1. DACCO Health Services: A comprehensive model for the integration of HIV medical care,
behavioral health care, & primary health care services in
Hillsborough County, FL
Bernice K. Lopez, M.P.H., C.P.H., Kristen Whitesell, B.A., Aditi Desai, M.P.H., C.P.H., Ivonne Moreno, B.S.; Diandra Latibeaudiere, B.S.
PROJECT CARE
Goals
• To increase the number of persons living with HIV/AIDS (PLWHA)
engaged in substance abuse treatment
• To encourage implementation of risk reduction strategies related to
high-risk sexual behaviors and intravenous drug use
• To increase linkage, engagement , and provide referrals to health
related services for PLWHA
Services provided
• Counseling, support groups, and education about living with HIV and
co-occurring behavioral health disorders
• Treatment for co-occurring HIV and substance abuse issues that address
risk factors, triggers, and consequences of relapse
• Alternative methods of treatment including tai chai, yoga, art therapy,
and music therapy
HIGH IMPACT PREVENTION (HIP)
Goals
• To increase the impact of HIV prevention efforts ,
particularly for African Americans (AA)
• To expand testing services beyond health care
settings in order to help high-risk individuals learn
their HIV status
• To de-stigmatize and provide greater awareness
about HIV prevention and intervention through
community outreach, education, and condom-
distribution
• To reduce high-risk behaviors among AA men who
have sex with men (MSM) through one-on-one
counseling
• To increase linkages of HIV positive individuals into
care and adherence to Highly Active Antiretroviral
Therapy (HAART)
Services provided
Community Outreach
• HIV education, testing and pre/post test counseling
targeting high-risk AA individuals
• Social media campaigns via Twitter, Facebook, and
Instagram
• Two-way text messaging campaign used to create
awareness, encourage prevention, and educate
Antiretroviral Treatment and Access to Services (ARTAS)
• Individual level, multi-session, time-limited
intervention based on Social Cognitive Theory
• Utilizes a strength-based case management
intervention to encourage clients to set and
maintain goals for themselves related to their
medical care
• Removal of barriers to care by linkage ,coordination
of medication assistance, and referral to social
services
• Advocacy on behalf of client’s needs
Personalized Cognitive Counseling (PCC)
• A single session counseling intervention designed to
reduce high-risk behaviors among men who have
sex with men (MSM) who are repeat testers for HIV
• Focuses on the person's self-justifications (e.g.
thoughts, attitudes and beliefs) that are utilized
when deciding whether or not to engage in high-risk
sexual behavior
• Causes individuals to reflect on these self-
justifications in order to decrease engaging in
behaviors that lead to risk for HIV
Peer Navigator Program
• Trained community members who are living with
HIV who act as mentors to newly diagnosed or
PLWHA that have fallen out of care
• Assist with explaining the basics of HIV/AIDS and
self-care to newly diagnosed persons
• Acts as a "voice of experience“; facilitates support
and education groups
• Act as gate-keepers into communities with low
access to HIV intervention and prevention methods
Business Responds to AIDS (BRTA)
• A public/private partnership that promotes the
involvement of businesses, trade associations, and
labor organizations in HIV/AIDS awareness,
prevention, and education
• Increases mobilization among businesses with an
interest in the AA community
TARGETED OUTREACH FOR PREGNANT
WOMEN ACT (TOPWA)
Goals
• To reduce perinatal transmission of HIV
among HIV positive women and whose at
high-risk for infection
• Lower the risk of substance abuse
exposure to newborn infants
• To engage pregnant women who are at
high-risk for HIV and substance abuse.in
education and prevention methods related
to HIV
• Encourage retention in HIV medical care as
well as prenatal care
Services provided
• Removal of barriers related to retention in
care through linkage and advocacy
• HIV and pregnancy testing and education
• Assistance with obtaining necessary items
for baby
• One-on-one client tailored sessions for
pregnant mothers which assess mother’s
current knowledge of HIV, substance
abuse/smoking cessation, pregnancy, self-
esteem, contraception, and post-partum
care
THE INTEGRATION OF MEDICAL CARE INTO
BEHAVIORAL HEALTH MODEL
Goals
• Increase HIV testing to identify behavioral
health (both substance abuse and mental
disorders) clients that are unaware of their
status
• Increase diagnosis of HIV among
behavioral health clients
• Increase number of clients who are linked
to HIV medical care
• Increase number of behavioral health
clients who are retained in HIV medical
care
• Increase number of behavioral health
clients that are receiving HAART
• Improve adherence to behavioral
treatment and HAART
• Increase number of behavioral health
clients who have sustained viral load
suppression
• Increase adherence and retention in
behavioral health treatment
Services provided
• Mobile Hepatitis C and HIV testing for
high-risk populations
• Co-located services related to:
• Medical case management
• Primary care
• Community outreach and
education
• Substance abuse treatment for
people who are at high-risk for
HIV and/or have a co-occurring
disorder