AIDS: IN-CARE connects HIV+ men of color to treatment

Published: December 7, 2011

The AIDS Foundation of Chicago ( AFC ) held a press conference Nov. 11 to showcase the strides its IN-CARE program has made since launching a little over a year ago.

Funded through a 3-year AIDS United grant, IN-CARE works to connect HIV-positive men of color to counseling, treatment and peer-to-peer support. The goal is to work through cultural differences that block these men from accessing care.

"In Chicago, people of color are heavily impacted by HIV," said Román Buenrostro, AFC’s director of special projects. "In fact, close to three out of every four infections are found in non-white African-Americans and Hispanics."

In 2009, Black people accounted for more than half of all new HIV infections in Chicago, according to the Chicago Department of Public Health.

Additionally, men who have sex with men still account for some of the highest transmission rates in the city.

Before launching IN-CARE—which stands for Identify, Navigate, Connect, Access, Retain and Evaluate—the AFC conducted a phone survey to identify trends among HIV-positive callers.

Of those interviewed, 31 percent said doctors prescribed too many medications; 33 percent said doctors placed too much trust in medication; and 16 percent said they believed medication does more harm than good. Furthermore, white and Hispanic callers were more than three times as likely than African-American callers to take medication as prescribed.

Recent data have proven that taking antiretroviral therapy medication on a regular basis reduces the likelihood of HIV transmission by 96.3 percent—that’s greater than condom usage. As such, many healthcare providers believe early and consistent treatment is the key to stopping the HIV/AIDS epidemic.

"Clearly we have our work cut out for us," Buenrostro said. "If people really want to engage fully in the HIV care system, there’s some attitudes [ and stigma ] that need to be addressed."

That’s where IN-CARE comes in. The program identifies and reduces barriers that are preventing HIV-positive men of color from accessing care, such as poverty and fear of stigma. IN-CARE’s key component is peer-to-peer counseling. Partner agencies such as the Test Positive Aware Network ( TPAN ) receive funding to hire peer specialists.

" [ The peers ] are helping clients navigate and access care through their personal stories," AFC President/CEO David Ernesto Munar said. "They act as buddies; they act as mentors; they act as role models. And they’ve been there. They’ve had the same challenges as their clients."

After several brief speeches from grant sponsors and AFC staffers, peer health navigator Jacob Ramos took to the podium to share his personal story. Ramos grew up in a broken home on Chicago’s West Side. With little adult supervision, he began experimenting with drugs and alcohol, and spent significant time in prison.

Before long, Ramos had tested positive for HIV—presumably as a result of frequent intravenous drug use. He would periodically receive medical care during prison tenures, but didn’t have the resources to maintain treatment once released.

"It wasn’t easy," Ramos said. "My way of dealing with it was going back to heroine, cocaine, women, booze—the whole nine. How can I go somewhere to get medication if I don’t even have food to eat?"

About two years ago, Ramos decided he needed a change and sought up help at the CORE Center. He got connected with local care groups and eventually landed as position as a peer educator. He had hoped to work in drug counseling, but found his niche with HIV peer-to-peer programs.

"It helps me more than I help the people," Ramos said. "And I help them because I’ve been there, and I’ve walked in those shoes … I’m going on 23 years of being HIV-positive, and I thought I was going to die 23 years ago."

Ramos receives a stipend for his work; it’s the first ‘on the books’ salary he’s ever received.

"I got my very first income tax check in 2011," Ramos said, beaming. "I’ve never had an income tax check in my life!"

While statistical data is not yet available for the fledgling program, Munar said IN-CARE is doing exceptionally well; he hopes it will continue to find funding once the grant money runs out.

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