• Black Cis-Gender and Trans Women, HIV Treatment, and PrEP
    2023/04/18
    Guests featured in this episode:Keosha Bond, M.D., Assistant Medical Professor, City University of New York School of MedicineTori Cooper, Director of Community Engagement for the Trans Justice Initiative, Human Rights CampaignLatesha Elopre, M.D., Associate Professor, Division of Infectious Diseases, University of Alabama at BirminghamModerator: Alexandra Walker, Director of Digital Communications, National Association of Community Health CentersAlexandra:. Welcome to Health Centers on the Frontlines, the podcast of the National Association of Community Health Centers. Today is the third and last in a three-episode series we've been doing about an epidemic that the nation's health centers have been battling for decades: HIV and AIDS. PrEP access and use remain unequal in the United States, with women overall accessing it at a fraction of the rates of men. Meanwhile, one in five new HIV cases annually occurs in women. The overwhelming majority of Black women. Transgender women specifically, are at an even greater risk for HIV acquisition and oftentimes lack access to competent care to access primary care. When we think about health centers and all the work that is done with Black communities, we cannot leave HIV prevention and care for Black women out of the conversation.To discuss today, we are joined by a panel of experts, Dr. Keosha Bond, Assistant Medical Professor at the City College of New York. Tori Cooper, Director of Community Engagement for the Trans Justice Initiative at Human Rights Campaign, and Dr. Latesha Elopre, Associate Professor in the Division of Infectious Diseases at the University of Alabama at Birmingham.We start this conversation about ways that health centers can improve the engagement of Black cisgender and transgender women in HIV testing, prevention, and care. So if we could start with you, Latesha, how can we improve messaging about HIV prevention and care to improve acceptance of services among all Black women?Latesha: Thank you. So, my name's Latesha and my pronouns are she and her, and I am really excited to be able to talk about this topic. I think that when we’re talking about access and we’re talking about it for specific populations, we have to do it in the framing and the understanding that access is not equitable to begin with. So number one, there is a system-level barrier in regards to who's able to receive the services. So when we’re understanding why, we’re seeing inequalities in regards to certain geographic locations. We're talking about things like being in a non-Medicaid expansion state, having poor public transit opportunities available to you where you live, being impoverished, and being a victim of systemic racism, those are all barriers that communities of color face a lot of times on a day-to-day basis that make access difficult.But when we're talking about specifically, how do we improve messaging and understanding around PrEP and HIV testing and prevention, I think that we have to do it from a framework where we're not talking about risk, but we're talking about health. And that's something that we haven't been doing well in regards to public health in general. So I've been very excited, I think, where a lot of conversations have been moving and shifting, because right now if you were to ask many people in America right now, do you think you're at risk for HIV? Should you be tested? They would say no. And based on how we've defined risk from a public health standpoint, you know, the answer actually would be not based on CDC guidelines and recommendations, a lot of times would put people, quote-unquote, at risk is nothing more than where you live. And that's social determinants of health that are currently impacting you.So, I think we just have to change our messaging, be more sex-positive, be more health-focused and oriented, more talking about HIV testing, PrEP, and messaging.Alexandra: Thank you. And turning to you, Tori, thank you for joining us. What are some of the things that you believe health centers can do to improve engagement of Black, cisgender, and transgender women, HIV testing and prevention, like PrEP? Tori: Well, thank you for having me. My name is Tori Cooper and my pronouns are she and her. And I'm a Black trans woman. So I speak on behalf of a lot of women who have similar backgrounds as I do. We're Black, we're transgender, we live in the South. One of the things really kind of going along with what we just heard, Black women, regardless of how you got to your Black woman, how you got to your womanhood, we often put others' needs ahead of ours. We trust people, perhaps, who don't deserve our trust, and yet we're distrustful of medical systems. And so one of the programs I'm involved with is changing Risks to Reasons (From Risk to Reasons)where we're actually helping Black women to reframe what risk is in terms of reasons.When we think about risk for HIV, we really are putting the responsibility, the power in someone ...
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    23 分
  • Long-Acting Injectable PrEP and HIV Treatment
    2023/04/18
