Health Resources and Services Admin

Health Resources and Services Admin

U.S. Department of Health & Human ServicU.S. Department of Health & Human Servic

H

RSA

HRS

HEALTH RESO

IN THISISSUE

The MultCapacity UnderstaInserts: Ca

is published by the Health Resources andServices Administration, Department of Healthand Human Services. All information containedherein is in the public domain.

Please forward comments, letters and questions to:Office of CommunicationsHIV/AIDS Bureau, HRSA5600 Fishers Lane, Room 7-46Rockville, MD 20857Phone: 301-443-6652Fax: 301-443-0791or by E-mail to: koneill@hrsa.govHRSA Care ACTION

HRSACare

10

HIV/AI

IntroductionScope and PrevalenceIt is difficult to answer the homeless people are there precisely. The National Coaestimates that over 700,000 are homeless on any given nLaw Center on Homelessness people are homeless in the course of a year (1). Mantemporary, unstable housing. ing from data gathered in Nthat 7.4 percent of Americanhave been homeless at one timStaying healthy is a monhomeless individuals. Vulnerelements, lack of medication refrigeration, poor access to general exposure to unsanitajust a few of the problems reindividuals living in unstable HIV is found in epidemic phomeless. HIV prevalence is eand above in homeless popustudied compared to .3 percention (3,4,5,6,7,8). Since homare less likely to be tested for viduals (9), these figures probscope of the problem.

How many individuals with HIV disease receive someHOPWA support?During the 1998 operating year, HOPWA granteesreported that about 48,990 persons living withHIV/AIDS and more than 24,900 family membersreceived some form of housing assistance fundedthrough the HOPWA program, including a largenumber who received a small, short-term paymentthat helped to prevent homelessness.What services do HOPWA grants fund?Grantees document that the programs operatingthrough 1998 used about 70 percent of funds toprovide housing assistance. Additionally, 22 percentof funds were used for related support services to helpclients maintain independent living or to providesupport in assisted living facilities and communityresidences. The remaining 8 percent was used bygrantees and sponsors for administrative costs.Why are HOPWA funds used for support services?The use of funds for supportive services directly helpsthese individuals and families maintain theirhousing and access health care and other supportthat is available in the community.Are individuals living with HIV disease protectedfrom housing discrimination?Yes. HUD's Secretary issued a Directive on HIV/AIDSto help ensure that all of HUD's programs are available in the community to assist clients, based oneligibility, and that appropriate actions are taken inresponse to housing discrimination against personswith HIV/AIDS. The Directive noted that it is illegal todiscriminate against a person because of a real orperceived disability. HUD's Office of Fair Housingand Equal Opportunity(FHEO) stands ready toinvestigate cases involving individuals with AIDS orHIV infection, or individuals perceived to have AIDSor HIV infection, who have been subjected to discrimination in housing. FHEO's Office of Investigationswill address these issues with and take immediateaction, when required, to prevent homelessness orother serious harm. The FHEO Office of Investigationsmay be contacted at 1-800-669-9777, via any HUDoffice, or at Headquarters at 202-708-0836. TheFederal Information Relay Service TTY number is 1-800-877-8339.

How are housing needs changing among HIV-positiveindividuals?Grantees and sponsors report that an increasingproportion of new HIV infections are among individuals living in poverty. Many of these individuals andfamilies will require housing assistance to accessmedical care and follow treatment regimens. Manypersons in treatment are living longer and will alsohave ongoing needs for housing assistance. TheDepartment works in partnership with each community to help assess their needs in this regard, toinventory existing resources, and to help plan forcoordinated efforts on behalf of persons withHIV/AIDS.How much unmet need for housing assistance isthere?Surveys of providers and residents have been conducted by AIDS Housing of Washington (AHW), aleading technical assistance provider. AHW indicates that currently an estimated 200,000 persons inthe country with HIV/AIDS are likely to be in need ofsome housing support; perhaps one-fourth of all thosein need are being assisted through the HOPWAprogram. It is essential that persons in need also beassisted under other available programs, includingthose funded by State, local and private sources.Find out more about HOPWA at http://www. hud.gov/cpd/hopwahon.html or call the Office of AIDSHousing headquarters at 202-708-1934.

Continued from Page9... UNDERSTANDING HOPWA
Continued from Page1... HIV/AIDS AND HOMELESSNESS

2

more likely than those who were housed to beinfected with bartonella quintana, the bacteriumthat causes bacillary angiomatosis-peliosis (25). ANew York study found that among HIV-positiveindividuals, those who were homeless had muchhigher rates of bacterial pneumonia (26). Anotherstudy in New York City found 21 percent of homelessindividuals with HIV/AIDS to have syphilis and 43percent to have antibodies to hepatitis B (8).Another study from the same city found that 37percent of homeless injection drug users werehepatitis C seropositive (27). Finally, a Boston studyreported that homeless persons were more likely tohave esophogeal candidiasis (17 vs. 9 percent) anddisseminated TB (9 vs. 2 percent) as their AIDSdefining condition (28).Generally, latent TB prevalence is also extremely highamong homeless people with HIV/AIDS; studies havefound prevalence rates ranging from 32 to 67 percent(4,8).Neurologic disorders are more frequent among

homeless people as well; one study found thathomeless people were 6 times more likely to sufferfrom a neurologic condition than a housed individual (32). This condition is relevant because theneurologic manifestations and sequellae of HIV/AIDSare protean and numerous.There are many conditions more common amonghomeless people that may have an impact on thechoice and success of HIV/AIDS therapy. The prevalence of diabetes (39); hyper-choloesteremia (30);anemia (34); chronic gastrointestinal tract illnesses(31,32); liver and hepatitic diseases (32); drug usedisorder (4,40), and mental illness (41,42) are allhigher among homeless individuals than among thegeneral population.A recent study from Boston found that HIV disease isthe most predictive condition for mortality amongall homeless people (44). Also, homeless people areless likely than the HIV-infected population as awhole to receive antiretroviral therapy(45,46,47,12). It is thus reasonable to surmise thatmortality due to HIV disease among homeless peopleis not dropping as rapidly as it is among otherpopulation groups.

