People living with or affected by HIV/AIDS, Greensboro and High Point, Guilford County: an action-oriented community diagnosis: findings and next steps of action
Creators: name: Avery, Matt
name: Perkins, Shantae
name: Mainwaring, Beth
name: Falcon, Theresa
name: Strauss, Elena
Publisher: name: The University of North Carolina at Chapel Hill University Libraries
Year: 2008

description: Background As of 2006, Guilford County has the third-highest Human Immunodeficiency Virus (HIV) prevalence in North Carolina, and the number of HIV-positive people in the county is expected to grow as effective treatments help HIV-positive people to live longer and potentially more productive lives. The result is an increasing burden on the AIDS service organizations working to provide quality medical care as well as access to housing, employment, and psychosocial support in the Greensboro/High Point area. Given this situation, where should limited human and financial resources be targeted to best meet the needs of people living with HIV/AIDS? In order to answer this question, a community assessment of people in Greensboro/High Point, NC living with or affected by HIV/AIDS was conducted from October 2007 to April 2008. The assessment was conducted by a team of five graduate students from the Department of Health Behavior and Health Education at the UNC-Chapel Hill School of Public Health, working under the guidance of two community preceptors, Ms. Debra Massey-Richardson and Mr. James McNair, of the Guilford Community AIDS Partnership. The assessment was carried out based on the Action-Oriented Community Diagnosis (AOCD) model of community assessment and engagement, which focuses on a wide variety of factors contributing to the health of a community, as well as the social environment which influence the perception of strengths and needs within a community. The goal of AOCD is to generate community ownership through a process of identifying priority issues and planning action steps for positive change. Methodology The focus of this AOCD was people infected with or affected by HIV/AIDS (PLWHA) in Greensboro and High Point. These two metropolitan areas of Guilford County were chosen as the focal points of this process because they share comparatively high levels of infection, a common network of service providers, and the potential for receiving common resources at the county level.3 The following report describes the process of conducting the AOCD, which began with gathering secondary data to provide a contextual background on life in the community and on the local epidemiology of HIV/AIDS. Team members gained entrée into the community through guided “windshield tours” of Greensboro and High Point and by participating in numerous community events, including church services, AIDS fundraising events, support group meetings, and social events held at a local day center for PLWHA. Team members also made contact with 21 service providers and 36 PLWHA living and working in Greensboro and High Point through focus groups and individual interviews which focused on community strengths and priority needs, available community resources, and barriers to change. The results of this data collection were analyzed to identify overarching themes, which were then prioritized with the assistance of a planning committee comprised of local service providers and community members. Five highest-priority themes were presented at a community forum held at the Macedonia Family Resource Center in High Point on April 14, 2008. The primary goals of the forum were to celebrate the strengths of the PLWHA community, transition the student team out Greensboro and High Point, and transfer ownership of the process to the local community. Forum participants discussed the priority themes identified through the AOCD, and generated specific action steps to address each theme. Themes and action steps are listed below. Priority Themes Theme One: PLWHA have many basic, unmet needs, including food, housing and unemployment, which overshadow HIV/AIDS as a priority. Action Steps: Talk with all major known service providers in addition to clients to determine what local resources are available to help meet basic needs such as food and housing. Based on the results of this investigation, compile a comprehensive resource manual to serve as a guide for both PLWHA and service providers. Theme Two: Mental health and substance abuse issues complicate living with HIV/AIDS by making it difficult to seek treatment for HIV/AIDS, follow medical regimes, and locate adequate support and care. Action Steps: Contact local organizations to assess the available mental health and substance abuse services in both Greensboro and High Point. After a comprehensive list is generated, compile the information into a pamphlet that can be distributed to community members in a variety of venues such as churches, grocery stores, social services and the Department of Motor Vehicles. Decrease the stigma associated with mental illness and addiction in addition to improving outreach efforts. Theme Three: The diversity of PLWHA, stigma surrounding the disease, and a lack of trust and dialogue between PLWHA all contribute to the absence of a cohesive community to provide support and engage in advocacy. Action Steps: Discuss community strengthening and other needs with residents of Williams Delashment Crossing, a housing community for PLWHA. Schedule a follow-up meeting on the topic of community strengthening, which may be held in the Williams Delashment Crossing housing community. Hold a regular meeting of High Point service providers to combat the tendency of some service agencies to become isolated from the larger community. Theme Four: There is an uneven distribution between services available for people living with HIV/AIDS in Greensboro and High Point. Action Steps: Contact churches to assist in meeting basic needs such as food and transportation. Educate people about existing services by involving the local libraries. Create a collaboration or directory of services useful to people living with HIV/AIDS, which would create unity among service providers and assist them in making referrals for clients who do not meet eligibility requirements for their services. Contact service agencies such as clinics and hospitals about the costs to expand available care. Theme Five: Misconceptions about HIV/AIDS in the community at large, a lack of people living with HIV and AIDS who are open about their status, and a strong emphasis on conservative values contribute to intense social stigma against people living with HIV and AIDS. Action Steps: Convene further meetings about HIV/AIDS-related stigma. Each member of the group will invite one friend or colleague to the first follow-up meeting. Create programs to reach youth at churches, YMCAs and Boys and Girls Clubs. Distribute condoms. Attend existing community events and pass out educational information and condoms. Encourage PLWHA to be proactive in sharing their experiences with the wider community. Team Recommendations The student team presents the following recommendations for improving the health and quality of life of people living with or affected by HIV/AIDS in Greensboro and High Point: Create a comprehensive and up-to-date directory of services for PLWHA. Create a Higher Ground-style community center for PLWHA in High Point. Where possible, centralize fringe medical services. Increase cooperation with local governments. Find venues to educate youth about HIV other than in schools. Increase awareness among service providers, funders, and political leaders of the importance of HIV, mental health, and substance abuse issues. Involve faith-based communities in awareness and education efforts. Include more of a focus on community building activities. Increase resources available for basic needs. The recommendations presented above are not comprehensive, and this document is intended as a starting point rather than a final report. Following sections include a detailed discussion of background data on HIV/AIDS in Guilford County, an in-depth examination of prioritized themes and action steps generated through the AOCD, a description of the community forum, and an explanation of the methodology used to carry out the assessment. Materials used to conduct the assessment, as well as a resource guide and a discussion of non-prioritized themes identified through the assessment can all be found in the appendices following the end of the report. It is the hope of the AOCD team members that the community of services providers and PLWHA in Greensboro and High Point will find the information useful as a foundation for moving forward and taking positive action to continue improving the lives of those living with or affected by HIV/AIDS.