GOMOJO Las Vegas Programs

In 2011 I began gathering information from the Whitehouse.gov to develop, evaluate, and implement effective prevention strategies and combinations of approaches including efforts such as expanded HIV testing (since people who know their status are less likely to transmit HIV), education and support to encourage people to reduce risky behaviors, the strategic use of medications and biomedical interventions (which have allowed us, for example, to nearly eliminate HIV transmission to newborns), the development of vaccines and microbicides, and the expansion of evidence-based mental health and substance abuse prevention and treatment programs.

It is essential that all Americans have access to a shared base of factual information about HIV. The Strategy also provides an opportunity for working together to advance a public health approach to sexual health that includes HIV prevention as one component. To successfully reduce the number of new HIV infections, there must be a concerted effort by the public and private sectors, including government at all levels, individuals, and communities, to:

• Intensify HIV prevention efforts in communities where HIV is most heavily concentrated.

• Expand targeted efforts to prevent HIV infection using a combination of effective, evidence- based approaches.

• Educate all Americans about the threat of HIV and how to prevent it.

STRATEGIES

1. Increase the availability and reach of media campaigns
2. Increase the availability of online interventions
3. Increase the number and availability of interventions that address substance use
4. Expand the availability of free and low cost HIV testing
5. Increase condom availability and appeal
6. Increase the number and availability of youth-specific interventions

THE NEED

• Community frustration with the quality and content of sexual health education that is delivered in schools

• Urgent need to develop sexual health programs that involve parents and include the roles of home and community

• Limited resources and programming that target youth and young adult

•Lack of coordination and collaboration with sexual health education programming in school districts

• Lack of parent/child intervention programs

• Lack of peer sexual health education programs for youth

• Limited support groups for HIV+ youth and youth adults

• Youth have become de-sensitized to HIV prevention messages

• Youth see HIV as a chronic manageable disease

• Youth are more concerned with pregnancy prevention than HIV/STD prevention

STRATEGY

• Develop sexual health education programs for parents and increase parent involvement in sexual health intervention

• Advocate for consistent and comprehensive sexual health education programs throughout all school districts in Nevada.

• Include a discussion of homosexuality in sexual health programs

• Address the stigma associated with discussion of sexuality, birth control and HIV/STD testing

• Create programs were HIV-positive youth share their experience with other youth

• Create a “tip sheet” on how to bring up condoms with a partner distributed at youth-focused events

• Provide opportunities for youth to role-play condom negotiation

• Create peer education and mentorship programs for young MSM, as well as heterosexual youth

INCREASE THE NUMBER AND AVAILABILITY OF YOUTH-SPECIFIC INTERVENTIONS

1. Target and tailor programming for sexually active and most-at-risk youth based on pattern of behavior and their needs.

2. Provide necessary information and skills building to help youth prepare to make their eventual transition to sexual activity safer and healthier, including delay of sexual debut.

3. Work with parents and guardians to help improve communication to youth about their values and expectations regarding adolescent behavior, as well as stressing the importance of monitoring and supervision of their adolescents.

4. Engage influential adults within the community to create an enabling environment conducive to the adoption of safer sex behaviors among youth.

5. Expand access to community-level prevention programs, including peer outreach, and curriculum-based programs for out-of-school youth.

GIVING PEOPLE MEANINGFUL THINGS TO DO!

Address GBV in Las Vegas

This Funding Opportunity Announcement (FOA) invites applications addressing ethical issues in research relevant to populations with HIV and associated co-morbidities, and populations at high risk of HIV acquisition. The bioethics projects supported through this program announcement will focus on at least one of the following three goals:

1) Development of the empirical knowledge base for human subjects protection and ethics standards in HIV/AIDS research;

2) Development of conceptual bioethics approaches to advance scholarship on difficult ethical challenges in HIV/AIDS research;

3) Supporting the integration of bioethics work with ongoing research in HIV/AIDS.

The goal of this funding opportunity announcement (FOA) is to provide a global outline of areas for innovative, targeted basic behavioral and social science research and intervention development research to reduce the number of new HIV infections and improve the overall health of those living with HIV and encourage research grant applications in these areas. This FOA encourages research designed to (a) conduct basic behavioral and social science research that is needed to advance the development of HIV prevention and care interventions, (b) translate and operationalize the findings from these basic studies to develop interventions and assess their feasibility and (c) conduct tests of the efficacy of HIV prevention and care interventions.

The R21 mechanism is specifically intended to encourage new exploratory and developmental research projects. These studies should break new ground or extend previous discoveries toward new directions or applications. These studies may involve considerable risk but may lead to a breakthrough in a particular area, or to the development of novel methodologies, tools, technologies, or interventions that could have a major impact on health research and practice.