There are indications that many homeless

people at risk for HIV are not tested (5,8,48). A largestudy of IDUs in New York City found that only 45percent of homeless participants had ever been testedfor HIV, compared to 58 percent of those who werehoused (9). A shelter-based study—a study thatreported HIV seroprevalence at 62 percent—foundthat only 18 percent of the participants had ever hadan HIV test (8), and a study in San Francisco showedthat only 25 percent of homeless individuals found tobe HIV-positive had ever been tested (4). A Denverstudy demonstrated that only 77 percent of homelessparticipants who reported high-risk behaviors hadreceived HIV testing (49).Even if homeless people are tested for HIV they oftendo not receive their test results. Only 66 percentreturned in a study in Atlanta (5) and 70 percent inNew York (8). A study in New Haven found that only23 percent of homeless people who had been tested inthe past for HIV knew their serostatus (48).

Homeless people with HIV/AIDS are probably at

greater risk of reactivating latent TB infection into activedisease (8, 29).Medical conditions common among homeless people thathave implications for HIV disease include(30,31,32)—critical since AIDS is associated withdecreased caloric intake, malabsorption, weight loss, andloss of muscle mass (33). Recently, it has been shown thateven small degrees of weight loss—as little as 5 percentover 4 months—is associated with an increased risk ofopportunistic infection and death (34).

are common (31,35) in homeless populations;

one study found that 14 percent of homeless adults hadsuffered from the previous year (36).

are also common among homeless persons

given their exposure to unsanitary environments (35,32,37).

The HIV/AIDS Bureau and the Bureau of PrimaryHealth Care at HRSA are sponsoring a project toexplore HIV/AIDS care among homeless persons, inpartnership with the Health Care for the Homeless(HCH) Clinicians’ Network and the National HCHCouncil. The sponsors convened a working group ofconsumers, providers, clinicians, researchers,advocates, and government representatives onMarch 19-20, 1999. Based on the group’s recommendations and existing medical research, thedocument , from which thisarticle was abridged, was created. It providesguidance to providers caring for homeless individuals living with HIV disease and addresses policy andethical issues.

malnutrition

Respiratory

infections

influenza

Infestations

HAB/Bureau of Primary Health Care

Project on Homelessness

HIV and Homelessness

MortalityHIV Care: Access and UtilizationTesting.

A 1998 U.S. Conferenage of 18 accounted fo3 percent. A 1987 Urages of 31 and 50.Families with children Weitzman, 1996; U.SThe ethnic makeup of U.S. Conference of Mpercent Caucasian, 12 experiencing homelesAmericans and migran1996).Of 777 homeless pareresidence because of dAccording to the U.S. homeless population wApproximately 20 to 2persistent mental illneThere is no generally among homeless adulactual rate for current Approximately 25 perMayors, 1998; Nationwould have to work 8income, which is the F

AgeFamiliesEthnicityVictims of DomVeteransMental IllnessAddictionEmployment

Continued on Page 4
4

Care. Homeless people have less access to health carethan housed individuals. A study of homeless individuals in Los Angeles, for example, found that 66percent of the sample had no medical insurance and56 percent had no regular source of care. Studyparticipants had, on average, 2.9 physician contactsin a year. These figures are contrasted to a nationalpoverty sample of housed people that reports 36percent without insurance, 24 percent without aregular source of care, and 6.3 physician contacts ayear (50). Meanwhile, a study of homeless individuals in Baltimore found that only 47 percent of men

and 30 percent of women could name a usual sourceof care (40). The Boston Health Study found thathomeless people with AIDS had three times moredifficulty accessing care than those with homesbecause of unmet needs (51). The AIDS Cost andServices Utilization Study (ACSUS) found that homeless people with AIDS were less likely to access carethan similarly situated housed people (52).There are other indirect indications that homelesspeople with HIV disease have poor access to care. Forexample, Health Care for the Homeless (HCH) clinics

nationally reported a 35 perinsurance coverage in 1997 found that only 15.6 percent owith HIV/AIDS had any kind (52). The lack of insurance adHIV care (54, 55). In additionbeen shown to predict less accpercent of providers of care tHIV/AIDS surveyed in an obtaining substance abuse patients difficult (57). Indare excluded from care beca(57); many providers in thHomeless survey had difficuprimary care (58 percent), percent), respite care (57 percment (48 percent) for their paless.Homeless individuals living wantiretroviral therapy at lowepopulation. In Boston, only individuals with HIV/AIDS eliging to Department of Health guidelines were taking any abaseline of study; of those, othree or more drugs (46). A stufound that only 8 percent of eluals were on HAART (45). A housing needs of individualthat only 17 percent of homeHAART were taking these me51 percent of housed people unclear to what extent inoffered these therapies were accepting but not taking them

Lessons learned f

sis. The treatment of TB amobeen well documented and treating HIV disease. First, it that there are high rates of noreturning to have skin tests rstudies have also demonstrat

Antiretroviral Therapyand the HomelessAdherence.

Housing and Adherence

Names have been changed to protect confidentiality.

