A recent immigrant to the U.S., Asha* was grateful to connect with Kalina*, a Helping Hands Program recruiter with Morris Heights Health Center (MHHC) located in the Bronx, N.Y. After getting to know her, Kalina suspected Asha was pregnant and guided her to MHHC, where her pregnancy was confirmed.
Unfortunately, she also tested positive for the Human Immunodeficiency Virus (HIV), which weakens the body’s ability to fight infections and disease. Without treatment, it can be passed from mother to child during pregnancy. Asha was completely unaware of her HIV status prior to getting tested.
Providers at MHHC helped Asha access prenatal care as well as antiretroviral treatment, which helps keep the level of HIV virus low and prevent it from progressing to AIDS – the final stage of HIV infection.
Months later, Asha delivered a healthy baby girl who is HIV-negative. Additionally, her own viral load is currently undetectable and Asha now provides coaching and support to other women she knows who are newly diagnosed.
Recognizing Improved Access to HIV Care
Asha’s story is one example of the power of MHHC’s Helping Hands Project – a project in which volunteer recruiters, like Kalina, encourage people in their communities to get tested for HIV and help link them to care.
Since implementing Helping Hands in 2012, they have seen a slow but steady increase in identifying individuals with HIV and connecting them with services.
These results over time are one reason why MHHC was selected as one of seven winners of the 2014 “Innovations in Care” Award as part of the BD Helping Build Healthy Communities initiative, implemented together with Direct Relief and the National Association of Community Health Centers (NACHC).
The awards seek to recognize innovative approaches to the prevention and treatment of diseases that disproportionately affect vulnerable populations in the U.S.
Building a Program on Proven Success
Helping Hands is based on the success of the Social Networks Demonstration Program, funded by the Centers for Disease Control and Prevention (CDC) between 2003 to 2005.
It was found that using community members who have tested for HIV and are dedicated to awareness was highly effective in reaching people at risk and connecting them with resources.
Morris Heights responded by using this proven strategy to help identify HIV-positive residents in the Bronx as soon as possible to immediately link them to treatment services through the creation of its Helping Hands Project.
HIV Prevalence in the Bronx Prompts Outreach
According to Ms. Candace Jones, program manager for CARE Services (MHHC’s HIV Program), peer-driven programming is much-needed in the community MHHC serves as the Bronx has an HIV prevalence that is higher than the city-wide rate (1.7 percent vs 1.3 percent respectively). Some neighborhoods in the area have rates as high as 2.2 percent, according to the New York City Department of Health and Mental Hygiene.
But for each person with HIV captured in the data, there are many others who don’t know their status. In the U.S., more than one million people are living with HIV, and it is estimated that nearly 1/4 of those infected are unaware.
The lack of awareness poses a major public health risk as the transmission rate of people who are unaware is estimated to be at least three and a half times greater than the rate of the transmission of HIV by people who are aware of their infection status.
Barriers to Getting Tested
Though MHHC provides testing at no cost to people without insurance, many other barriers exist. Jones said that many sub-populations “have been extremely difficult to infiltrate because of stigma.”
Jones said that in addition to stigma, other barriers to testing include: fear or mistrust of an organized system (especially among undocumented community members), poverty, mental health, substance use, comorbidities like hepatitis, and lack of knowledge about how to access resources.
That’s why training recruiters like Kalina, who already have existing knowledge, trust, and relationships within these communities, has made significant advancements in getting at-risk people tested and linked to care.
Enhancing Helping Hands as Program Expands
To further refine the Helping Hands Project, MHHC decided to implement a formal training component to strengthen community members’ communication skills and provide them with the tools to conduct effective outreach to engage, refer and link their social networks in care through testing.
Participants of the Helping Hands Project are MHHC patients. The health education training they receive also provides them with the skills to educate their peers on HIV and other sexually transmitted diseases, including Hepatitis C.
This training, which will be implemented with funds from the award, will help recruiters better articulate the benefits of testing and increase their ability to confidently educate peers in their social networks on HIV modes of transmission, harm and risk reduction.
To date, the BD Helping Build Healthy Communities Award has:
- Funded peer advocates who function as recruiters
- Enabled MHHC to facilitate trainings in-house
- Provided incentives for more than 200 people to receive HIV testing
Morris Heights: Helping the Underserved Since 1981
MHHC was established in 1981 and emerged as a premiere and much-needed medical presence for the medically underserved and socially disadvantaged populations of the Central and South Bronx.
MHHC consists of six diagnostic and treatment centers, two licensed Mental Health Counseling Centers, a Women’s Health Pavilion, a Mobile Medical Unit, and 15 school-based health centers.
Each year, MHHC serves more than 48,000 patients, of whom 13,000 are uninsured. In 2013, the organization tested more than 13,000 patients for HIV.
Their dedication to looking past the statistics to reach individuals like Asha is making a difference in the health and lives of people in the community.
*names have been changed to protect patient privacy