    This episode, Long-Acting Injectable PrEP and HIV Treatment, is the second in a three-episode series about new evidence-based strategies for addressing HIV and AIDS.Guests featured in this episode:Jeremiah JohnsonProgram ManagerPrep4All Amy Killelea, J.D., Killelea Consulting Aviva Cantor, PA-C, AAHIVS, PhD, Callen-Lorde Community Health CenterModerator: Alexandra Walker, Digital Communications Director, NACHCAlexandra: Hello and welcome to Health Centers on the Frontlines, the podcast of the National Association of Community Health Centers. Today is the second in a three-episode series we're doing about an epidemic that the nation's health centers have been battling for decades: HIV and AIDS. During these episodes, we're sharing promising news about how community health centers, health center controlled networks and primary care associations are employing the latest strategies to link people to ongoing HIV prevention, treatment, and care services. Today, we're happy to be joined by a panel of experts, Jeremiah Johnson, who is the Program Manager at Prep4All, an organization of professionals and patients based in New York City who advocate for greater access to lifesaving medication for HIV. Also joining us is Amy Killelea, JD, an expert in policy, medication access, and health care financing to develop sustainable HIV and Hepatitis programs. And Dr. Aviva Cantor, HIV specialist and primary care provider at Callen-Lorde Community Health Center, which serves New York City's lesbian, gay, bisexual, and transgender communities. So in late 2021, the US public was introduced to a bi-monthly injectable form of PrEP, which stands for Pre-Exposure Prophylaxis. Taken in pill form and now also available as an injectable this medication reduces the chance of getting HIV from sex or injection drug use. When taken as prescribed, PrEP is highly effective for preventing HIV, a landmark push to end the HIV epidemic. At the same time, people living with HIV have been introduced to a monthly injectable form of treatment that similarly puts them in charge of their healthcare needs without having to remind themselves to take a daily oral medication. This is revolutionizing the field of treatment and prevention of HIV because we never have had a form of either that was this long lasting. Also, it's exciting news because it expands the number of tools we have in our hands to fight HIV. Health centers have been taking their first steps in implementing these tools. So, starting with our health center guest. Aviva, can you explain to our audience the two types of injectable antiretroviral medication? We've heard that one can be used as PrEP for people who are HIV negative and the other as an HIV treatment for people who are living with HIV. Can you tell us about the similarities and differences?Aviva: Sure. Yeah. So the two medications and we use brand names here. I normally don't like to use brand names, but we’ll use them so that they're more clear for patients in the community. So one is called Cabenuva. That's the medication that's used for HIV treatment. And the other is called Apretude. That is the medication that's used for HIV prevention. What they both have in common are that they are both what I describe to patients and my colleagues as deep intramuscular injections. So they're a little different than your regular intramuscular injections. They have to be done by nurses who have been trained just a little bit differently to make sure they do it the right way. So they're both these deep intramuscular injections. They're actually both now available as bi-monthly or every-two-month injections. They actually sort of follow the same schedule where you're given your initial injection, you're given one one month later as a loading dose, and then you take an injection every two months, every eight weeks, essentially. The big difference between these medications is, first of all, for HIV treatment (Cabenuva), it's two (injections;) it's a combination of two medications. So it's two separate injections, one in each buttock (one medication in each buttock). For HIV treatment, for Apretude, for prevention, it's just the one injection in one buttock.Alexandra: Yeah, that's a good first start. We can get back to some of those issues in more depth. Jeremiah, drawing from your experience as a community member and advocate, what do you think is important for the community health centers that we represent around the country to know and consider as they see these new options for prevention and treatment?Jeremiah: Yeah, happy to talk about that. Thanks for having me on the podcast today. And really, you know, I think, Dr. Cantor, you really set us up really well because I think you clearly have a clear sort of centering of your patients and the way that you're sort of talking about things. Because I think one of the first things that I'll say about long acting injectable is it is exciting. I also, as a community advocate, am very ...
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    21 分
  • HIV Status Neutral and Health Centers
    2023/04/18