LawrenceSamuel SonyaIn 1997, L. T. startedantiretroviral medications,taking them for 6 monthswith diligence. During thattime he was housed in asingle residence hotel. Whenhe became homeless again,however, he told me that heknew that he would not beable to take his medicationsas prescribed, and he did notwant to take them for fear ofresistance. For the last year,L. T. has been homeless andnot taking medication. HisCD4 count fell to 250 and hisviral load climbed to over300,000. He is aware that hemay be in trouble medically.(Barry Zevin, M.D., SanFrancisco)Samuel is a 32-year-old manwho entered our therapeuticcommunity for alcohol abusetreatment. He had testedpositive for HIV 2 yearspreviously. His blood workwas remarkable for a CD4count of 410 and a viral loadof 130,000. An antiretroviralregimen of AZT, Epivir and

Viracept was prescribed. Itwas stressed that Viracept hadto be taken on a full stomach.We saw Samuel 2 weeks laterand—among otherthings—reminded him to takeViracept after a full meal. Hetold us he was doing so, withthe exception of Saturday andSunday mornings. The shelterin which the therapeuticcommunity was located servedthree meals on weekdays, buton weekends served only twomeals a day – brunch (atnoon) and dinner (in theevening).So on Saturdays and Sundays,Samuel took his morningViracept on an empty stomach.(Elizabeth Lutas, M.D., NewYork City)Being housed and in a morestable situation—and seeingsocial and nursing staff on aregular basis—S.A. successfullyrecovered from rectal surgeryand kept her regular follow-upappointments with me. InOctober 1997, almost 6months after her initial visitand frequent subsequent visits,

I felt comfortable and eager tostart antiretroviral therapy.She started AZT/3TC andNelfinavir. The regimen causedher only minimal diarrhea,and after a month her viralload had decreased considerably to 16,000 and her CD4 haddoubled. These results wereencouraging, but after 3months, her viral load wasagain over 300,000. S.A.disclosed to me that she hadstopped the Nelfinavir after thefirst month because there weretoo many pills, and that veryrarely would she take the 3TCor AZT. A few months later herCD4 count was 10, but we feltready to attempt therapy again.With the assistance of theBridge Project physician andother staff, we amplified andreinforced the message ofadherence. Since May 1998,her viral load has been undetectable, and her last CD4count was 240. I keep frequentvisits with her ...There are stillmany obstacles, however.Bridge Project housing, forexample, is limited to 18months. (Linette Martinez, M.D.,San Francisco)

Dr. Song currently is a fellow in gHopkins and Georgetown Univeravailable upon request.

Continued from Page2... HIV/AIDS AND HOMELESSNESS
6 

The Multiple Diagnosis Init

The RWCA SPNS Program and the U.S. Department ofHousing and Urban Development Office of AIDSHousing are collaborating to serve

HIV-positive individuals threatened by

homelessness.Determining the actual number of people affected byhomelessness, HIV/AIDS, mental illness, and substance abuse may be impossible, but estimatesprovided by the National Coalition for the Homeless(NCH) give an indication of the extent of the problem:

multiplydiagnosed

Up to 50 percent of persons with HIV/AIDS areexpected to need housing assistance of some kindduring their lifetimes (NCH Fact Sheet #9: Robbinsand Nelson, 1996).Approximately 20-25 percent of the single adulthomeless population suffers from some sort ofsevere and persistent mental illness. (NCH FactSheet #3: Koegel et al, 1996).Projections as to the extent of addiction among the

30 to 35 percent of the homesome form of addiction (NC

In response to complex needs ply-diagnosed people with Hare currently are being fundWhite CARE Act Special PSignificance Program.The 16 projects address isshomelessness, substance abusindividuals living with HIV d

HAB - HUD

Multiple Diagnosis

Initiative

AIDS Supportive Housing Project, Salvation ArmyHarbor Light Multi-Service Center, Minneapolis, MNProvides permanent housing. Flexible leasingallows clients to utilize treatment programs, suchas detoxification, at the adjacent Multi-ServiceCenter. Clients can re-enter treatment programswithout losing their apartments.

The Rectory House Project, AIDS Task Force ofAlabama, Inc., Birmingham, AL Provides 24-hocare in service-enriched community housing incentral Alabama. Receives funding from areahospitals, HMOs, public health agencies, themental health authority, and local municipali

Santa Cruz County Multiple Diagnosis InitiatiHIV/AIDS Housing, Housing Authority of SantaCruz County, Santa Cruz, CA Facilitates acontinuum of care from the streets to permanehousing for a primarily rural population.Provides emergency funds, long-term scatteredsite housing assistance, and support services.

Share Project, Housing and Services, Inc., DadeCounty, FL An integrated housing and serviceassistance program. The goal is to eliminatebarriers to housing, medical care, and otherservices by increasing collaboration among areaagencies.

MDI Housing Project, Houston Regional HIV/AIDSResource Group, Inc., Houston, TX Provides short-termcrisis housing, makes service referrals, andcoordinates activities among area organizations.Clients exiting drug treatment programs have accessto funds for rental deposits and utilities.

The Bridge Project, Lutheran Social Services of NorthernCalifornia, San Francisco, CA A collaboration of sixagencies committed to eliminating the barriers thatprevent multiply-diagnosed clients from accessingneeded services. Combines stable shelter in aresidential hotel setting with on-site services.

Casita Esperanza, United Bronx Parents, Inc., Bronx,NY Combines emergency shelter with transitionalsupportive housing and other services. Emergencybeds available for individuals entering or leavinginpatient detoxification services and/or awaitingresidential treatment placement.

Canaan House, Catholic Community Services,Jersey City, NJ Permanent independent livingfacility. Enables individuals and their families tocontinue living in the community while accessingnecessary care and services.

NYC Youth MDI Housing Project, The Center forChildren and Families, New York, NY Targetsminority youth aged 18-24 through aggressivestreet and institutional outreach. Servicesinclude tutoring and GED instruction.

HIV Multiple Diagnosis Initiative for Orlando,Orange County, Florida, and The Local HealthCouncil of East Central Florida, Inc., Orlando, FLCoordinates with four sponsors to identify homelessmultiply-diagnosed individuals. Uses casemanagers to link clients with services.
8

What is Housing Opportunitie(HOPWA) and when did it begiHOPWA is the Federal governtance program for low-incowith HIV disease and their famIndividuals living with HIV personal health and financiafinding or maintaining dehousing. Those in unstable hserious barriers to adherence care. For them, housing assiHIV/AIDS care.HOPWA provides several formand essential support servicesthe AIDS Housing Opportunity were first appropriated for Funds are made available by fstatistics in metropolitan aallocations are made to coConsolidated Planning Procesthe involvement of citizens, artions, housing and communitzations, government entities, tions, and other interested panity. HOPWA funds are inconjunction with other resograms involving health care afor persons with HIV/AIDS undAct and other Federal, Stasources.Who administers HOPWA?