6. Provide or refer sexually active youth to confidential youth HTC, and ensure linkages to care for HIV positive youth.7. Encourage sexually-active youth to learn their HIV status, practice safer sex and reduce their number of sexual partners.

Provide sexually active young people with risk reduction information and skills building, including access to male and female condoms and information on correct and consistent condom use.

8. Prioritize interventions targeting evidence-based prevention, care and treatment for adolescents living with HIV/AIDS in the following areas:

a) Measurement: Work with the UN and partner governments to better track the numbers of adolescents living with HIV (ALHIV) and the coverage of critical HIV services for these populations.

b) Prevention: Work with global experts to identify the most effective interventions for preventing new HIV infections in vulnerable adolescent populations and support partner governments to bring them to scale.

c) Treatment: Work with partner governments and implementing partners to scale programs that increase access to treatment for ALHIV, and help those currently in pediatric care to effectively transition to adult care.

d) Advocacy: Work with UNICEF and other global partners to raise awareness of the needs of ALHIV and vulnerable adolescents, and

Build commitments to bringing effective programs and interventions to scale.

9. Provide comprehensive packages of interventions for highly vulnerable youth and young member of key populations tailored to be accessible and acceptable to younger people.

10. Support structural interventions to reduce young people’s exposure to risk and increase protection.

11. Strengthen and expand gender-sensitive programs to respond to the unique needs of male and female youth, including addressing harmful gender norms that foster the spread of HIV.12. Evaluate the impact of PEPFAR-funded youth programs to build a stronger evidence base for these interventions.

INCREASE THE AVAILABILITY AND REACH OF MEDIA CAMPAIGNS

THE NEED

• Community member frustration over lack of media attention on HIV/AIDS

• Current media campaigns only target the GLBTQI community and reinforce the stigma that associates HIV as a “gay disease”

• Pharmaceutical companies heavily promote HIV as a manageable chronic disease

• Sexuality and condom use still portrayed as negative, dirty, and unhealthy.

THE GAPS

• No current media campaigns targeting injection drug users

• Campaigns targeting specific minority communities and HIV+ populations need to be expanded

• No current radio campaigns and limited television marketing

• No current campaigns that feature celebrities, athletes, and politicians getting tested for HIV

• No current campaigns that demonstrate that while HIV can be treated effectively, living with HIV is not easy and drugs have many side effects.

INCREASE THE AVAILABILITY AND REACH OF MEDIA CAMPAIGNS

• Expand media campaigns to portray safe sex in a healthy, fun, sexy way

• Reinforce safer sex messaging on a variety of media outlets to reach diverse populations, including those with a focus on Latinos/as and African-Americans

• Encourage discussion of condoms in movies and television shows

• Develop campaigns that feature celebrities, athletes, and politicians getting tested for HIV

• Flash statistics of the number of people who are unaware of their HIV infection to reinforce testing messages

• Create advertisements that demonstrate that while HIV can be treated effectively, living with HIV is not easy and drugs have many side effects

• Include prevention messages in restrooms of bars/clubs, airports, and casinos

• Include information about HIV/AIDS prevention at gas stations, grocery stores, and bus stops

• Develop more HIV prevention materials in Spanish.

INCREASE THE AVAILABILITY OF ONLINE INTERVENTIONS

THE NEED

• Increase in the availability and use of internet sites and phone applications that people use for the purpose of seeking sexual partners (ie: gay.com, adam4adam, craigslist, grindr, etc.)

• Increase in the availability and use of social networking and dating sites that people use for the purpose of seeking sexual partners (ie: facebook, myspace, match.com, etc.)

• Advances in technology allow people easier access to meet sexual partners in a private and efficient manner

THE GAPS

• Limited staffing for active peer education

• Limited staffing for disease investigation

• No coordinated statewide internet interventions/marketing campaigns

• No active online intervention on craigslist

• Lack of interventions reaching out to MSM population in non-MSM online venues

• Limited educational outreach on online sites, such as chat room educational sessions

INCREASE THE AVAILABILITY OF ONLINE INTERVENTIONS

THE RECOMMENDED STRATEGIES

Increased online HIV prevention interventions may be the most efficient way to reach sexually active MSM, particularly those who do not self-identify as gay or bisexual, as well as younger populations.