    The first in a three-part series of conversations about an epidemic health centers have been on the front lines of addressing for decades: HIV (human immunodeficiency virus) and AIDS (acquired immunodeficiency syndrome). In this episode, HIV expert Nick Diamonds leads a conversation about new strategies for preventing HIV transmission. Guests featured in this episode:Robyn Neblett Fanfair, MD, MPH, Acting Division Director, Division of HIV PreventionCenters for Disease Control and PreventionJuan Carlos Loubriel, Director of Community Health and WellnessWhitman-Walker HealthCraig Thompson, CEO, AIDS Project Los Angeles (APLA) HealthModerator: Nick Diamond, Manager, Editorial Services, Elizabeth Glazer Pediatric AIDS FoundationEpisode transcriptEpisode transcriptNick Diamond: I want to start with Robyn by asking you, "What excites you the most about the new evidence based-strategies introduced for people who are HIV negative and want to stay that way?" Dr. Robyn Neblett Fanfair: Thanks to a robust toolbox that includes pre-exposure prophylaxis, post-exposure prophylaxis, treatment as prevention, and syringe service programs, we now have more tools than ever available for HIV prevention, and we must realize the full potential of these tools, we understand how important it is to make sure that it gets into the hands of everyone who needs them. So what excites me a lot right now is a status neutral approach to HIV prevention, which we believe can really help improve access, reduce stigma, and help prioritize health equity. So as far as exciting strategies go, it's really about reframing how we think about traditional HIV service models to better reach people where they are with the services that they need. So no matter their HIV status, we know that people need similar health care as well as essential support services. These can include medical care, housing, transportation, and employment. A status neutral approach can create a one door approach for HIV prevention and treatment, which can help normalize both. It eliminates HIV stigma by integrating prevention and care instead of supporting separate systems. And we believe it can enable people to know their status by making HIV testing and next approaches, whether they're behavioral or biomedical prevention, more accessible, and it can advance health equity by connecting people to the services they need regardless of their HIV status. So those are just a few things that I think are really exciting in HIV prevention right now.Nick Diamond: And Juan Carlos, I want to turn it over to you to ask about your experience and programs at Whitman-Walker. Would you talk a little bit about what your health center is doing to improve HIV prevention services in the community? I know Robyn just talked about this toolkit; are you seeing the implementation of things in those toolkits at the health center? Juan Carlos Loubriel: Yes, indeed. We are very excited about this new approach. Whitman-Walker Health delivers tailored education and sexual health services that are sex-positive and inclusive. Our training and linkage efforts are community-based service delivery interventions. They promote access to effective tools for HIV prevention and timely diagnosis. We also provide immediate access to nPEP (non-occupational post exposure prophylaxis) and PrEP (post exposure prophylaxis) for HIV prevention. We provide early diagnosis and prompt linkage to medical care, including ART (antiretroviral therapy). And these efforts occurred alongside treatment of HIV and other chronic diseases. We strive to eliminate barriers to care. And to do this, we deliver status neutral services and connect clients to medical, behavioral health, harm reduction, and social services through customized risk reduction. Staff provide health literacy and education for clients on understanding and navigating the medical system at every stage of the care continuum. And we need to understand that education is also a necessary component to normalize conversations around sex, so we want to increase client’s active participation in care decisions so they can make informed decisions about their sexual health and HIV risk. And these services help move these clients along the continuum from prevention to care, and there are entry points to care in each of our programs. Nick Diamond: One thing that's really exciting about this conversation is that we're convening a really diverse group of stakeholders, from government to community health centers, and the response to HIV, and Juan Carlos, I might ask if you have a question for Dr. Fanfair related to HIV prevention from your perspective, working in community health, you know, with an opportunity to engage government?Juan Carlos Loubriel: Yes, definitely, Doctor Fanfair, you know, over the past 40 years, there have been many HIV prevention best practices, including condom use and PrEP. And my question is, what do you see as an HIV prevention best practice coming in...
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    22 分
  • Q&A with Dr. John Hatch, Health Center Pioneer
    2023/01/11
    In this episode, we hear from Dr. John W. Hatch about the history of Community Health Centers and how it intersects with the Civil Rights Movement. Dr. Hatch is a professor emeritus of public health at the University of North Carolina, Chapel Hill, and a legend in the health center movement. He was instrumental in establishing one of the nation's first community health centers in Mound Bayou, Mississippi, which was an all African American town founded in the 1860s.