Ryan White CARE Act Data Bite

1997 State AIDS Drug Assistance Program

Total Drug Expenditures by Drug Classification

Protease Inhibitors (PI)

- 4 drugs- Cost - $104,264,584

Nucleoside Reverse Transcriptase Inhibitors (NRTI)

- 5 drugs- Cost - $96,217,165

Non-Nucleoside Reverse Transcriptase Inhibitors(NNRTI)

- 2 drugs- Cost - $6,097,742

Opportunistic Infection Medications (OI)

- 31 drugs- Cost - $27,668,594

Other Drugs

- 7768 drugs- Cost - $80,087,665

Unde

An Interview 

Capacity Building in

Minority Community-Based Organizations

HRSA Pilot Project Explores Approaches

HRSA's HIV/AIDS Bureau (HAB) initiated a technicalassistance demonstration project this spring toidentify methods of capacity building among minority community-based organizations. The Bureau andthe National Minority AIDS Council (NMAC) teamedto conduct pilot workshops in Baltimore, Detroit, andLos Angeles. The effort supports the CongressionalBlack Caucus Initiative on HIV/AIDS and seeks toaddress infrastructure development needs of minority organizations.A total of 113 service providers registered for theworkshops, which focused on developing skills tomaximize Federal, State, local and Ryan White CAREAct resources. Participants represented small-tomedium sized community and AIDS service organizations, health clinics, substance abuse and treatmentclinics, housing facilities, and new agencies emergingto serve the needs of minorities. Agency budgetsranged from $1,000 to $863,000. Average budgetsvaried across the three sites: $154,300 in Baltimore,$202,700 in Detroit, and $375,300 in Los Angeles.

"As more HIV resources are being made available tocommunities of color, we want to help organizationsserving these communities to access funds and moreeffectively provide services," said Angela PowellYoung, Branch Chief of the Technical AssistanceBranch in HAB's Division of Training and TechnicalAssistance. "These demonstration workshops helpedus focus on areas where technical assistance is mostneeded and refine strategies for providing it."Workshop sessions covered:

An overview of the CARE Act from Federal andcommunity perspectives;Accessing resources (fundamentals of accessingfunds, how to write competitive funding proposals,and the grant review process);

Fiscal management and oversight;Development and management of budgets;Budget and staff allocation; andStrategic planning as a tool for program planning,

resource development, and fiscal management.

Participants' feedback was usfor the second two sessions anrefine training currently undeon suggestions, HAB will:

Make the training as "hand

example, participants mmission statements and gouse in small group exercisesto apply what has been pres

Place more emphasis on th

1.

33%

31%

2%

9%

25%

35%30%25%20%15%10%

5%0%

PI NRTI NNRTI OI Other
C

Ryan W

“Making 

Ja

will include standards of care, treatment guidelines, dental services, programs forco-morbidities, population specific programs, and the impact of a managed caresystem on care and treatments. Workshops will highlight programs that havedeveloped creative strategies for coordinating interventions into a system of care.The top five topics of interest identified by grantees are: adherence; clinicalprovider training; new therapies and related outcomes; clinical implications forunderserved and hard-to-reach populations; and HAART -- compliance issues.The topics of interest related to Federal and state policy and financing include:policy and financing implications of the shifts in the structure of social welfaredelivery systems (e.g, Temporary Aid to Needy Families, Medicaid, managed care,Children’s Health Insurance Program, etc.) and the impact on accessing andmaintaining specific HIV infected populations in the care system -- specifically,racial or ethnic minorities, persons with substance abuse and/or mental healthproblems, and incarcerated persons; expanding access to HIV care via private andpublic programs (e.g., Medicaid, Medicare, and private health insurance);integrated health and social service networks and establishing/enhancing relationsbetween CARE Act and other public/private funded programs; buildinginfrastructure and capacity for HIV care services among traditionally underservedcommunities; local and national policy implications of the development and useof standard program and consumer outcome measures; and current challenges tothe reauthorization of the Ryan White CARE Act. Other topics will be considered.The top five topics of interest identified by grantees are: data collectionrequirements - measuring outcomes; impact of demonstrated outcomes on fundinglevels; reauthorization; multiple funding streams and access to care/availability ofservices; and Medicaid managed care.Policy and Finance
CALL FOR ABSTRACTS

Ryan White CARE Act All-Title National Meeting

“Making a Difference: HRSA’s HIV/AIDS Programs”

Renaissance Washington DC Hotel

January 18-21, 2000, Washington, DC

The Ryan White CARE Act All-Title National Meeting presentations will be selected througha Call for Abstracts process. Persons who would like to present information relevant tothe Ryan White CARE Act Titles or other HIV-related care programs are urged to submitabstracts for consideration. We encourage all CARE Act Grantees to consider submittingat least one abstract about successful or innovative practices in their areas.Subjects presented at the Meeting must be relevant to the CARE Act Titles, cross-Titlecollaboration, and HRSA’s four guiding care principles:

Better serving the underserved in response to the HIV/AIDS epidemic’sgrowing impact among underserved minority and hard-to-reachpopulations;Ensuring access to existing and emerging HIV/AIDS treatments that can makea difference;Adapting to changes in the health care delivery system and the role of CAREAct services in filling gaps in care; andDocumenting outcomes.Workshops are presentations of information and issues about specific topicsin which skills will be developed by those in attendance. Workshoppresenters should have statements of clear expected outcomes for thepresentation. Workshops can either be interactive (format A) or didactic(format B) with time allowed for questions and answers. Workshops are twohours in length and may be conducted by an individual, co-presenters, or apanel. (See Abstract Submission Guidelines, last page).Roundtables are information presented on specific topics through informalconversation among small groups of ten individuals convened at roundtables. Participants will typically attend two different one-hour roundtablediscussions during the two hour session.Affinity Sessions are designed for a group of individuals interested in acommon topic to meet, discuss, network, and share information about thistopic. They are an hour in length and will be scheduled, per request,depending on space availability.



