Substance Abuse Treatment and HIV Services for young
Latino/African American MSM – Bridging The Gap
Latino Community Services, Inc.
Program Coordinator
Yvonne Wilson, BS, FDC
September 11, 2015
HIV AND AIDS
AMONG LATINOS
A Snapshot
• Hispanics represent approximately 16
percent of the U.S. population, but
account for an estimated 19 percent of
people living with HIV (220,600
persons) and an estimated 21 percent
of new infections (9,800) in the United
States each year.
• Men account for 87 percent of new
infections among Hispanics.
Estimated New HIV Infections
among Hispanics, 2010, by
Transmission Category
MSM
IDU Female
2%
8%
Hetero female
IDU MALE
7% 3%
12%
68%
Hetero Male
MSM-IDU
MISSION
To further reduce the spread of
HIV/AIDS in the Latino community
and other at-risk populations and
improve the quality of life and
health of people with HIV/AIDS.
INTRODUCTION
Latino Community Services Inc. (LCS), Project STEP is funded
through a 5-year federal grant from SAMHSA’s Center for
Substance Abuse Treatment (CSAT) for its Targeted Capacity
Expansion Program for Substance Abuse Treatment and
HIV/AIDS Services (TCE/HIV).
Project STEP targets young Latino and Black men who have sex
with men (MSM) who have received a primary diagnosis of
substance abuse. The purpose of the project is to develop and
enhance a system in which young MSM of color can access
culturally competent and effective treatment and supportive
services to reduce the impact of behavioral health problems and
reduce HIV risk and incidence.
PROJECT GOALS
Project STEP targets young Latino and Black men who have sex with men (MSM) who have
received a primary diagnosis of substance abuse. As described in the grant proposal, the
goals of the project are to:
• To provide evidence-based services over a period of 12 months to a total of 230
young MSM during the grant period (30 in year one, 50 per year in years two-five)
• To expand system of culturally competent substance abuse, mental health, and other
related services for young MSM of color.
• To reduce HIV risk and incidence among target population.
• To reduce the impact of behavioral health problems among the target population.
• To increase access to treatment for individuals with co-existing behavioral health,
HIV and Hepatitis
METHODS/DESCRIPTION
The project aims to engage 230 individuals over the grant period, providing:
1) screening for substance use and co-occurring disorders;
2) HIV and Viral Hepatitis testing along with Personalized Cognitive Counseling (for those who meet
the screening criteria);
3) substance abuse case management;
4) substance abuse and mental health treatment;
5) wrap-around support services, including recovery support groups, job training and placement
assistance, and computer training.
Hartford Behavioral Health (HBH), a licensed treatment provider, delivers treatment services. Other
partners include Capital Workforce Partners and the Court Support Services Division of the State of
Connecticut Judicial Branch.
PROGRAM DESIGN
Phase I
Assessment and Enrollment
Phase II
Intensive Program
Phase III
Wrap-Around Services
PHASE I
Participants will be screened and assessed for the
presence of mental and substance use needs.
Assessment
and Enrollment
•
Screening Tools: LCS Intake, K6 and CAGEAID
•
Complimentary HIV/Hepatitis C Testing for
program participants only
•
Intervention: Personalized Cognitive
Counseling (PCC)
PHASE II
Single Session Intervention designed to reduce
unprotected anal intercourse (UAI) among men who have
sex with men who are repeat testers HIV and who meet the
criteria.
Intensive
Program
Months 1-6
30 to 50 minute intervention conducted as the counseling
component of CTR.
Eligible men for PCC are those whom:
 Previously tested for HIV,
 Showed seronegative on that test,
 Had UAI since their last test,
 Had UAI with a male who was not their primary partner
&

That partner’s serostatus was positive or unknown
PHASE III
Recovery Support Services
We are an approved Access to Recovery III agency and provide
faith recovery support services for participants that qualify. In
addition to; on-going recovery support groups
Wrap-Around
Services
Months 7-12
Job Training & Placement Assistance
We collaborate with organizations that provide job training and
placement assistance. We work with participants to assess
employability skills and provide support through group and
individual sessions.
Computer Training
We provide individualized computer skills training based on the
level of proficiency. The training will range from computer
basics and typing to Microsoft Office applications.
CLIENT
INCENTIVES
•
Transportation Assistance
a. clients will receive a max of four
tokens a month
b. clients will be connected to
transportation services if identified
as a need
•
Gift Cards
a. Clients will receive a $20
dollar gift card for the 12 month
enrollment period.
b. Gift cards will be distributed
throughout the year. ($5 initial, $5
mid-point, $10 Follow-up)
Eligible Clients Only
CLIENTS BY TARGET POPULATION CATEGORIES
Project STEP improved its recruitment of MSM and young MSM of color
dramatically over the first two years of the project. In Year 1, only 5 of
34 clients were young MSM. As shown in Figure 1, LCS recruited and
enrolled an increasing number of young MSM over the course of Year 2.
This is partly due to positive word of mouth among young MSM
participants, and through the ongoing efforts of a STEP client who
volunteered to help recruit peers. Project STEP has enrolled 103 clients
to date.
RISK BEHAVIORS
Figure 2: Risk Behaviors at Intake
Percent of Clients Reporting Behavior in the Past 30 Days
67%
Used alcohol and/or drugs
54%
Drank alcohol
50%
Used illegal drugs
40%
Engaged in sexual activity
For clients who drank alcohol, had 5+ drinks in one
sitting
44%
For clients who were sexually active, had unprotected
sex
74%
0%
10%
20%
30%
40%
50%
60%
70%
80%
RESULTS
Goal 1.
Partially Achieved.
Project STEP is meeting overall participation and retention objectives. Enrolling 50
clients in Year 2. In Year 2, 37 of the 50 clients were MSM and 20 were young MSM.
Goal 2. Substantially Achieved.
STEP has successfully reached out to agencies that provide services to young MSM,
including HYHIL (Hartford Youth HIV Identification & Linkage Consortia) and True
Colors. Project STEP case managers made referrals to at least 38 agencies in Year 2.
In addition, LCS has Memoranda of Understanding (MOU) with several CBO’s. At least
75% of clients rated all STEP services (including those delivered by partner agencies)
as “good” or “excellent.”
RESULTS (cont’d)
Goal 3. Partially Achieved.
STEP is meeting objectives in offering rapid HIV testing (100%) and decreasing reported
HIV risk behaviors (63% to 86%), is close to meeting objectives for linking HIV-positive
clients to care (94%+), but is well below objectives for eligible clients receiving the PCC
risk reduction intervention (44%). The absence of a PCC-trained staff person during a
portion of Year 2 adversely impacted participation in PCC.
Goal 4. Substantially Achieved.
STEP is meeting or nearly meeting objectives for offering substance abuse or co -occurring
mental health services (100%) and linking client to behavioral health services within 48
hours (89%).
Goal 5. Substantially Achieved.
STEP is meeting objectives for increasing access to treatment for individuals with co occurring conditions, linking all clients to care.
CONCLUSION
Successes
Challenges
•
Progress in Recruitment
•
Engaging YMSM
•
Client Completion Rate
•
Transient population
•
Establishing a presence within this
community.
•
Limited culturally sensitive
providers/services
•
Establishing Trust through addressing
social biases
QUESTIONS?