    Dr. Hatch pioneered approaches to addressing social drivers of health and describes building latrines, installing window screens, and starting a farm cooperative to provide affordable, nutritious food to the community. He explains how community input was part of the health center model from the very beginning. He also calls for more activism and policy change to address the challenges facing health centers and their patients today.

    Featured in this Episode

    Benjamin Money Jr
    Senior VP, NACHC
    Linkedin: https://www.linkedin.com/in/ben-money-6133436
    Profile: https://www.ncdhhs.gov/about/leadership/benjamin-money

    Dr. John W. Hatch
    Professor Emeritus of Public Health
    University of North Carolina, Chapel Hil

    Chapters

    00:00 Introduction
    01:31 The changing of terms
    02:35 The social drivers and how to address them
    12:30 Moving in the area of environmental health
    15:18 Establishing the Co-op
    16:49 Adding benefits like non-medical things
    21:18 Envisioning what Health Centers could become
    25:12 Continuing the legacy
    29:42 Addressing racial inequality
    34:18 Communities addressing the public health issues
    45:54 The incredible community health workers
    52:54 The communities of today
    56:05 Giving Thanks

    Produced by Heartcast Media.
    www.heartcastmedia.com
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    47 分
  • Work As a Social Driver of Health: How La Casa Family Health Center Identifies Farmworkers
    2022/10/10
    The pandemic made our nation aware of the importance of the people who raise, pick, and process our food. We now understand that farmworkers, as well as grocery store cashiers and shelf stockers can be counted among our country’s Essential Workers. However, it’s not always clear to the Community Health Center care team what a patient’s occupation is. Occupation is one of the most important social drivers of health, affecting patients’ health and access to healthcare in many different ways. This episode of Health Centers on the Front Lines takes us behind the scenes at a health center and their partner network as they change the culture around disclosure of occupation among patients. Our guests talk about what it takes to collect data about a patient’s occupation and why it improves care when the care team knows what work their patients do.


    Featured in the Episode

    Katherine Chung-Bridges, MD
    Director of Research at Health Choice Network
    Linkedin: https://www.linkedin.com/in/katherine-chung-bridges-8a0127170/

    Daniel Parras
    Research Data Scientist
    Health Choice Network
    Website: https://www.hcnetwork.org/

    Yvonne Armijo
    Director of Operations/Information System Analyst
    La Casa Family Health Center
    Website: https://www.lacasahealth.com/

    Giddel Thom, MD
    Chief Medical Director
    La Casa Family Health Center
    Website: https://www.lacasahealth.com/

    Chapters
    00:00 Introduction
    01:56 The story of dairy farm workers
    07:49 What is occupational data and how does it affect health care?
    10:18 The difficulty of collecting these data
    12:19 The challenge of integrating occupational data into the E-health records
    15:44 The importance of occupation in health and in socioeconomics
    20:00 Reactions when meeting new patients having to know their past medical records
    24:03 Takeaways from our guests

    Produced by Heartcast Media
    https://www.heartcastmedia.com/
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    25 分
  • What to Expect When You Vaccinate Your Child Under 5 for COVID-19
    2022/07/18
    After a long wait, children younger than 5 are finally eligible to get vaccinated for COVID-19. What does this mean for parents and caregivers? Wanda Montalvo, PhD, RN, FAAN, a senior fellow and team lead for public health integration and innovation at NACHC, interviews pediatrician Lisa Costello, M.D., MPH, about vaccine benefits as well as answers some commonly asked questions.

    For more resources about vaccines, view the U.S. Department of Health and Human Services’ COVID-19 Public Education Campaign, We Can Do This provider and patient education materials on pediatric COVID-19 vaccines: Resources About COVID-19 Vaccinations for Children

    Key Takeaways
    The systematic process for approving the COVID-19 vaccine for children
    The risk assessment on children getting vaccinated
    The definition of Long CoVid and what it means to children
    Engaging with parents and communities to promote vaccination for children

    Quotes
    From what I've experienced, choosing vaccination is the safest path for the protection of your children - Dr. Costello

    The communities trust their local health care provider and if we provide them with resources, we can do a great deal in improving vaccine confidence - Dr. Costello

    Featured in the Episode
    Wanda Montalvo, PHD, RN, FAAN
    Senior Fellow, Public Health Integration,
    National Association of Community Health Centers
    Linkedin: https://www.linkedin.com/in/wmontalvophdrn
    Twitter: https://twitter.com/Montalvo501
    Company Website: Nachc.org

    Lisa Costello MD, MPH, FAAP
    Pediatrics Dept. West Virginia University School of Medicine
    Profile: https://directory.hsc.wvu.edu/Profile/35594
    Linkedin: https://www.linkedin.com/in/lisa-m-costello-b1329391
    Twitter: https://twitter.com/lisacostellowv?lang=en
    Contact Details 304-598-4835

    Chapters
    00:00 Intro and Guest's background
    02:28 the process of approval
    06:37 Risk assessment
    11:25 Long Covid, and what it means to children
    13:34 Promoting children's vaccination
    18:25 post-vaccination for children
    21:43 Final thoughts

    Produced by Heartcast Media
    https://www.heartcastmedia.com
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    25 分
  • Talking to Parents About the Value of the COVID-19 Vaccine for their Children
    2022/06/28
    Vaccine hesitancy has been on the rise due to COVID and the lack of information about this kind of medication. Vaccine hesitancy is not always new. It is especially common among parents who are reluctant to get their children immunized. Added to misinformation and disinformation, children are at risk of getting sick if they will not get vaccinated.

    In this episode, Dr. Wanda Montalvo invited Dr. Jennie McLaurin and she explained what Emergency Use Authorization is and its purpose. Moreover, Dr. McLaurin talks of the rising vaccine hesitancy among parents and the risk if children will not get vaccinated on time. She also emphasized that the hesitancy is caused by misinformation and disinformation campaigns in the public.