Types of Presentation Formats:

 Poster Pr

format ddesignateavailable 

The meeting will consiroundtables, affinity s

1. Administ2. Clinical a3. Policy an

Each track is designed learn through interactand poster presentatioBureau principles. For as being most importaitalics in the descriptioabstracts. However, G

This track is desskills and knowcollection requiexisting programtechnical assistahard-to-reach pTitle collaboratEmphasis will bachieve collaboprogram and sequantification ocare on outcomThis track will aHIV/AIDS, succewith the latest simplementation with examples oreceive and be mdiscussed

Track Descriptions:

AdministrativClinical and S
Ryan White CARE Ac1a. Track:1b. Presentation 1c. Abstract Title1d. Primary Auth1e. Co-Authors (u

ABSTRACT SUBMIDeadline for Receip

Adm a

Rank the abstraRank only those Are you willing 

Author_______________Organization_________Address_______________

(Street) 

Telephone_____________

Name______________________Organization_______________Address____________________

(Street) 

Telephone _________________Name______________________Organization_______________Address____________________

(Street) 

Telephone _________________Name______________________Organization_______________Address____________________

(Street) 

Telephone _________________Name______________________Organization_______________Address____________________

(Street) 

Telephone _________________

Abstract Submission GuidelinesAbstracts to be considered for presentation at theMeeting must be submitted on the attached abstractsubmission form in accordance with these guidelines.All information on the abstract submission formmust be typed. Abstract title, presenter(s), and phonenumber and organization must be provided in theindicated space. All authors must be listed.*Abstracts may be typed directly on the form orprinted on blank paper and cut and pasted onto theoriginal form. Abstracts should be between 150 and200 words (e.g., no more than one page). A font nosmaller than 12 points should be used. Noillustrations are permitted within the abstract.The body of the abstract should conform to one of thefollowing formats:Format A:1. Topic Description2. Issues to be discussed3. Learning objectives4. Solutions, Methods, Models, or ExamplesThis format may be best suited for sessions designedto enhance skills building, frame discussions on HIVrelated services delivery, policy, and maintenance,describe community based programs or interventionsfor bringing and maintaining hard to reach andunderserved populations into care, describe aparticular model or method of health servicesprovision, and describe systems of health servicesdelivery and care that include collaboration betweenprograms funded under different Care ACT Titlesand/or other PHS or other sources of funding. Thisformat could be used for Workshops, Round-tables,Posters, or Affinity Sessions.Format B:1. Objective2. Methods3. Results4. ConclusionsThis format may be best suited for presentingscientific and research-oriented workshops andposters.Programming for this Meeting will be based on thisCall for Abstracts. Submission of an abstract impliesa commitment to present at the Meeting if selected bythe Steering Committee.Because many popular sessions are offeredconcurrently, some presenters may be asked to repeat

Abstract selection criteria include the relevance toCARE Act titles and to people and families affected byHIV/AIDS, cross-title collaboration, HRSA’s fourguiding care principles, level of interest expected inthe proposed session, and overall clarity of theabstract.Notification of abstract disposition (whether theabstract was selected for presentation or not) will bemailed to presenters no later than September 30,1999. Abstract dispositions will be sent to thepresenting author .Incomplete abstract submission forms and those notin accordance with the guidelines will not bereviewed or considered.If you have any questions about this abstract form orinstructions, please contact Elisa Luna at MOSAICA,the contractor assisting the HIV/AIDS Bureau (HAB)with this Meeting, at (202) 887-0620, Ext. 14, orAngela Powell, Chief, Technical Assiatance Branch,HAB, at (301) 443-6561.*NOTE: Authors whose abstracts are accepted forpresentation at the Meeting will receive furtherinformation on curriculum vitae and facultydisclosure requirements in order that presentationsmay be considered for CEU/CME credits.

Abstracts must be received at the PSAoffice by August 13, 1999.

ONLY
Page 2 - Abstract Submission Form

2. ABSTRACT: Follow one of the formats described in the Abstract Submission Guidelines

(Typed, minimum 12 Point font, 150-200 words):Title_____________________________________________Primary

Author____________________________

___________________________________________________________

HRSA's Ryan White CARE Act All-Title National Meeting

Final decision on placement of presentation within track, category, and level will be up to the discretion of the Steering Committee.

Page 3 - Abstract Subm3. Please indica

require for you

4. Submission In

_____Overhead pro_____35-mm slide p_____LCD Projecto_____Videotape pla_____Podium with _____Table with MNote: Authors of abaudio-visual requea. Mail to: b Or, fax to: 
HHealth Resources and Services Administration Health Resources

Rand Services Administration

SA

HRSACare

CALENDAR OF EVENTS CALENDAR OF EVENTS

U.S. Department of Health & Human Services U.S. Department of Health & Human Services

1

JULY

7-9 Message for the Millennium: Responding to the

Many Voices of Change

Brooklyn NY

Sponsor: Child Welfare League of America (CWLA)

Contact: CWLA, 202-638-2952; Fax: 202-638-4004

Web: www.cwla.org

8 HIV Prevention Counseling: The Facts

Richmond VA

Sponsors: VA Commonwealth U. HIV/AIDS Ctr.;

Mid-Atlantic AETC, HIV/AIDS Bureau,

HRSA; Central VA Resource &

Consultation Ctr.

