COMMUNITY CONSULTATION SERIES Women Who Have Sex With Women (WSW) and HIV Prevention Presented by: The Institute @ Harm Reduction Coalition May 14, 2010
Harm Reduction Coalition Founded in 1994 to work with individuals and communities at risk for HIV infection due to drug use and high-risk sexual behaviors. Committed to reducing drug-related harm by initiating and promoting local, regional and national harm reduction education, interventions and community organizing Offer specific expertise in how to best incorporate the principles of health and safety promotion for drug users.
HRC Programs & Services Policy Advocacy Lifting the Federal Funding Ban on Needle Exchange National and Regional Conferences Next conference: Austin, November 18-21, 2010 The Institute @HRC Harm Reduction Training Institute Hepatitis C Project Skills and Knowledge on Overdose Prevention (SKOOP) Capacity Building Assistance (CBA) for Communities CBA for Community Based Organizations
Examples of (Free!) CBA Services Providing skills-building trainings at HRC or on-site at CBOs Consultation and coaching around the implementation, adaptation, and evaluation of the Diffusion of Effective Behavioral Interventions (DEBIs) Develop quality assurance and evaluation plans for effective HIV prevention interventions for high-risk seronegatives and HIV positive individuals Integrating cultural competence and linguistic appropriateness into intervention activities
Examples of (Free!) CBA Services DEBIs Training Technical Assistance Adaptation Implementation Evaluation Cultural Competency Linguistic Appropriateness OIPS Board Development Strategic Planning Fiscal Management Grant Writing Program Collaboration and Service Integration CMM Community Identification and Definition Communitylevel Assessment, Collaboration and Development Skills building, consultation, and coaching M&E Quality Assurance Outcome Monitoring Data Collection, Management, and Analysis
Community Consultation Series The purpose of the Community Consultation Series (CCS) is to: Raise awareness about HIV prevention issues in the community Solicit feedback from our consumers CBOs, HDs and other community stakeholders working with people infected and affected with HIV/AIDS Ensure the meaningful integration of consumer input into The Institute s work
Agenda Introduction by Moderator: Alicia Heath-Toby, Women s Institute at Gay Men s Health Crisis Panelist presentations Naomi Braine, Brooklyn College Jennifer Lorvick, RTI International Darlene Jenkins, New York Harm Reduction Educators Jae Quinlin, Consumer Question & Answer Moderated Discussion and Solutions/Strategies Brainstorm Next Steps Evaluation & Closure
Web Conference Guidelines Your Phone Will Be Kept on Mute until the Q&A period Chat Function Will Enable You to Send Questions To the Moderator Respect Each Other No cross talking One person at a time Step Up, Step Back
ALICIA HEATH-TOBY, MODERATOR
NAOMI BRAINE, PANELIST
WSWs and HIV: thinking about identities and dynamics of risk Naomi Braine Sociology Dept Brooklyn College WSW and HIV Webinar Harm Reduction Coalition May 14, 2010
Some things change, some things stay the same 1990+/- : The challenges of identity Are lesbians at risk? In what ways? Woman-to-woman transmission Sex with men Injection drug use What does lesbian HIV risk mean? And how did the CDC define lesbian? Now: WSW-IDU @ SEPs (data collected 2000-05) 18% of sexually active women (last 30 days) overall 32% @ program with highest proportion WSW
Identities, Risk and HIV, round I Identity behavior Identity and prevention Contradictions of identity and sexual practice MSM, WSW, epidemiology and culture
Identities, Risk and HIV, round II Social Location Identity Resources/ Marginality HIV Risks Social Networks
Marginality, resources and risk Interactions of race, class, gender(s), and sexuality Stigmas within sexual minority communities Access to services, experience with service providers Mainstream Community based Multiple marginalization* *Young, R., Friedman, SR, and Case, P (2005) Exploring an HIV Paradox. Journal of Lesbian Studies, vol 9(3)
