# Presentation: 699383

## Emerging AHP Strategies for Recruitment

**Maria E. Alvarez, MPA**
**CDC/NCHSTP/DHAP/PPB**
** ****Public Health Advisor**
**Duty Point: NYC**
**mma8@cdc.gov**
**212-268-6221**

## Recruitment

- An activity or set of activities intended to bring persons at high risk for being exposed to or for transmitting HIV into interventions to promote the adoption and maintenance of risk-reduction behaviors
- A critical element to the success of any intervention

## Recruitment

- Strategies to engage members of a target audience/population into HIV prevention interventions, care, and services
- Promotion of awareness of HIV programs
- Outreach, referral network, social marketing, community-level interventions and individual-level interventions

## Fundamental Strategies for Recruitment

- Outreach
- Intensive/Enhanced/Targeted
- In-reach
- Referral Network
- Social Marketing
- Community Level Interventions (CLI)
- Individual Level Interventions (ILI)

## Outreach

- Working in the community rather than waiting  for the community to come to the agency or organization
- A set of  activities conducted in the community to
- provide HIV prevention information
- communicate the benefits of early knowledge of one's serostatus
- conduct risk-reduction interventions
- promote agency programs
- refer or link persons at high risk to prevention interventions and services

## Outreach

- Conducted by peers, health educators, or outreach workers on the streets and face-to-face
- Conducted in specific venues where persons at high risk congregate, such as neighborhood streets, parks, bars, bathhouses, adult book stores, shooting galleries, or crack houses

## Outreach (Intensive or Enhanced )

- Implements a “higher threshold outreach” with specific objectives and methods for engaging high-risk populations and or sub-populations into care and treatment
- Uses non-traditional venues and hours
- Provides a direct connection to needed and or wanted services as well as consistent support
- Encourages recruitment into prevention interventions, care, and services (using highly trained and experienced peers)

**Notes:**
Enhanced Outreach Workers are trained and cross-trained in a variety of topics, harm reduction, behavior change and motivational interviewing. They provided consumers with a continum of services that may include HIV counseling and testing, and referring individualss to prevention case management, supportive and health care services.

## Outreach(Targeted)

- Designed to reach a specific population or sub-population of persons, as opposed to “general outreach,” which may involve mass mailings and tabling of information (e.g., health fairs) and is not targeted to any particular audience

## In-reach

- Educational activity that provides HIV prevention information and promotes HIV program services to its own staff and to persons participating in services and programs
- Conducted in the waiting areas or during an intake process for programs serving high-risk persons

## Referral Networks

- Are an important strategy for recruiting persons at high risk into HIV intervention activities
- Identifies other providers of services to the same population
- Develops reciprocal agreements between service providers

## Referral Networks

- Bi-directional (most often)
- Formal mechanism for client referrals and service provision, delineating responsibilities
- Broader HIV prevention services, including
- Clinics
- Substance abuse treatment facilities
- Homeless shelters
- Domestic violence programs
- Health department based STD, TB, or hepatitis related services

## Social Marketing

- Planning and implementation of programs designed to bring about social change using concepts from commercial marketing
- Social Marketing includes the use of
- advertising, billboards
- media campaigns, public service announcements
- Web site development
- brochures, palm cards

## Community Level Interventions (CLI)

- Seek to improve the risk conditions and behaviors in a community through a focus on the community as a whole
- Work to alter social norms, policies, or characteristics of the social environment
- Implement community-wide events, policy interventions, and structural interventions

## CLI and Activities

- Outreach to promote awareness of program services (e.g., agency meetings, conferences, health fairs)
- Health communication/public information (e.g., presentations at community forums, use of print/electronic media, telephone hotline, information clearinghouse, resource library)
- Social marketing campaigns
- Community mobilization

## Individual Level Interventions(ILI)

- Assist clients make plans for individual behavior change and ongoing behavioral appraisals
- Facilitate linkages to services in both clinic and community settings in support of behaviors and practices that prevent transmission of HIV
- Help clients make plans to obtain needed services
- Provide health education/risk reduction counseling to one person at a time

## ILI Activities

- Client intake
- Assessment of clients’ strengths and developmental assets as well as risks for HIV infection or transmission
- Comprehensive HIV prevention education and counseling, e.g., abstinence, risk reduction, interpersonal/ negotiation skills development
- Prevention Case Management (PCM)

## ILI Activities

- HIV Counseling and Testing (on-site or through a direct referral agreement)
- Partner notification assistance counseling and communication skills-building for HIV positive clients
- Referral and follow-up to needed services (e.g., primary health care, STD screening/tx, pregnancy testing, substance use, mental health, housing, education, employment, legal services)

## ILI Activities

- Crisis interventions
- Outreach to provide HIV prevention/risk- reduction education
- Distribution of HIV prevention/risk- reduction supplies and materials (e.g., male and female condoms, dental dams, bleach kits, print/video/audio educational materials)

## In Conclusion.... Emerging AHP Strategies

- Depends gravely on RECRUITMENT
- And remains key in effectively working with the three primary areas of HIV prevention that CDC is emphasizing:
- Early detection of persons who are HIV positive and referral to care services
- Prevention interventions with persons living with HIV
- Prevention with persons who are at high risk for HIV infection

##  Recruitment Is Critical to Successful HIV Prevention