Public Health Leadership: HIV/AIDS Intervention Strategies Review

This report examines various intervention strategies employed in Baltimore to combat the HIV/AIDS epidemic, focusing on the leadership role of public health organizations. It discusses strategies such as 'Seek, Treat, and Test,' enhanced linkage strategies, the COMPASS program for managing c...Read More

Running head: LEADESHIP IN PUBLIC HEALTH 1
Leadership in Public Health
Name
Institution

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LEADERSHIP IN PUBLIC HEALTH
Introduction
Baltimore city is one of the highest United State Metropolitan places in the entire nation
for individuals staying with HIV/AIDS (Freedman, 2017). Baltimore recorded a total of 25% of
the EMA number of people, but 77% of all those (EMA) are living with HIV/AIDS. Regarding
City, race and state data reveals that the Disease affects mostly the Baltimore’s African
American population. A total of 63% of the population staying in Baltimore are African
American. However, they disproportionately indicate 83% of them are living with HIV infection.
Then there exists the problem of poverty. Based on the 2010 statistics, one out of four
Baltimoreans lives in poverty. There is also the problem of the unemployment rate (Leider, Shah,
Williams, Gupta, & Castrucci, 2017). The injection use of drugs continues to spread HIV
epidemic in the city (Baltimore city). Different intervention strategies developed with the
intention of controlling the spread of the disease.
Intervention Strategies
1 Seek, treat and test strategy
The target of this strategy is to control the HIV prevalent through the provision of (ART)
Antiretroviral treatment and increasing the HIV testing to individuals recognized as HIV
infected, thus, help in reducing infectiousness and viral load (White-Newsome, Meadows &
Kabel, 2018). Recent research found that an approximate of 2 in 5 of all people infected pass
through prisons and Jails each year, and all the population has psychosocial problems, increasing
burden of substances, and high-risk characteristics. Though there exist issues of delivering

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(ART) and performing HIV testing to jailed people, and this involves bureaucratic barriers,
stigma, problems due to high turnover rates, and cost constraints. In spite of the issues, treatment
of criminals and HIV testing can decrease HIV transmission (Brownson, Baker, Deshpande, &
Gillespie, 2017).
The implementation of STT involves engaging jails, community correction, and prison.
Because of stable population and longer sentences, it is easier to give care and HIV testing to the
prison population. Jailed offer access to many people through the office of criminal justice, with
approximately 12 million admitted annually. The united State prisons are control by state, and
jails are under local jurisdiction. There are several correlation centers in the United States.
The high turnover of incarcerated population has not affected the process of HIV testing
as it is essential and feasible in detecting individuals. The duration of stay in jail affect the
process of delivering HIV test results, initiate ART, complete baseline evaluation, and offer
linkage to the surrounding community after once release (McManus, 2017).
The study must, therefore, be conducted to determine the efficiency of the
implementation of STT within the Hospital and Jails. The task should be the offer to Agencies
available and be connected to community HIV care. Due to the high population of people who
are entering through jails, the facilities are an essential factor in a more comprehensive STT
strategy.
2Enhanced link strategy
The plan focused mainly on prevention to individuals diagnosed with HIV. It encourages
agencies like BCHD to work together with the Healthcare delivery system to assist in the
implementation of the intervention to reduce transmission risk and increase adherence to the
enacted regimens and retention in care. It helps to develop, identify, and evaluate response,

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technologies, and strategies to improve use of (ART) antiretroviral therapy and linkage to care;
retention in care; offer partner service; increasing adherence to ART, and decrease transmission
risk behaviors
The strategy also ensure that the evaluation and implementation of various interventions,
technologies, and strategies to improve habit of using ART and linkage to care; lower
transmission risk; increase retention in care and observance to ART; and offer partner services
(White-Newsome, Meadows, & Kabel, 2018).
3 Community support and partnership strategy (COMPASS)
COMPASS assist in managing care for the jailed population, and it mostly requires
effective policies to overcome the problems associated with integrating people after release from
jail terms.
The programs (COMPASS) have the significant influence on sector care arrangement for
justice to individuals with HIV. The model requires personnel like the Nurses to go into prisons,
find HIV infected individuals before they are discharged. The COMPASS initiative modified
project Bridge’s approach dealing with transient and short duration of the inmate in jails. The
results of the programs are constant with both studies getting the positive correlation between
positive health and post-release management of the case and the outcome of behavior for
previous prisoners with a high demand for a medical requirement (Kuo, Thomas, Chilton &
Mascola, 2018).
COMPASS provides an opportunity of assisting a large number of the population moving
out and in of correlational places obtains patient-centered care. The application of the model has
been enhancing by different pieces of evidence that provides the importance of efficiently