Contact: VCU HIV/AIDS Ctr., 800-525-7605

11-14 13th Meeting of the International Society for

STD Research

Denver CO

Sponsors: Intl. Society for STD Research; American

STD Assn.; American Social Health Assn.;

Natl. Ctr. for HIV, STD, and TB

Prevention, Div. of STD Prevention, CDC

Contact: ISSTDR Meeting Secretariat

201-947-5545, Fax: 201-947-8406

12-14 Balm in Gilead's 1999 Training Conference:

Partnering with Black Churches in AIDS

Prevention and Service

Myrtle Beach SC

Sponsor: Balm in Gilead

Contact: Same, 212-730-7381; Fax: 212-730-2551

Web: www.balmingilead.org

12-14 Advances in Health Care Conference 1999:

Pediatrics, Pharmacology, Emergency/Primary

Care & Complementary Medicine

North Falmouth MA

Sponsor: Nurse Practitioner Associates for

Continuing Education

Contact: Same, 781-861-0270; Fax: 781-861-0279

Web: www.npace.org

12-16 Tuberculosis Program Manager's Course

San Francisco CA

Sponsor: Francis J. Curry Natl. Tuberculosis Ctr.

Contact: Same, 415-502-4600; Fax: 415-502-4620

Web: www.nationaltbcenter.edu

15-18 AIDS Impact 1999: Connecting a World of

Resources 4th International Conference

Ottawa, Canada

Sponsor: Canadian Psychological Assn.

Contact: AIDS Impact 1999, Canadian

Psychological Assn.

613-237-2144; Fax: 613-237-1674

Web: www.cpa.ca or

www.aidsimpact.com

15-16 HIV Prevention Counseling: The Approach

Richmond VA

Sponsors: VA Commonwealth U. HIV/AIDS Ctr.;

Mid-Atlantic AETC, HIV/AIDS Bureau,

HRSA; Central VA AIDS Resource &

Consultation Ctr.

Contact: VCU HIV/AIDS Ctr., 800-525-7605

16 Nutrition Issues for HIV and Substance Abuse

New York NY

Sponsor: Harm Reduction Training Institute

Contact: Same, Sara Kershnar, 212-683-2334

Ext. 32, Fax: 212-213-6582

17-23 24th Annual National Wellness Conference: The

Wellness Connection... Experience It!

Stevens Point WI

Sponsor: Natl. Wellness Institute, Inc.

Contact: Same, 800-243-8694; Fax: 715-342-2979

Web: www.wellnessnwi.org/nwc/

21-23 Conference on the Role of Families in

Preventing and Adapting to HIV/AIDS

Philadelphia PA

Sponsors: Office of AIDS Research, Natl. Institute of

Mental Health, NIH; U. of PA

Contact: Loretta Sweet Jemmot, U. of PA

215-898-6373, Fax: 215-573-9193

Web: www.nimh.nih.gov/events/

hivaids99.htm

21-23 4th Annual National Prevention Institute

Seattle WA

Sponsor: Comprehensive Health Education Fdn.

(CHEF)

Contact: Same, 800-323-2433; Fax: 206-824-3072

E-mail: chefstaff@chef.org

Web: www.chef.org
2

July

21-23 NAHN Annual Conference: Unidos Para Nuestra

Comunidad (United for Our Community)

San Juan, Puerto Rico

Sponsor: Natl. Assn. of Hispanic Nurses (NAHN)

Contact: Same, 202-387-2477 or 800-662-7742

Fax: 202-483-7183

E-mail: nahn@juno.com

Web: www.incacorp.com/nahn

22-25 9th Annual Retreat for People Living with HIV:

Celebrate the Past, Embrace the Present, Create

the Future

Springfield VT

Sponsor: VT People with AIDS Coalition

Contact: Same, 800-698-8792 or 802-229-5754

Web: www.vtpwac.org

22-27 12th Annual National Catholic HIV/AIDS

Ministry Conference: Prophetic Voices

Chicago IL

Sponsor: Natl. Catholic AIDS Network (NCAN)

Contact: Same, 707-874-3031; Fax: 707-874-1433

Web: www.ncan.org

24-26 6th Annual Strictly Positive Wellness

Conference: Into the New Millennium

Walt Disney World FL

Sponsors: Hope & Help of Central FL; FL AETC,

HIV/AIDS Bureau, HRSA; HUG Me

Program at Arnold Palmer Hospital

Contact: Michael W. Fuchs, Hope & Help of

Central FL 407-645-2577

Fax: 407-645-1570

24-28 1999 National Conference of State Legislatures

Annual Meeting and Exhibition

Indianapolis IN

Sponsor: Natl. Conference of State Legislatures

Contact: Same, 303-830-2200; Fax: 303-863-8003

25-28 National Council of La Raza 1999 Annual

Conference: Launching a New Millennium

Houston TX

Sponsor: Natl. Council of La Raza (NCLR)

Contact: Same, 202-785-1670 or 800-331-NCLR

Fax: 202-776-1790

` E-mail: conference@nclr.org

Web: www.nclr.org/special/conf99

25-28 14th Annual Conference - Working with

America's Youth

Minneapolis MN

Sponsors: Natl. Resource Ctr. (NRC) Youth Services;

U. of OK, College of Continuing Education

Contact: Susan Schelbar, NRC Youth Services

918-585-2986; Fax: 918-592-1841

E-mail: sschelbar@ou.edu

Web: www.nrcys.or.edu

26 Case Management and Harm Reduction

New York NY

Sponsor: Harm Reduction Training Institute

Contact: Same, Sara Kershnar, 212-683-2334

Fax: 212-213-6582

27-30 Substance Abuse and Mental Health Services

Administration (SAMHSA) 2nd National

Conference

Los Angeles CA

Sponsors: SAMHSA; CDC; HRSA; NIH; Public

Health Service Office of Women's Health;

other Federal agencies

Contact: Courtesy Associates, 202-973-8657

28 National Technical Assistance Conference Call

"Medicaid/CARE Act Coordination"

(for Ryan White CARE Act grantees)

2:00-3:00 PM (EST)

