; clinical care is unlikely to be successful without social services support delivered through case management services. Case management services include an initial intake, which occurs on the first day that a participant accesses The Clinic.

The intake first screen for urgent needs including housing and food, with the goal of assuring that the participant has a safe place to spend the night and enough to eat in the immediate period, and then include a biopsychosocial assessment which are completed over the first two visits. Following intake and assessment, a case management plan is developed by the case manager and participant, which covers domains such as stable housing, food security, obtaining public benefits including Medicaid and any income support the participant may be entitled to receive, including ADAP prescription benefits if not entitled to Medicaid, local transportation support, and local housing programs. The plan also covers the safety net services that are available to HIV-infected persons.

Because this project is focused on Puerto Rican participants who are American citizens and entitled to public benefits, obtaining benefits and accessing the safety net will not pose the problems it can with undocumented immigrants. Future case management encounters are devoted to carrying out the plan, while also responding to any new or ongoing crisis that the client might be experiencing.

Crucial to the development and implementation of the case management plan are the involvement of the Care Navigators, who are near peers, a person from Puerto Rico or of Puerto Rican descent, and a native Spanish speaker who, while expected to be more acculturated to the dominant culture than a newly arrived individual, and have deep familiarity with and understanding of Puerto Rican cultural beliefs and customs and be able to be trusted by the participant. The care navigator was selected specifically to have a strong empathetic relationship to potential participants. The care navigator assists clients in a practical way. For example, the care navigator will accompany the participant to the welfare office or other government offices to obtain a birth certificate, proof of social security enrollment or assistance in enrolling, proof of residency, etc. The care navigator is expected to make a visit to the participant’s home or wherever the participant is staying within the first 30 days of enrollment into the program, and is available to meet family members or other important people in the participant’s support network. Early in the program the care navigator participates in outreach to community organizations and churches, although we anticipate that as the participant base grows there are less time for that activity and others will take up the outreach role.

2. GROUP-LEVEL SESSIONS

GROUP-LEVEL SOCIAL SUPPORT & SKILLS BUILDING

Goal: Increase engagement and retention of target population in medical care and adherence to prescribed HIV treatment regimens.

Strategy:Five-session group level intervention that:

  • Provides social support, social belonging, and enhanced self-esteem in the context of a Latino MSM and HIV-positive identity and community;
  • Promotes critical awareness of social and cultural forces that impact and shape participant’s social and health care seeking beliefs and attitudes;
  • Increase participant’s self-knowledge, with particular emphasis on individual beliefs, attitudes and situations of personal vulnerability that limit participants’ ability to maintain adherence to HIV primary medical care and treatment.

The Intervention incorporates key concepts of Hermanos de Luna y Sol (Brothers of the Moon and Sun), an intervention originally developed as an HIV risk reduction program for Spanish-speaking gay/bisexual men. Established in 1995, HLS offers peer social support and a safe, fun environment where participants can connect with others with similar experiences. The intervention, now titles Hermanos, emphasizes cultural pride, transnational themes, and personal empowerment as key factors that enhance a person’s ability to remain engaged in HIV primary care and adhere to HIV medications.

Each session lasts two hours and takes place over the course of five weeks. Sessions are offered in both English and Spanish.

Required Supplies:

  • Sign-in sheet
  • Name tags
  • Flip chart paper
  • Flip chart markers
  • Journals/diarios
  • Workshop evaluation

Session I:

•Introduction to the five-session workshop

•“Who am I” exercise – Part 1 (Connecting to various aspects of self)

•“Who am I” exercise – Part 2 (Connecting to transnationalism and Mexican Heritage)

•Impact of HIV

•Coping with HIV

• “Who am I” exercise – Part 3 (Connecting to HIV)

•Personal strengths

Session II:

•Welcome and introduction to today’s session

•Introduction to the concept of Ideal Self

•Stigma and discrimination related to living with HIV

•Impact of stigma

•Coping with stigma (Introduction to cognitive techniques and social support as coping tools)

Session III:

•Welcome and introduction to today’s session

•“Rejection to Celebration” exercise

•HIV 101

•Introduction to disclosure decision-making process

•Benefits and costs of disclosure

•Planning for disclosure

Session IV:

•Welcome and introduction to today’s session

•Current health regimen

•Coping with barriers to health regimen

•Rights as a person living with HIV

Session V:

•Welcome and introduction to today’s session

•Vision of the future

•Narrative of life and self

•Celebration of who you are

•“Who am I” exercise (Connecting to HIV)

3. SOCIAL MARKETING
The social marketing campaign promotes HIV testing and (re-)engagement in HIV primary care among men of Mexican descent, while also serving to lessen the stigma of HIV and of HIV testing in the Mexican community. The campaign has two waves that will be implemented in separate years of the program. The first wave consists of targeted print advertisements placed in bus shelters across the city; these ads incorporate the visual motif of the lotería, a popular game in the Mexican community, while encouraging men to get tested and engage in treatment for HIV. The campaign’s four distinct print ads were developed, with both Spanish and bilingual versions, through focus groups with men of Mexican descent. The different ads debuted at various locations throughout the duration of the first year of intervention to reach a higher volume of Mexican MSM and with the goal that persistent messaging would contribute to the destigmitization and normalization of HIV testing among men of Mexican descent. Ad placement is intentional; ads with gay-focused messaging are placed in neighborhoods with larger gay populations, whereas the more general health messages are placed in areas with a large Mexican community. Approximately 40 bus shelter ads ran for a three month period during year one of the project.

The year one campaign also included a two month run of radio ads to capture themes not easily visually represented in the print campaign; these ads both brought the campaign’s messaging into an individual’s home and reached men who may not respond well to visual ads or who may struggle with literacy. Radio spots incorporated themes that may resonate with some men of Mexican descent living in Chicago, including the motif of the loteríaand concerns about citizenship status.

Ongoing social media promotion of the campaign, as well as coverage of the campaign by online and print publications, also serve to spread awareness about The Intervention and encourage men of Mexican descent to get tested and engage in care. Throughout the digital campaign, focused bursts were made to increase awareness via targeted Twitter, Facebook, and Instagram posts particularly around the National Latin@ AIDS Awareness day in 2015. As of October 2015, the digital ads were targeting users on the following websites and leading interested individuals to a landing page: Grinder, Facebook, Twitter, BoyAhoy, gayety.com, thenewcivilrightsmovement.com, instictmagazine.com, transgenderdate.com, and queerty.com. Sites were chosen based on their subscriber base and the likelihood that the base would be men of Mexican descent.