Since MAP's inception, the initial case load of 15 clients has grown to 1,200. Atrican-Americans account for at least 65%, while Latinos ac- count for 31%, with the remaining 4% coming from Anglo and Asian pop- ulations. Through The Client Services Department, we deliver a broad range of services in response to the dilemmas and difficulties facing our clients. One of the goals of our agency is to bridge the gap of set vices for our clients. Our multi-ethnic client profile reveals a population in dire need of assistance in two or more of these categories: O Housing O Detox/Drug and Alcohol Rehabilitation o Psychological Support Services O Emergency Funding for Rent, Utilities, Transportation O Basic Survival Needs of Food, Clothing, Shelter o Assistance in Obtaining Benefits O Medical Follow-Up With a staff of ove 30 people, including the Director, Case Managers, Licensed Social Workers, psychiatrists, Registered Nurses, Certified Hi Testing Counselors, and Administrative Support, the Client Services Department provides a number of services summarized below, to meet the challenges posed by the increasing numbers of HIV- infected people.
Case Management Many of our clients come from marginal economic situations where existing problems of unemployment, homelessness, and social iso- lation is intensified by being HIV positive or by being AIDS-Diagnosed. Generally, they have multiple needs and require the help of Case Manag- ers in Client Services to negotiate the large, bureaucratic governmental systems on which they must rely for benefits and medical care. It is the job of the Case Manager to do a comprehensive in take interview with new clients to assess their needs and to develop service plans for them. After intake} the Case Manager coordinates overall care and ser- vices for clients to ensure they receive full and appropriate assistance through help in obtaining benefits, health care, referrals, counseling /s port, and prima y survival needs. Each Case Manager currently has a caseload of 65 active clients. Our clients' basic needs of housing, food, clothing, health care are met directly by MAP or through refer- rals; they also receive legal services, Section 8 housing, and admission to drug/alcohol rehabilitation facilities through a Case Manager�s ef- forts.
Home Nursing Care MA offers a cost-effective alternative to short or long-term hospital- ization for clients that are ill and need nursing care. 91-his program, coordinated by Registered Nurses and a Social Worker, includes Medi-Cal waiver funded by the state to cover it services. Currently, 60 slots are available for the home nursing program.
Dignity House and Housing Referral We receive calls daily from people with HIV/AIDS who are homeless. Dig- nity House, a coed residential facility, is one way MAP has responded to this crisis situation. Under the guidance of four staff Resident Managers, MAP provides a safe, clean, temporary shelter for homeless, Hi positive client who are healthy enough to take care qt themselves. Re4idents of Dignity House are encouraged to help one another and devel- op a medical/psychosocial support system, which includes NAP staff and volunteers, Staff a so assist with completing the process required for residents to qualify for federally funded Section 8 housing. When the house is at maximum capacity, or when a client is too physically weak or il1 to qualify for community resources residency, we seek alternative housing from other
Psychosocial Support MAP contracts the 5 services of 2 Psychiatrists and five accredited and/or licensed Social Workers to provide psychiatric assessments, crisis in- tervention counseling, and short-term therapy to clients, their famil- ies, and/or significant others. Therapists also facilitate support groups for men and omen living with HIV/AIDS.
Rent, Utilities, Food, Transportation Assistance In the African-American and Latino communities, many live on the margins of economic survival, underemployment, unemployment, poverty, limited access to health care, homelessness, chemical dependency, and a myriad of other problems p1ague the people who live in these communities. HIV infection and AIDS compound these problems. We found, from the outset, that we had to prove de help for our clients in meeting their primary survival needs since most lived on marginal incomes. In addition, ap- proximately 8% of those who seek our services are undocumented and do not qualify for public assistance programs. MAP provides rental assistance and move-in costs to clients through fund in from the City 0' Los Angeles. Clients who cannot qualify, because the are not city residents, receive emergency case assistance and/or utility payments for MAP's donated, unrestricted fund. Clients may come to our Food Party once a week to supplement their meager food al- lowances. For clients who need assistance with money for transport- ation, MAP makes taxi coupons and bus tokens available.
Alternative HIV Anonymous Testing As an alternative to other kinds of HIV testing sites, MAP offers anon- ymous testing free to everyone, although the primary focus of the pro- gram is to encourage people to be tested in Central and South Central Los Angeles who are at high risk. The Alternative Test Site Coordinator, assisted by trained and certified Pre/Post-Test Counselors and volunteers, take call-in appointments for testing hours on Saturdays at MAP. Walk-ins are also accommodated when time slots have bee booked to the maximum. No identifying information about individuals is used for making appointments, in giving the test, or in reporting test results. Before the test is given, testing part- icipants are required to watch a video to inform them about the test and the testing process. Also, a trained counselor talks privately with each participant to reduce any anxieties and answer questions. When participants return they see a counselor privately for test results and, if results are positive, they arrange for intake with MAP or a- nother agency, and give referrals for follow-up medical care.