Rockville MD

Sponsor: HIV/AIDS Bureau, HRSA

Contact: Mira Levinson, 617-482-9485

28-30 Getting it Right - A UK Conference of People

Living with HIV and AIDS - Shaping the Future

of HIV Services

Coventry, United Kingdom

Sponsors: UK Coalition of People Living with HIV

and AIDS; Natl. AIDS Trust; The Network

of Self Help HIV and AIDS Groups

Contact: Jo Robinson, Natl. AIDS Trust

+01718146729

E-mail: jo.robinson@nat.org.uk

Web: www.nat.org.uk

28 Relocating Therapy: Frontline Staff as Mental

Health Service Providers

New York NY

Sponsor: Harm Reduction Training Institute

Contact: Same, Sara Kershnar, 212-683-2334

Fax: 212-213-6582

7/29-Comprehensive Review of HIV Management:

Symposium

Sun Valley ID

Sponsor: Dept. of Medicine, U. of CA

San Francisco

Contact: Continuing Medical Ed., UCSF

Box 0656, San Francisco CA, 94143-0656

7/31-NAPWA Eastern Regional Meeting

8/1 Jersey City NJ

Sponsor: Natl. Assn. of People with AIDS

Contact: Beri Hull or Hector Rivera, 202-898-0414

Web: www.napwa.org

Continued

8/3 Summer
3

AUGUST

2 Harm Reduction Counseling II - A Two Way

Street

New York NY

Sponsor: Harm Reduction Training Institute

Contact: Same, Sara Kershnar, 212-683-2334

Fax: 212-213-6582

2-4 National Conference on Health Statistics -

Health in the New Millennium: Making

Choices, Measuring Impact

Washington DC

Sponsor: Natl. Ctr. for Health Statistics, CDC

Contact: Same, 301-436-8500

Web: www.cdc.gov/nchswww

8-10 NARMH 25th Anniversary Conference: Creating

Visions for Rural Mental Health in the New

Millennium

Bloomington MN

Sponsor: Natl. Assn. for Rural Mental Health

Contact: Lu Ann Rice, NARMH, 320-202-1820

Web: www.nrharural.org

8-13 97th Annual Scientific Assembly & Exposition

of the National Medical Association

Las Vegas NV

Sponsor: Natl. Medical Assn.

Contact: Same, 202-347-1895; Fax: 202-347-0722

Web: www.nmaonline.com

12-15 1999 Minority Executive Director's Leadership

Forum: Challenges for the New Millennium

St. Thomas Virgin Islands

Sponsor: Natl. Minority AIDS Council

Contact: Same, 202-483-6622; Fax: 202-483-1135

Web: www.nmac.org

12-13 HIV Innovations Along the Border

Tucson AZ

Sponsor: CODAC Behavioral Health Services, Inc.

Contact: Same, 520-327-4505; Fax: 520-792-0033

13-19 9th International Conference for People Living

with HIV/AIDS

Warsaw Poland

Sponsors: Global Network of People Living with

HIV/AIDS; Intl. Community of Women

Living with HIV/AIDS

Contact: Conference Secretariat Office, Polish

Fdn.

for Humanitarian Aid, +48 22/ 826-06-

60

Fax: +48 22/ 826-62-21

E-mail: resaids@waw.pdi.net

15-17 Community Planning Leadership & Orientation

Training (CPLOT) Platinum

Virgin Islands, Virgin Islands

Albuquerque NM

Sponsors: Natl. Native American AIDS Prevention

Ctr.; Natl. Minority AIDS Council

Contact: CPLOT Platinum Registration, c/o NMAC,

202-483-6622

Fax: 202-483-1127

E-mail: rcantu@nmac.org

Web: www.nmac.org

18 Harm Reduction with Crack Users

New York NY

Sponsor: Harm Reduction Training Institute

Contact: Same, Sara Kershnar, 212-683-2334

Fax: 212-213-6582

19 Science in a Fishbowl

Boston MA

Sponsors: Natl. Institute of Mental Health; School

of Public Health, Boston U.; School of

Public Health, Harvard U.; MA Dept. of

Public Health; Boston Public Health

Commission; American Psychological

Assn.; CDC

Contact: Dr. Willo Pequegnat, 301-443-6100

Fax: 301-443-9713

E-mail: wpequegn@nih.gov

22-27 9th Congress on Pain

Vienna, Austria

Sponsor: Intl. Assn. for the Study of Pain

Contact: Same, 206-547-6409; Fax: 206-547-1703

E-mail: iasp@locke.hs.washington.edu

Web: weber.u.washington.edu/crc/

iasp.html

25 The Harm Reduction Voice in Therapy

New York NY

Sponsor: Harm Reduction Training Institute

Contact: Same, Sara Kershnar, 212-683-2334

Fax: 212-213-6582

26-28 Connections 99: Finding the Balance - 3rd

National Conference for HIV/AIDS Hotlines,

Helplines, and Referral Services

Atlanta GA

Sponsors: American Social Health Assn.; CDC

Contact: Joseph Barna, 919-361-8413

E-mail: josbar@ashastd.org

Web:

www.ashastd.org/press/012099.html

26-28 GLMA's 17th Annual Symposium: Taking Care

of our Whole Community

San Diego CA

Sponsor: Gay and Lesbian Medical Assn.

