Rachel Levine, MD, physician general for the Commonwealth of Pennsylvania and Professor of Pediatrics and Psychiatry at the Penn State College of Medicine, delivers a keynote address during the statewide Minority AIDS Conference that JHF hosted in late May.
Since 2012, the Jewish Healthcare Foundation has provided coaching and training to AIDS Service Organizations (ASOs) in Pennsylvania that participate in the Minority AIDS Initiative (MAI), which links HIV‐positive individuals with medical, behavioral, and social services to help them better manage their condition and ultimately reduce community viral loads. The 20 ASOs that have participated in MAI have linked nearly 1,600 previously lost-to-care patients to outreach services, and more than 1,200 to medical care.
Collective learning is a cornerstone of MAI’s success. JHF has hosted a number of ASO-directed collaborative education meetings, where service organizations from across Pennsylvania share their outreach strategies and find ways to hurdle barriers that stand in the way of better care for their HIV-positive clients.
On May 23-24, the Foundation hosted a two-day conference that explored top-of-mind topics for the 11 service organizations currently participating in MAI: reducing HIV/AIDS health disparities, addressing stigma, advocating for clients, and delivering trauma-informed care. The “Let’s Talk” conference featured a keynote address by Rachel Levine, MD, physician general for the Commonwealth of Pennsylvania and Professor of Pediatrics and Psychiatry at the Penn State College of Medicine.
Minority AIDS Initiative participants from across Pennsylvania gathered at the QI2T Center for a JHF-hosted conference on reducing HIV/AIDS health disparities, addressing stigma, advocating for clients, and delivering trauma-informed care
Richard Smith, MSW, the Foundation’s HIV/AIDS project director, kicked off the conference by outlining the elements that have made MAI successful. JHF has partnered with agencies to provide quality improvement, data management, and motivational interviewing training. But the ASOs took it to the next level by tailoring their approaches to engage the particular clients that they serve including adolescents, individuals who use drugs, the homeless, and people who had been previously incarcerated.
“The people on the ground know best,” Smith said. “We want to give outreach workers the flexibility to apply training in a way that works for their organizations.”
Kyle Fait, a program outreach specialist for the Pennsylvania Department of Health Special Pharmaceutical Benefits Program (which awarded the MAI grant to the Foundation), provided an update on the SPBP program. Fait noted that SPBP is looking to infuse into communities nearly $25 million in revenue generated through drug rebates over the next five years, with a focus on innovative, Ryan White-eligible projects.
The two-day statewide Minority AIDS Initiative conference included a panel discussion on reducing stigma in health care, faith-based organizations, and communities, featuring (L-R): Trisha Gadson, MS, executive director of Macedonia Family and Community Enrichment Center, Inc.; Beth Scott, BSW, a medical case manager for Conemaugh Community Care Management; Dr. Rachel Levine; Project Silk Peer Navigator Michael Brookins; Adrienne Walnoha, CEO of Community Human Services; and Project Silk Peer Navigator Richard Wilson.
During her keynote, Dr. Levine outlined the difference between gender roles, orientation, and identity, and outlined alarming health disparities among the LGBTQ population. Dr. Levine noted that gay men represent two-thirds of new HIV infections in males, and that half of African-American men who have sex with men will be diagnosed with HIV in their lifetime. LGBTQ individuals have higher rates of alcohol and drug abuse, and are more likely to be the victims of physical and verbal abuse than the general population. Dr. Levine said that around one-third of transgender individuals report receiving a negative reaction from health providers. Forty percent of transgender individuals will attempt suicide during their lifetime, nearly ten times the overall rate for the U.S. population.
The reasons for LGBTQ health disparities are multi-faceted, Dr. Levine noted. Health providers may lack knowledge on the particular needs of LGBTQ individuals. LGBTQ individuals may not have adequate health insurance, and may fear talking with doctors about issues of sexual health due to stigma. They may also be subject to legal discrimination that could affect their ability to access employment, housing, and social programs.
“Pennsylvania has no statewide anti-discrimination law,” Dr. Levine said. “I worked with Penn State to add transgender individuals to its anti-discrimination laws. I was welcomed in an environment of inclusion. Elsewhere, I could have been fired. In most parts of the state, I could be denied housing. But Governor Wolf is committed to addressing these issues.”
Dr. Levine also addressed the opioid crisis, which led to more than 3,500 overdose deaths across Pennsylvania in 2015 (the most recent year of data available). Opioid addiction is a suburban and rural issue spanning demographics. Dr. Levine said that more than 3,000 lives have been reversed since she signed a standing order for the overdose-reversal drug naloxone. Pennsylvania is focused on providing counseling, therapy, and wraparound services to those suffering from addiction.
Following her keynote, Dr. Levine participated in a panel discussion of reducing stigma in health care, faith-based organizations, and communities. The panel, moderated by Pitt Men’s Study Medical Director Ken Ho, MD, MPH, included Project Silk Peer Navigators Michael Brookins and Richard Wilson; Trisha Gadson, MS, executive director of Macedonia Family and Community Enrichment Center, Inc.; Beth Scott, BSW, a medical case manager for Conemaugh Community Care Management; and Adrienne Walnoha, CEO of Community Human Services.
Sally Jo Snyder, director of advocacy and consumer engagement, led a workshop with service organizations on translating health advocacy into concerted action. She shared her four corner strategy for advocacy: care for your advocates, cover all aspects of an issue and have advocates’ backs, command the space, and control the timing. She left attendees with a quote from pioneering social worker Jane Addams: “the good that we secure for ourselves is precarious until it is secured for all.”Snyder also took part in a panel discussion on policy and advocacy that featured Erin Molchany, the Southwest Regional Director at the office of Governor Wolf and a former PA House representative, and Bart Rauluk, board president of ALPHA Pittsburgh.
During day two of the conference, MAI participants learned more about trauma-informed care during a workshop facilitated by Casey Swartz, MS, CCTP, LPC. Swartz explained the emotional and physical impact of trauma, and ways that ASOs can create a safe environment to empower clients to engage in needed medical and social services. To wrap up the conference, the agencies action planning workshops facilitated by the Foundation’s HIV/AIDS team.