Lesbian/Bi identified clients at Bronx MMTP Hetero (N=108, 83.7%) Lesbian/Bi (N = 21, 16.3%) % N % N Age 47.4 7.4 44.8 8.2 Ethnicity Latino 68.5 74 66.7 14 Black 24.1 26 23.8 5 White 5.6 6 4.8 1 Other 1.8 1 4.8 1 Born in the US 75.0 81 95.2 20 Education Less than H.S. 62.1 67 57.1 12 High school or GED 19.4 21 38.1 8 Any post-h.s. 18.5 20 4.8 1 Illegal job 2.8 3 28.6 6 Used illegal drugs 19.4 21 28.6 6 Buy sex with money or drug 0.0 0 4.8 1 Sell sex for money or drug 1.9 2 9.5 2 Overdosed in lifetime 19.4 21 42.9 9 Response = Agree I met with a case manager in the last year 93.5 101 81.0 17 The clinic staff makes me feel comfortable. 95.4 103 70.0 14 I don't always feel I can trust the staff. 30.6 33 42.9 9 I don't like the way clinic staff treat patients who are still using illegal drugs 30.2 26 50.0 9 The clinic staff are very friendly to me. 93.5 101 90.5 19 The clinic staff always treat me with respect. 97.2 105 90.5 19 The staff are often too busy to help me out. 14.8 16 47.6 10 I always feel that I can count on clinic staff. 87.0 94 71.4 15 I feel comfortable talking with my methadone counselor about personal issues 92.6 100 66.7 14
Gender, sexuality, and WSW identities AG, Boi, Butch, Femme, Drag King, Trans, and more Social locations: networks, cultures, spaces and contexts Sexual locations: desires, partners, contexts and practices Inherently relational A place in the world A way of understanding self and others
JENNIFER LORVICK, PANELIST
Sexual & Injection Risk among WSW who Use Methamphetamine Jennifer Lorvick, MPH Urban Health Program RTI International jlorvick@rti.org HRC Webinar May 2010
Women and Meth Study Objective: To examine sexually transmitted infections and sexual risk among women who use methamphetamine in San Francisco Community-based Quantitative (n=322) and qualitative (n=37) HIV and STI testing, counseling & treatment Bio female, > 18, meth past month >1 male sex partner past 6 months Sex with woman past 6 months: 36% (n=116)
Sexual behavior, past 6 months (n=322) Unprotected vaginal or anal sex, >2 partners* Non-WSW (n=206) % WSW (n=116) % 54 66 Unprotected anal sex* 17 30 > 10 male sex partners* 19 37 Sex for money or drugs 57 67 *p<.05
Drugs & injection, past 6 months (n=322) Injected drugs Injected meth Shared syringes: distributive Shared syringes: receptive Smoked crack* Used meth daily Non-WSW (n=206) % 54 52 7 10 66 13 WSW (n=116) % 55 52 10 15 78 16 *p<.05
Potential Prevention Implications Findings similar to a much earlier study of WSW who use injection drugs or crack (Kral & Lorvick, 1997) Sex with female partners a possible indicator of greater overall sexual risk Among drug-using WSW, identity-based prevention approaches may not be effective
DARLENE JENKINS, PANELIST
Staying Safe Saving Lives Womyn who have sex with Womyn (WSWs) Presented by: Darlene Jenkins, MPA
New York Harm Reduction Educators (aka NYHRE) A harm-reduction based social service agency specializing in providing case management, support groups, and individual therapy to active drug users and their partners. Services provided to highly marginalized populations from two offices and sixteen mobile sites.
How Capacity-Building Agencies Help They can: Assist with identifying target population Assist with community outreach Identify the need for on-going staff development Facilitate networking with appropriate agencies Can offer WSW-specific services
HIV Prevention Needs for WSW Logistics: A safe and appropriate setting Knowledgeable Staff (of both HIV and gay issues) Educational materials (pamphlets, etc) Safer-sex Equipment (i.e., Dental Dams, Finger cots, etc) HIV Counseling and Testing
Intervention and Outreach What Can Service Providers Do? Do you know your population? Do you have a plan for building relationships? How do you engage? Are you or can you be non-judgmental? Are you prepared?
For further information contact: Darlene Jenkins, MPA 212.828.8464/718.842.6050 Email: djenkins@nyhre.org
JAE QUINLAN, PANELIST
QUESTION & ANSWER
DISCUSSION AND BRAINSTORM Solutions & Strategies WE WILL NOT SOLVE ALL PROBLEMS! HOWEVER, WE ARE TAKING THE FIRST OF MANY STEPS TOWARDS A SOLUTION
NEXT STEPS
EVALUATION & CLOSURE
For More Information The Institute @ Harm Reduction Coalition 22 West 27 th Street, 5 th Floor New York, New York 10001 Tel: 212-213-6376 Fax: 212-213-6582 Website: www.harmreduction.org theinstitute@harmreduction.org