Mobile Testing Unit In addition to the site for testing at MAP, we have a Mobile van HIV testing program to provide HIV counseling, testing and immune assessment services to clients in drug treatment programs. The primary goal of this program is to increase the use of HIV counseling and testing services by clients in specific treatment programs in Los Angeles County, and if appropriate, increase their access to early medical and HIV service intervention
Adult Day Program It has been demonstrated that clients who do not have adequate social support systems are prone to depression and accelerated symptoms of HIV infection. The activities offered in this program address both basic and psychosocial needs of clients while giving them an opportunity to develop social support systems and enjoy recreational activ- ities. On a daily basis, clients receive case management services, mental health therapy, medical ser- vices and health maintenance information, nutritional, and par- ticipate in special activities. We have found that involving clients in satisfying active programs that encourage bonding is physcologically and emotionally beneficial to them.
Health Education Department It is an equally important goal that Minority AIDS Project bridge the gap of accurate, up to-date information about HIV and AIDS in commun ities of color. It is the Health Education Department's intent: (I) to provide a foundation of knowledge so that people are able to separate facts from fiction and replace fear with understanding; (2) to clearly pre4ent facts in language commonly used, spoken and understood by mem- ber of the various communities we are attempting to reach; (3) to reach out to our communities with programs encouraging people to adopt and maintain low-risk lifestyle behaviors; (4) to teach people theft skills they need to best protect them-selves from the virus; (5) to promote a good health and a commitment to wellness, which includes regular HIV Antibody Testing for everyone and early intervention health care for HIV positive people. Our department's out reach activities take various forms to work effect- ively within the broad spectrum of cultures, neighborhoods and ethnic- ities here in Los Angeles. Aside from the contract-funded programs tailored to meet unique HIV educational needs of diverse target pop- ulations, the Health Education Department delivers an f addition- al educational services to the public: free HIV/AIDS testing, staff training for social service agencies in HIV/AIDS issues, -speakers for various public even 5, media shows and education settings, information tables at health fairs and community festivals, conference workshops, training for our agency volunteers, a quarterly newsletter and inform- atonal articles for community newspapers, HIV educational materials including posters, brochures, print ads, and radio spots, delivery of hot meals to people with HIV (Angel Food). With the help of a educated group of outreach volunteers, the- Health Education Director, the Program Coordinators, and staff provide commun- ity education through the department's core programs which, are geared to specific at-risk to get populations. These programs are summarized in the categories below
Outreach to Men of Color who Have Sex with Men A look at the number of Black and Latino AIDS cases in Los Angeles County shows an alarming picture; Blacks account for just under 12.5% of the population, 17% of the AIDS cases; Latinos are almost 30% of the population, yet the incidence of AIDS is 21%. Furthermore, the means of transmission for well of 50% of the Black and Latino adult AIDS cases is high-risk ex between males. Male to male sex is a hidden, but an accepted behavior in the Latino culture. It is a behavior often engaged in, but denied and hidden in Black culture as we I. Cultural pressures concerning male gender roles often result in hid en and denied male to male sexual beha1vior'; in both the Latino and Black cultures, a great many men who have sex with men do not self-identify a homosexual, no do they seed themselves within the context of the Gay communities of color. In order to reach men of color who have sex with men, whether the gay- identify or not, has designed several programs that address the needs of at-risk me in diverse cultural subgroups of the Black and La- tino communities. 411 of the programs include providing safer sex and safer drug-use methods through personal contact with outreach staff and volunteers in street , park and bar locations; several programs use the group education approach with emphasis on skill-building for risk reduc- tion behavior (proper condom use, safer sex negotiation, self-esteem and low-risk behavior). Newer programs feature promotional media campaigns focusing on the imp5rtance of HIV testing and early health care inter- vention, safer sex parties, a call-in Info Line, entertainment shows, and seminars for private groups or special organizations. Changing be- haviors from high-risk to low-risk, as well as maintaining low-risk be- haviors is the over 11 goal of each program.
