Women and HIV/AIDS Initiative

Transcription

1 Women and HIV/AIDS Initiative Program Guidelines AIDS Bureau Ministry of Health and Long-Term Care April 2012 (Updated April 2012)

2 Table of Contents Introduction.3 Approaches.5 The Initiative: 1 Goals Objectives Principles Role of Provincial Director..8 5 Supervision and Support of the WHAI Provincial Manager 8 6 Role of the Women & HIV/AIDS Community Development Coordinator Supervision and Support of the Coordinator Required Reporting and Financial Management...10 Page 2 of 10

3 Introduction Each year in Ontario, about 300 women test positive for HIV. About 15% of Ontarians diagnosed with HIV are female, and women now make up an increasingly large proportion of new HIV cases in Ontario: 23 to 25% in 2007 and 2008 (Ontario HIV Epidemiologic Monitoring Unit 2009). The AIDS Bureau at the Ontario Ministry of Health and Long-Term Care (MOHLTC) established the Ontario Working Group on Women and HIV/AIDS in response to the need for a coordinated, province-wide strategy to address increases in HIV/AIDS among women. This working group was comprised of ministry staff, researchers, clinicians, community representatives, and people with HIV/AIDS (PHAs), and collaborated to identify emerging issues, effective prevention strategies, and the best treatment and support for women living with HIV. Overall, the working group completed the following activities: A literature review on HIV education and prevention strategies was produced; A survey of health care and social service organizations and professional associations providing services to women was conducted; A research team was established to plan a province-wide program of HIV prevention research. 1 From these activities, the working group concluded that women s vulnerability to HIV transmission is linked to the social determinants of health and individual lived experience, and that an important access point for women s HIV prevention messages, information, and interventions are local community agencies that serve women. In response, the working group conducted a Points of Contact Survey to examine the health care and social service sectors provision of HIV/AIDS information, programs, policies, and services. Findings revealed that while considering HIV/AIDS to be an important issue, few organizations serving women offered HIV-specific programs and/or developed adequate policies or operational procedures related HIV/AIDS. From this foundational work, the AIDS Bureau established the Women and HIV/AIDS Initiative in 2009, and provided funding for Women and HIV/AIDS Community Development Coordinator positions in key communities across Ontario. 1 Materials prepared by the work group will be made available to agencies and coordinators including: Ontario Women and HIV/AIDS Working Group: Literature Review: HIV Prevention and Women 2006; Women and HIV/AIDS Women s Points of Contact Survey 2006; Women and HIV/AIDS Fact Sheets. Page 3 of 10

4 Based on the Points of Contact survey findings, the Women and HIV/AIDS Initiative (WHAI) focused on increasing the capacity of local community health and social service providers to address women and HIV/AIDS in Ontario. The WHAI would be delivered by Women and HIV/AIDS Community Development Coordinators in specific communities, who would be responsible for implementing community-based responses to women and HIV/AIDS-related issues using a social determinants of health and community development approaches. While the focus of the position is building community capacity, there may be times when the Coordinators may provide referrals to AIDS service organizations and other agencies for support and care. As of 2012/13, the AIDS Bureau has allocated funding for the Women and HIV/AIDS Initiative to be implemented in key communities across Ontario. Based on an assessment of ASO program utilization data and program plans; review of local service plans; and analysis of the most recent epidemiological data on HIV/AIDS trends in Ontario (Report on HIV/AIDS in Ontario 2007), the following communities receive funding to implement the WHAI: Durham Region Guelph-Wellington Hamilton Kingston Kitchener-Waterloo London Niagara Region North Bay Ottawa Peel Peterborough Sudbury Thunder Bay Toronto Windsor York The Women and HIV/AIDS Initiative Program Guidelines provide an overview of the goals, objectives, principles, roles and responsibilities, and a framework for implementation using a community development approach. Page 4 of 10