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involving the justice population in the process of post-release care. Evidence proves that
associating health care system with inmate released from incarceration can help in lowering
recidivism.
4 Project start
Project START is an individual level intervention directed to the inmate being discharged
from correlation facilities and taken back to the community. It depends on the idea of
incremental reduction of risk; and aim at the increasing patient’s alertness of Hepatitis risk
behaviors and their HIV after release and offering with resources and tools to lower the risk
(Carr, Raj, Kaplan, Terrin, Breeze, & Freund, 2018).
The agency staff joining this project start training should have necessary knowledge on
conducting the intervention, specify implementation strategies, and exercise implementation
strategies. Priority should be put on training participant who can implement START project. All
the staff involved in conducting START project must attend to training (Brownson, Fielding &
Green, 2018).
All the staff should well conversant with activities dealing with the prevention of
Hepatitis/HIV/STD and the needs of the individuals being released from the correctional
settings, for example, mental health issues, homelessness, and prevention of substance abuse).
The staff working at the correctional facilities should possess personal features useful in
facilitating communication, e.g., listening skills, friendly, nonjudgmental attitude, real
personality and outgoing.
5 Project start plus

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According to the research performed on the primary intervention on project START
performed at different prisons. The result is that fewer Men who took part in the process of
multi-session (project START plus) stated to have unprotected Vaginal or anal sex at three
months after incarceration (Shelton, Cooper & Stirman, 2018).
The pre-release session emphasize on1) transitional needs; 2) individual risk behaviors,
and post-release linkage to care.
The post-release sessions compose of the following activities:
• Arrange meeting with the member within two days of release at community health
center
• Making sure that the medical supplies are given to the community participating
• Provision of risk reduction materials (syringe exchange, condom and cleaning
supplies) as required
Relative efficiency of a multisession sexual reduction intervention
The process involves the comparison of the effects of single-session intervention with
improved multisession intervention on the sexual risk associated with individuals initially release
from prison. It helps addresses hepatitis, HIV, and other different sexually transmitted diseases.
The START plus is useful in providing for the community needs, e.g. (employment and
housing). The process also makes use of the project START in highlighting the efficiency of
reduction of sexual risk intervention for community reentry.
Nurses role in treating and preventing HIV
The Nurses are the primary resources that most of the community and family members
visit to provide training and education. The Nurse speaks personally to the disease and

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encourages them on how they can live well (James, 2017). Nurses visit various schools and
community with the intention of giving proper guidance and counseling.
Use of BCHD Agency
By taking into consideration distinctive features of the HIV epidemic in Baltimore,
(BCHD) Baltimore City Health Department has performed various activities designed to answer
them, notably decreasing racial health disparities. Baltimore City Health Department has
established core partnerships with community health center, academic institution, and
community-based organization to increase care linkage with other referrals, admittance to
testing, and transportation during the time of diagnosis (Fraser, Castrucci & Harper, 2017).
BCHD fund non-traditional partners, agencies, and community organizations with the highest
credibility to assist in reaching the entire populations- including MSM (men who have sex with
men), injection drug users, racial minorities, transgendered individuals, and expanding care and
testing to the needy. BCHD offer community-based HIV counseling and testing by use of the
strategy known as abroad mobile van outreach. It provides five nights and six days a week
targeting mostly population at a higher risk of the disease infection and high prevalence regions.
BCHD also take part in testing campaigns and national HIV awareness to assist in the
department of emergency and customized people with high risk.
Also, BCHD essential plan involves strategies for increasing collaboration both outside
and within the department of health (Nkengasong, Maiyegun & Moeti, 2017). BCHD also needs
organizations that are supported by their grants to implement partner service and HIV screening
in line with the national standards on linguistically required service and it should be based on the
cultural norms.This will assist in the provision of linguistically and culturally appropriate

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services. It will also enhance the usage of DHMH’S complete technical assistance and training
that non- profits and agencies can quickly get in time. The DHMH also established packet for
cultural competence, and BCHD distributes this packets to the entire sites/new grantees as
elements of their orientation. The packages state cultural competence gives guidance for
standards implementation and outlines CLAS standards for the provision of the service. Lastly,
the linguistic and cultural competence for all services will be examined through consistent
evaluation of the programs and staff, and site visit (Burke & Fox, 2018).

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