• Require users of dating or sexual networking websites to click on a pop-up that acknowledges the importance of using condoms

• Display local links for HIV testing and services on the first page of websites

• Have peer educators create profiles and respond to ads with information about where to obtain free condoms and/or free testing

• Have peer educators set up an educational profile on social networking sites and ‘friend’ others

• Create social networking profiles (myspace, facebook, twitter) that send information about HIV prevention• Have public health professionals host live chats where individuals can ask questions about HIV and other STDs

• Display HIV risk reduction pop-ups that will catch the attention of target populations (ie: using attractive models and positive promotion of safer sex)

• Randomly display innovative and diverse condom advertisements

• Include a standard place for HIV status disclosure on all sites

• Development of a sex-positive branding strategy that promotes safer sex and harm reduction approaches

EXPAND THE AVAILABILITY OF FREE AND LOW COST HIV TESTING

THE NEED

• Community members are engaging in risky sexual and/or needle sharing behavior; yet, these people are not getting tested for HIV due to barriers in cost and availability

• Minority communities, although disproportionately at risk for HIV, report less availability of

free or low cost HIV testing options in their communities

• The Centers for Disease Control and Prevention recommend routine screening of HIV in health care settings for all adults

• There is community stigma around HIV testing; HIV testing has not yet been “normalized”

THE GAPS

• Limited diversity in HIV testing providers | South

• No online HIV test result options

• Limited education to providers about routine HIV testing

• Lack of testing incentives for high risk populations

• Limited free off-site testing outreach to minority and heterosexual communities

EXPAND THE AVAILABILITY OF FREE AND LOW COST HIV TESTING

THE RECOMMENDED STRATEGIES

• Offer more rapid testing to increase the number of people who receive their test results

• Offer more oral testing options to increase the number of people who are willing to test

• Test where straight-identifying people hang out (e.g., “straight” bars, clubs, and concerts) to reach MSM who are not “out” and high-risk heterosexuals

• Encourage testing at fraternities, sororities, and the dorms

• Offer testing in more “mainstream” locations (farmers markets, grocery stores, schools)

• Encourage providers to make HIV testing a routine part of medical exams

• Increase street-based HIV testing to reach sex workers and their partners

• Encourage testing with one’s partner

• Give incentives for testing (discounted admission to shows, free drinks, vouchers for STD

screening and/or birth control)

• Offer testing at special events and/or host new community events for targeted populations at risk (i.e., block parties, Cinco de Mayo, and community barbecues)

• Expanding testing and outreach in the jails and in collaboration with probation and parole services

INCREASE CONDOM AVAILABILITY AND APPEAL

THE NEED

• Community members stated lack of accessible, free condom distribution locations

• Community stigma surrounding the purchase and/or use of condoms result in less frequent use

• Few bars and clubs offer free condoms

• Free condoms that are available lack appeal The Current Resources: Free, yet limited,

condom availability in the Reno and Las Vegas areas at MSM and Y/YA targeted sites.

THE GAPS

• Lack of funding and resources for widespread condom availability

• Limited locations for free condom distribution sites

• Limited hours of operations for many free condom distribution sites

• Lack of funding and resources for “appealing” condoms

INCREASE CONDOM AVAILABILITY AND APPEAL

THE RECOMMENDED STRATEGIES:

• Widely distribute condoms in both gay and non-gay establishments, including mainstream

locations such as barber shops, bus stops, movie theaters, dorms, bars, and clubs

• Advertise and provide a wider variety of condoms (range of flavors, colors, sizes)

• Couple condom distribution with campaigns that promote condom use as sexy and desirable

• Advertise locations of free/reduced-cost condoms

• Have nightclub bouncers hand out condoms as people enter the

establishment• Install condom machines at bars, clubs, and gyms• Distribute condoms at locations frequented by youth such as skate parks, schools, Boys & Girls Club• Actively hand out condoms in places of high-risk activityINCREASE THE NUMBER AND AVAILABILITY OF INTERVENTIONS THAT ADDRESSSUBSTANCE USETHE NEED

• Substance use is a growing issue in all communities throughout Nevada

• Used syringes are being found on streets and in parks throughout Nevada

• Community members stated that they engaged in the “most risky” sexual behavior while

under the influence of alcohol and/or drugs

• Syringe access (needle exchange) is illegal in the state of Nevada

• Decrease the stigma surrounding addiction

Objectives

RESOURCES

Project Summary

Support countries in articulating a strategy for condom programming that addresses key supply and demand issues related to increasing condom use, assessing the relevant target populations that need to be reached with condom programming and delineating how different market actors(e.g., public, social marketing and private sectors) can contribute to provision of condoms for these target populations.

Address structural, social and economic barriers to effective HIV prevention, including GBV, stigma and discrimination and gender inequality, with a focus on advocacy, policy and evidence based interventions.

Employ evidence-based strategies to create demand for, and utilization of, male and female condoms, such as ensuring that high-quality condoms are available, that offered condoms correspond to consumer preferences, and that a variety of price points for different distribution channels are used.

Increased online HIV prevention interventions may be the most efficient way to reach sexually active MSM, particularly those who do not self-identify as gay or bisexual, as

well as younger populations.