    Key Takeaways

    Emergency Use Authorization and what is it all about
    Increased vaccine hesitancy among parents
    Explaining the risks of unvaccinated children among parents
    Rising cases of disinformation and misinformation about drugs and vaccines

    Quotes

    "Emergency use authorization is not rushing of preparation and skipping oversight. The drugs have to get through a number of clinical trials before they're allowed to be part of an emergency use authorization."- Dr. McLaurin

    "Parents are always thinking about what they allow their children to receive in their bodies, whether a vaccine or a drug or a certain type of food nutrition." - Dr. McLaurin

    "Vaccines have gotten safer and safer."- Dr. McLaurin

    Featured in the Episode

    Wanda Montalvo, PHD, RN, FAAN
    Senior Fellow, Public Health Integration,
    National Association of Community Health Centers
    Linkedin: https://www.linkedin.com/in/wmontalvophdrn
    Twitter: https://twitter.com/Montalvo501
    Company Website: Nachc.org

    Jennie McLaurin, MD, MPH, MA
    Senior Fellow Public Health Integration and Innovation
    National Association of Community Health Centers
    Linkedin: https://www.linkedin.com/in/jennie-mclaurin-5111b6133/
    Twitter: https://twitter.com/MclaurinJennie
    Company Website: Nachc.org

    Chapters

    00:00 Intro
    02:41 What is Emergency Use Authorization?
    05:56 The rising vaccine hesitancy among parents
    07:34 Vaccines that most parents dislike
    10:53 Children's risk against unvaccinated and COVID
    14:35 Simple picture for protecting your child
    19:30 Disinformation and misinformation
    26:14 Final thoughts

    Produced by Heartcast Media
    https://www.heartcastmedia.com
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    25 分
  • A Path to Healing for Health Care Workers
    2022/03/15
    Coming off another surge in COVID cases, health care workers who may have been stressed and strained before are now experiencing emotional exhaustion. This is no less true for the staff of the nation’s 1,400 health centers. Supporting the emotional and mental health of health center workers has been a focus of two of NACHC's Senior Fellows, Dr. Jennie McLaurin and Dr. Grace Wang. 

    Dr. McLaurin is a pediatrician with 30 years of experience caring for underserved families at the local, state, and national level, including as medical director of migrant and community health centers. Dr. Wang is a family physician who worked for more than 30 years at health centers and public health departments in New York City and Seattle, most recently at International Community Health Services in Seattle. 

    They talk about the dynamics of "moral distress" and "moral injury" affecting health care workers right now, made more acute during the pandemic. And offer some answers to the question: When so much is out of their control, what are some practices that health center staff can use to deal with the stress of work? And what can health center leaders be doing to support staff?

    📍Key Takeaways
    ☑️Understanding the Mental and Emotional Health of Health Center Employees
    ☑️Addressing Moral Injury and Distress, What is it and Where it comes from
    ☑️Supports and Recommendations for Dealing with the Problem Among Health Care Personnel and Their Organization
    ☑️Changes in policy and new programs to address the problem at healthcare facilities, among healthcare workers, and in the people of color community

     

    📍Quote Takeaways
    📣“It's critical that the health center's leaders understand what's going on in the workforce, and that they provide both time assistance and a healing environment to improve the situation. 
    - Grace
    📣“So when the leadership denies us the capacity to provide high-quality treatment or contradicts the knowledge that underpins our care, we've suffered a moral injury. - Jennie


     📍Our Host and Guest for this Episode
    🎙️Alexandra Walker | Linkedin
    Director of Digital Communications, National Association of Community Health Centers (NACHC)
    Nachc.org


    🎙️Dr. Jennie McLaurin | Linkedin | Twitter
    Senior Fellow Public Health Integration and Innovation at National Association of Community Health Centers (NACHC)
    Nachc.org

    🎙️Dr. Grace Wang | Profile
    Senior Fellow Public Health Integration and Innovation at National Association of Community Health Centers (NACHC)
    Nachc.org 

    📍Time Stamp
    ⌛[00:00] Introduction
    ⌛[01:49] Mental And Emotional Health
    ⌛[07:45] Moral Injury for oneself
    ⌛[12:10] Moral Injury in a Healthcare setting
    ⌛[17:09] Effects of the distress 
    ⌛[19:16] supports and recommendations
    ⌛[28:03] Policy and Programs
    ⌛[34:38] Conclusion


    This podcast was produced by Heartcast Media

     

     
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    38 分