Contact: Same, 415-255-4547; Fax: 415-255-4784
4

August

8/29-National HIV Prevention Conference

9/1 Atlanta GA

Sponsor: CDC

Contact: www.cdc.gov/nchstp/hiv_aids/

conferences/nhpc99.htm

8/30-Adolescent Health Promotion (Training)

9/24 Santa Cruz CA

Sponsor: Intl. Health Programs, Public Health

Institute

Contact: Same, 831-427-4965; Fax: 831-458-3659

E-mail: ihp@cruzio.com

Web: www.ihp.org

1-5 2nd Conference on Global Strategies for the

Prevention of HIV Transmission from Mothers

to Infants

Montreal Canada

Sponsors: Intl. AIDS Society; American Fdn. For

AIDS Research; Office of AIDS Research,

Natl. Institutes of Health (NIH);

Canadian Assn. For HIV Research; CDC;

Elizabeth Glaser Pediatric AIDS Fdn.;

Fogarty Intl. Ctr.; Global Strategies for

HIV Prevention

Contact: Felicissimo & Associates Inc.,

514-874-1998

Fax: 514 874-1580

E-mail: globals@total.net

Web: www.globalstrategies.org

5-6 Advances in Pediatric AIDS

Montreal Canada

Sponsor: New York Academy of Sciences

Contact: Same, 212-838-0230; Fax: 212-838-5640

E-mail: conference@nyas.org

Web: www.nyas.org

9-12 Second Millennium Infectious Disease in

Corrections; A Coordinated Approach

Scottsdale AZ

Sponsor: Correctional HIV Consortium (CHC)

Contact: Same, 415-439-5285; Fax: 415-439-5299

E-mail: chc@silcom.com

Web: www.silcom.com/~chc/index.html

12-14 Community Planning Leadership and

Orientation Training (CPLOT)

St. Thomas Virgin Islands

Sponsors: Natl. Minority AIDS Council; Natl.

Native

American AIDS Prevention Ctr.

Contact: NMAC, 202-483-6622; Fax: 202-483-1135

Web: www.nmac.org

12-15 12th Annual National Prevention Network

Research Conference

Buffalo NY

Sponsor: Natl. Prevention Network

Contact: Sue Carlson, U. of OK; 405-325-1447

E-mail: scarlson@ou.edu

Web: www.nasadad.org

9/13 - Implementing AIDS Programs (English)

10/8 Santa Cruz CA

Sponsor: Intl. Health Programs (IHP)

Contact: Same, 831-427-4965; Fax: 831-458-3659

E-mail: ihp@cruzio.com

Web: www.ihp.org

14-17 Comprehensive Management of the HIV

Disease Continuum: A Clinical

Preceptorship for APRNs, PAs and RNs

New Orleans LA

Sponsor: Delta Region AETC, HIV/AIDS Bureau,

HRSA; LSU School of Nursing

Contact: Dana Gray-Ward, Delta Region AETC

E-mail:

15-17 SPNS Cooperative Agreement Steering

Committee Meeting

Poster and Panel Sessions (Sept. 16)

(Ryan White CARE Act Special Projects of National

Significance Program)

Rockville MD

Sponsor: HIV/AIDS Bureau, HRSA

Contact: Sandy Gamliel, 301-443-3660

E-mail: sgamliel@hrsa.gov

16-17 Permanency Planning: Facing Challenges of

Children and Families with HIV/AIDS

New York NY

Sponsors: Natl. Abandoned Infants Assistance

(AIA)

Resource Ctr.; Leake and

Watts Services, Inc.

Contact: Gwendolyn Edgar-Miles, 510-643-7018

Fax: 510-643-7019

E-mail:

gwendoly@socrates.berkeley.edu

16 HIV Prevention Counseling: The Facts

Richmond VA

Sponsors: VA Commonwealth U. HIV/AIDS Ctr.;

Mid-Atlantic AETC, HIV/AIDS Bureau,

HRSA; Central VA AIDS Resource &

Consultation Ctr.

Contact: VCU HIV/AIDS Ctr., 800-525-7605

16-19 6th Annual AIDS Meal & Nutrition Providers'

Conference: Food Fight 1999

Atlanta GA

Sponsor: AIDS Nutrition Services Alliance (ANSA)

Contact: Same, 202-289-5650; Fax: 202-842-3323

Continued

SEPTEMBER

dgray@lsumc.edu
5

16-17 Chicago National Primary Care

Chicago IL

Sponsor: Nurse Practitioners Associates for

Continuing Education (NPACE)

Contact: Same, 781-861-0270; Fax: 781-861-0279

E-mail: npace@npace.org

Web: www.npace.org

22 HIV Prevention Counseling: The Facts

Fairfax VA

Sponsor: Northern VA HIV Resource &

Consultation Ctr.; Mid-Atlantic AETC,

HIV/AIDS Bureau, HRSA

Contact: Shelia Hautbois, Inova HIV Services

703-204-3776

E-mail: shelia.hautbois@inova.com

Web: www.inova.com

23-24 New Challenges for the New Millennium: HIV

and Adherence, Adolescence & Cultural Issues

Ft. Myers FL

Sponsors: Everglades Area Health Education Ctr.,

Inc.; Gulfcoast South Area Health

Education Ctr., Inc.; FL Dept. of Health -

Area 8 Southwest AIDS Network

Contact: FL Dept. of Health, 561-844-1099 ext.32

29-30 HIV Prevention Counseling: The Approach

Richmond VA

Sponsors: VA Commonwealth U. HIV/AIDS Ctr.;

Mid-Atlantic AETC, HIV/AIDS Bureau,

HRSA; Central VA Resource &

Consultation Ctr.

Contact: VCU HIV/AIDS Ctr., 800-525-7605

29-30 HIV Prevention Counseling: The Approach

Fairfax VA

Sponsors: Northern VA HIV Resource &

Consultation Ctr.; Mid-Atlantic AETC,

HIV/AIDS Bureau, HRSA

Contact: Roy Berkowitz, Inova HIV Services

703-204-3793

E-mail: roy.berkowitz@inova.com

Web: www.inova.com

NOTE:

The CDC National AIDS Clearinghouse has a database of

national HIV/AIDS-related meetings. To obtain a copy, call

1-800-458-5231 (TTY: 1-800-243-7012); Fax: 1-888-282-7681;

E-mail: info@cdcnac.org; or visit their web site at

http://www.cdcnpin.org. This calendar also is available on the

HIV/AIDS Bureau web site: http://www.hrsa.gov/hab. To have

your activity included on the calendar, contact Kathryn O'Neill

at 301-443-7239, or via E-mail at koneill@hrsa.gov.