5 Approaches Social Determinants of Health Approach Social determinants of health (SDOH) are the economic and social conditions that influence the health of individuals, communities, and jurisdictions as a whole. 2 Among the variety of models of the SDOH that exist, the one developed at a York University Conference held in Toronto in 2002 has proven especially useful for understanding why some Canadians are healthier than others. The 14 SDOH in this model are: Aboriginal status Food insecurity Race/ethnicity Disability Gender Social exclusion Early life Health services Social safety net Education Housing Unemployment and job security Employment and working conditions Income and income distribution SDOH have a significant influence on whether individuals stay healthy or become ill, as well as the extent to which a person possesses the physical, social, and personal resources to identify and achieve personal aspirations, satisfy needs, and cope with the environment. 3 As well, the AIDS Bureau has incorporated other factors into the SDOH in the upcoming Provincial HIV/AIDS Strategy based on consultations, including: immigration, sexual orientation and gender identity. The Women and HIV/AIDS Initiative adopts a social determinants of health approach through its focus on changing environments within the wider community. In response to the Points of Contact Survey, WHAI Coordinators are working towards enhancing local community capacity to address women and HIV/AIDS-related issues. Community Development Approach 2 Dr. Dennis Raphael, Keynote Address at the Healthy Communities Conference, 2008: 3 Dr. Dennis Raphael, Keynote Address at the Healthy Communities Conference, 2008: Page 5 of 10

6 Community development refers to collective efforts by communities which are directed towards increasing community control over the social determinants of health, thereby improving health. Coordinators work with community members to assist them in identifying and addressing their shared health concerns. This involves providing training and resources to strengthen the ability of community organizations and groups to build structures, systems and skills that enable them to participate and take action in or on behalf of their community (Skinner, 1997). A key principle separating community development from other health promotion approaches is that the needs, problems or issues around which a community is organized must be identified by community members themselves. It focuses on collaborative problem-solving and raising awareness of structural forces and getting people to view their problems as collective social issues, not just individual problems. Community development strategies are unique in several respects: The problem or issue is defined by the community rather than the sponsoring organization. The process of planning the community development initiative is ongoing, based on continued negotiation between organizations and community groups, with the community worker serving as a liaison. Community development emphasizes enhanced community capacity, the collective ability of a community to control the factors affecting their health, rather than measurable changes in health-related risk factors, as the desired outcome. Implicit in the definition of community development is the notion that the needs, problems or issues around which a community is organized must be identified by the community members themselves, not by an outside organization or change agent. The Women and HIV/AIDS Initiative adopts a community development approach by working with local organizations and groups to build their capacity to serve women living with or at risk of HIV/AIDS. Page 6 of 10

7 The Initiative 1 Goals The overall goals of the initiative are to: Reduce HIV transmission among women Enhance local community capacity to address women and HIV/AIDS Build safe and healthy environments to support women and their HIV/AIDS-related needs. 2 Objectives The following objectives will assist in meeting the stated goals: Raise awareness and inform local community organizations and groups that serve women about HIV/AIDS and the need for women s HIV-related services Work with local community organizations and groups to promote the integration of HIV/AIDS into their current programs, services and policies/procedures Work with staff at community organizations to build their knowledge and capacity to respond to women s HIV-related needs (including Poz Prevention). 3 Principles Recognize the impact of the social determinants of health on women s risk for HIV and their capacity to make healthy life choices Work within a community development framework to build broad community capacity to respond to women s HV/AIDS-related needs Work within the strategic plan/missions and goals of the agency and complement current work in the area, utilizing available resources and working within geographic boundaries, unless otherwise specified by the AIDS Bureau Advance the values, principles and priorities of related HIV/AIDS prevention strategies including A Proposed HIV/AIDS Strategy for Ontario to 2008; Ontario Aboriginal HIV/AIDS Strategy; and strategies to address HIV/AIDS in Ontario s African and Caribbean communities. Apply fundamental harm reduction principles recognizing potential constraints imposed on women and their capacity to incorporate HIV prevention methods. Apply anti-discrimination principles recognizing women s multiple and intersecting identities and experiences of oppression (e.g. gender, race and ethnicity, immigration status, poverty, etc.). Work within the context of the Greater Involvement of People living with or affected by HIV/AIDS (GIPA) and strive to include PHAs and those affected in initiative consultation, planning and delivery from a community development approach. Page 7 of 10

