UMBAST - How is HIV Training/TA Different on the Border?
Tom Donohoe, MBA Director, UCLA Local Performance Site, Pacific AETC U.S.-Mexico Border Project Coordinator, Pacific AETC
Over the past couple months I have completed trainings in both rural and urban areas of the border in California and Arizona. We also had an UMBAST face-to-face meeting on the border near Brownsville, Texas. I’d like to use this posting as a discussion of unmet border needs. I’d like to hear about your HIV-related training and technical assistance (TA) needs as providers in community clinics and organizations on the border. Over the next 3 years the AETCs and other federal training centers (FTCs) covering TB, substance abuse, STDs, prevention, and family planning will collaborate with UMBAST to better serve border community health centers.
I am often asked, "How is HIV training/TA different on the border?" Please help us answer the question above by responding to 1-2 of the following questions:
- How are HIV stigma and discrimination different on the border?
- How is access to HIV testing and care different on the border? What about retention in care?
- What are the top HIV-related substance abuse training/TA needs on the border?
- What are your STD, TB, or HepC training/TA needs?
- What are your HIV workforce and recruiting issues?
We need the feedback of providers and organizations who are working on the border to help address your unmet needs. We need your help!
Thank you.
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Judy Collins posting comments on behalf of an HIV services program manager within a large California Border FQHC:
How are HIV stigma and discrimination different on the border?
Unfortunately lack of information and stereotyping continues to be prevalent in our border
community, having as a result the permanency of stigma associated to HIV/AIDS.
Religion is prominent in our community; permeating opinions regarding HIV. HIV,
within this point of view, continues being associated to homosexuality and
unfaithfulness for those married.
How is access to HIV testing and care different on the border? What about retention
in care?
Fear of immigration enforcement agencies continues to be a deterrent for many
undocumented individuals in accessing testing services and care at an early
stage. Another variable that comes into play in our border communities is the
perception that HIV happens only in certain groups such as homosexuals and
injection drug users; therefore many individuals do not consider themselves
being at risk. Others, even if suspecting their own infection, delay testing
for fear of facing the disease.
Transborder population mobility is an issue when keeping patients/clients in care, as well
as fear of losing their jobs if requesting too much time off to attend medical
appointments.
What are the top HIV-related substance abuse training/TA needs on the border?
substances
What are your STD, TB, family planning or HepC training/TA needs?
What are your HIV workforce and recruiting issues?
Judy Collins posting a comment on behalf of a family planning program worker within a California Border FQHC:
When working with a population that has less access to education there may be old myths/misinformation around HIV/AIDS that persist.
Judy Collins posting comments on behalf of an HIV program administrator in the Arizona border region:
How are HIV stigma and discrimination different on the border?
What I have heard from HIV positive individuals is that there really has not been that much change regarding stigma and discrimination. They are still fearful of disclosing their status to
family and friends. As for accessing medical care along the border if they have no way to come to Tucson or Phoenix they will seek care at a clinic along the border. Their fear is that they will be discovered by someone that they know while they are in the clinic lobby.
What are the top HIV-related substance abuse training/TA needs on the border?
The training on meth seems to be appropriate at this time since there has been a rise in meth use in border and rural areas (US side). Is there data of meth use in the Mexican border area? Another area that you may want to consider is the use of medical marijuana. You have providers sitting on both sides of the camp. How will this affect the treatment of patients with chronic illnesses?
What are your HIV workforce and recruiting issues?
Specific to behavioral health it seems that there are few professionals that have educated themselves beyond AIDS 101 or are not sure that they have counseled someone who was
positive. Educational institutions that train medical providers and behavioral health providers need to include HIV/AIDS as part of their curriculum. It takes us here about 6 to 9 months to find and hire a qualified behavioral health therapist. We have been looking since November and received 19
applications of which 4 were interviewed we are still looking. What will HIV care look like in 2014 if healthcare reform is implemented?