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North Carolina Positive Charge Initiative Access to Care
+Who is out of Care?In North Carolina generally and the NC Positive Charge Initiative
In North Carolina, an estimated 23.4% of those who know they are HIV+ are not receiving HIV medical care.
NC Epidemiologic Profile for HIV/STD Prevention and Care Planning (12/11)
Age of Clients, NC PCI18-2425-2930-3940-4950+
Annual Income, NC PCI
<$20,000$20,000-40,000$40,000-80,000Missing
Race, NC PCI American Indian/Alaska NativeBlack, non-HispanicHispanicWhite, non-Hispanic
+A quick introduction to NC What impacted our program design
NC has unique geographies Mountains and sea Urban and rural Resources are
concentrated in certain areas
I-95 and I-40 corridors run through the state
HIV service system is splintered prevention/education/care
Stigma is strong throughout the state
History of peer training programs but not of agencies hiring peers
Gaps in funding often prevent continuum of services
Clients must be in medical care to get most services
No one is looking for people outside of the HIV system
Belief that PLWH can relate to other PLWH in a unique way
+Program OutlineAccess to care for those living with HIV
Access Coordinators (HIV+ peers) are the core of the program
Access Coordinators (ACs) work in teams of 2 or 3 in each agency
ACs receive special training when they start and monthly conference calls
ACs split their time between their agency and the community
Short-term relationship 3-9 months
Identifying Community outreach Testing events Referrals Agency in-reach
Connecting to Care Medical appointments Support services
Thriving in Care Communication skills Empowerment
+NC PCI Partners Across the State Three areas
representative of the state Rural (11
counties) Suburban (6
counties) Urban (1 county)
Different types of agencies Health
Department Community-based
Organization Faith-based
Organization
+Why are people out of Care?Barriers to Care and Meeting Basic Daily NeedsNC Positive Charge Initiative clients
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Current Needs of NC PCI clients at Enrollmentpercentage
+Program Outcomes Improved health outcomes
Increased CD4 Decreased viral load Increased number of undetectable clients
Number of self-identified barriers to care decreased Improved referral systems
Decreased no-show rates
New partners HIV testing, prevention and education
Skills-based curriculum for Access Coordinators Tools for thriving in care
+Challenges and Lessons Learned Street and community outreach is difficult Basic HIV education is still needed Training Access Coordinators has to be done right Transportation remain a barrier Access Coordinators need to be fully integrated in their
agency Some of our greatest opposition has come from the HIV
service system There’s a reason people have been out of care, but
they can thrive in care with the right support and skills
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