8 4 Role of the WHAI Provincial Manager The WHAI Provincial Manager will undertake the following activities to achieve the Initiative s goals and objectives: Knowledge Translation & Exchange: Disseminate consistent and accurate evidence and information related to women and HIV/AIDS; Plan, coordinate, and implement ongoing educational and training opportunities, including quarterly webinars and an annual Forum, in consultation with the local Coordinators and AIDS Bureau staff; Relationship Building: Build and maintain positive relationships between and with the local Coordinators. Promote meaningful communication, interaction, and partnerships between regions, as appropriate and necessary; Coordinate teleconferences for Network members to ensure ongoing and meaningful communication between local Coordinators, Executive Directors, and the AIDS Bureau; Strategic Planning & Community Development: Lead or support the development of an evaluation framework for the initiative; Work with local Coordinators to identify and/or develop shared communication tools and resources; Support the development of responses by local Coordinators that accurately reflect community development and social determinants of health approaches. 5 Supervision and Support of the WHAI Provincial Manager The Executive Director of the AIDS Committee of Toronto (ACT) will provide direct support and supervision to the WHAI Provincial Manager to ensure: The work is being done according to the guidelines; Professional and educational opportunities are made available to Manager ; Systemic structures are in place to support the Manager. Page 8 of 10

9 In addition, there will be meetings at least 3-4 times per year with the WHAI Provincial Manager, ACT Executive Director and the AIDS Bureau to ensure overall support and guidance for the WHAI. 6 Role of Local Women and HIV/AIDS Community Development Coordinators The local Coordinator will undertake the following activities to achieve the Initiative s goals and objectives in their respective communities: Community Development Identify local community organizations and groups that serve women within the geographic boundary served by the agency. (For some programs the geographical boundary will be determined by the AIDS Bureau.) Meet with local community organizations to determine their capacity and their need to respond to women s HIV-related needs Participate in local community planning initiatives and promote the integration of HIV/AIDS into planning initiatives. Respond to requests to provide consultation and advice to local organizations that serve clients living with or affected by HIV/AIDS and facilitate linkages with local AIDS Service Organizations. Training & Resource Development: As part of the community development response, provide women and HIV/AIDSrelated information at local community organizations and/or at community events, forums, or conferences. Distribute resource materials and other HIV prevention tools (e.g. safer sex materials including female condoms). Partnership Development: Participate as an active member of the agency s staff team, including participation in program planning, coordination and collaboration with other staff. Meet with other Community Development Coordinators as required, and make appropriate links with other service providers (e.g. Public Health). Evaluation & Monitoring: Maintain sufficient data to complete reports required by the AIDS Bureau, such as the Ontario Community HIV/AIDS Reporting Tool (OCHART). Page 9 of 10

10 Participate in program evaluation. 7 Supervision and Support of the Coordinators Each funded organization will provide the local WHAI Coordinator with direct support and supervision on a regular basis to ensure that: the work is being done according to the guidelines professional and educational opportunities are made available to the coordinator systemic structures are in place to support the coordinator the local Coordinator is fully integrated into the existing ASO team ensuring they are part of the coordinated response to HIV in their communities 8 Required Reporting and Financial Management The organization is accountable to the AIDS Bureau for financial management and reporting requirements. For details on financial management, please consult the AIDS Bureau Financial Guidelines. For more information on reporting requirements, please contact: Joanne Lush, Senior Program Consultant AIDS Bureau, Provincial Programs Branch Ministry of Health and Long-Term Care 5700 Yonge Street, 5 th Floor Toronto ON M2M 4K5 Tel: Fax: Joanne.Lush@ontario.ca Website: Page 10 of 10