Outreach to Women of Color There are many Latina and African-American women who live in areas of Central and South Central Los Angeles, where it is commonplace to find homelessness, poverty, the exchange of sex for drugs and/ r money, sub- stance use, drug sales, gang warfare, and crime activities . because many HIV education 4gencies are fearful of neighborhoods like these, the women, who live there and are at high risk for HIV, get little, if any, information about h6w to reduce their risk for infection. The various subpopulations of women targeted by this broad-based program include: young sexually active girls, women who are substance and in- jection drug users, Latinas who share needles to inject vitamins and antibiotics, female sex workers, bisexual women, lesbians, female sex partners of bi-sexual men, and partners of both male and female injec- tion drug users Staff and volunteers for this program are themselves women of color who have formerly led lies that placed them at-risk for HIV. : They are as- pecially trained to e culture/gender-sensitive to subgroups of women targeted by this program as they do one-to-one HIV prevention outreach in barsr food lines, on the street, and at housing projects. HIV educa- tion groups are convicted as well in prison settings, in recovery homes, and homeless
Model Needle Exchange Program Intravenous drug us , cocaine and alcohol abuser and use of other sub- stances are all co-factors in the spread of HIV/AIDS. Minority AIDS Project realizes that a needle exchange program alone cannot fully address the problem of drug use and its role in HIV infection. Alarming statistics on rates of HIV infection in California communities of color gave us compelling reasons to establish a needle program. Our compre- hensive program aim to provide education and other forms )f support for safer drug-using he behaviors to lower the risk of HIV transmission. The program does no promote drug use. It is designed to provide in- terventions in South Central Los Angeles to help Black and Latino drug injectors eliminate or significantly reduce drug using behaviors placing them at risk for HI infection. MAP operates the street outreach program in geographic areas where both iv drug use and HIV infection is prevalent. Our model demonstration program includes an exchange rather than a distribution of needles, on- site counseling, education about substance abuse and HIV/AIDS, on-site referrals to medical] and drug treatment facilities, social and HIW/AIDS services, access to substance abuse treatment on demand, a research and evaluation component.
Outreach to Transexual/Transgender/Cross-Dressing Communities Undeserved and unserved multi-ethnic people have historically been targeted by MAP `sHV outreach education programs. The scope of our outreach experience brought to our attention communities that are a risk for HIV had been largely unrecognized. Specifically, we found. that trans- sexuals, trangenderists, cross-dressers, drag queens, tran1svestites, female impersonator , who are all members of the communities, are largely overlooked as target populations at high risk.
Volunteer Services This program bridge the gap in HIV information services to these pop- ulations in Los Angeles County. Intervention strategies include bar and street outreach at sites where community members frequent and gather re- gularly, and specifically for private call-in referrals, discussion, and questions from our target audience. Other strategies for reaching these communities inaccessible to outsiders in- clude tapping into social organizations and special entertainment ve- nues, recruiting as peer group members and "gatekeeper" leaders to serve as program advisors recruiting peer group members to do out reach and to work within the pro ram in various capacities.
Queens Program The Minority AIDS Project provides HIV/AIDS Education and Prevention to men who identify as "queens" in L.A. County. We propose to reach queens at bars and through street outreach in the Hollywood areas of Santa Monica and Hollywood Boulevards. We will provide bar outreach to 1,000 queens at the various bars and venues in this area. During street outreach at all the parks, the other 1,000 will be educated on HIV prevention.
"Hands Across the Hood" Minority AIDS Project intends to target "gang members", both male and female, who are at high risk for HIV infection in the Rod Leimert Park, Inglewood and West Adams area of Los Angeles County Program will provide street and community HIV/AIDS education and prevention, risk reduction and early intervention/case management `to tills community which is very sexually active, heavy users of drugs and/or alcohol.
"Pathways" Minority AIDS Project's Treatment Advocacy Program provides tree ser- vices to persons living with HIV. These services include: access to the latest information n new HIV medications and complementary therapies; an educational resource library, with books, videos, pamphlets, and newsletters on nutrition and other health issues; educational sympo- siums, community up ate forums, and small group discussions; and re- ferrals to clinical trials and medical services. The Treatment Advo- cates are personal resources for persons living with HIV. They provide information, support and connection 5 to the latest developments in HIV managements. HIV is a treatable disease. Treatment empowers persons living with HIV to be Survivors by encouraging those persons to: 1) take steps to educate themselves about HIV/AIDS and to keep up with the latest medical advances, 2) to be an active participant in health treatment decisions made by their healthcare providers, and 3) to be alert to their bodies, reactions to these treatments. Persons living with HIV are encouraged to eat healthy well-balanced meals, to maintain a stress management program. and to get active in community advocacy programs.
"Promotion of Services" Promotion Services is a program that is designed to ensure the enrol- lment of African-American and Latino Gay and Bisexual Men who engage in gay and bisexual practices but who do not identify as being gay and bisexual (MSM) who are not currently accessing services, with a comprehensive system of care. This system includes but is not limited to; medical outpatient care, case management, treatment education and advocacy, support groups, mental health services, housing, financial, and legal services. Promotion Services consists of three components. (1)A targeted medical campaign that will include but is not limited to: public service announcements, bus benches, posters, brochures, fliers, & etc., developed bas d on an informed qualitative research and focus groups. (2) A Peer Buddy-Buddy program, that will assist current as well as newly HIV + diagnosed, gay, bisexual men, men and women in enrollment into HIV/AIDS services. The Peer-Buddy will consist of HIV + volunteers who are already enrolled into services. (3) A col laborative referral system.
