Posts of: NMAC

This summer, NMAC will officially launch our Ending Stigma through Collaboration and Lifting All to Empowerment (ESCALATE) and Engage Leadership through Employment, Validation, and Advancing Transformation and Equity (ELEVATE) training programs. For more information on these programs, please contact Charles Shazor at cshazor@nmac.org or Terrell Parker at tparker@nmac.org.

ESCALATE 

Purpose 
The purpose of the ESCALATE training program is to facilitate transformative and relational change in Ryan White HIV/AIDS Programs and the communities they serve through deepening awareness of and practices for cultural humility amongst Persons with HIV (PWH) and RWHAP providers.

The ESCALATE program will train participants in the 57 jurisdictions identified in Ending the HIV Epidemic: A Plan for America (EHE) to recognize and address HIV stigma with a particular focus on transgender/gender nonconforming individuals, men who have sex with men, and the Black/African American community. NMAC works in partnership with NORC at and the University of Chicago, Abt Associates, and TRX Development Solutions.

Central to the focus of ESCALATE are community involvement and cultural competency. HIV stigma is a multi-dimensional social issue with various complexities and nuances. Understanding the needs of community is critical. The ESCALATE program engages subject matter experts from impacted communities through the curriculum design. This ensures “buy in” and also guarantees the success of the program. MIPA or the Meaningful Involvement of People Living with HIV and AIDS challenges the idea of creating a service or program without the intentional inclusion and advice of PWH.

Goals

1. Create an environment of psychological safety for persons with HIV and RWHAP providers to deepen their understanding and practices of cultural humility
2. Effectively engage in difficult dialogues with communities and institutions about the influence of race, power, privilege, and identity
3. Identify stereotypes, prejudice, and discrimination as forms of bias while learning to recognize and manage unconscious thoughts and feelings influencing behaviors

Objectives

• Create a shared mental model of cultural humility in theory and in practice
• Define the “American Dilemma” in the context of race and health care delivery
• Define intersectionality and demonstrate how it impacts outcomes for marginalized people and groups
• Introduce the multidimensional model of privilege as a tool to disrupt the single-target group approach
• Introduce and utilize de-biasing tools and strategies
• Use reflection and self-critique to explore participant attitudes and beliefs
• Review individual and organizational strategies to disrupt implicit bias in health care settings

ESCALATE Training Participants  

• Persons with HIV (PWH) and RWHAP Recipient/Subrecipients Partners (Parts A, B, C, & D)

ELEVATE 

Purpose 
The purpose of the ELEVATE program is to expand the participation of people living with HIV (PLHIV) in the HIV workforce, planning councils, and other community leadership roles. ELEVATE builds on the achievements of HRSA and Ryan White HIV/AIDS Program (RWHAP) training programs and incorporates their features into a single project. NMAC works in partnership with the JSI Research Training Institute, Inc., the Association of Nurses in AIDS Care (ANAC), and the Latino Commission on AIDS (LCOA). Program evaluation will be provided by NMAC’s long term evaluation partner, ICF an internationally recognized evaluation firm.

The ELEVATE program is modeled on NMACs previous HRSA-supported training program, Building Leaders of Color (BLOC) and will integrate the BLOC curriculum with other training programs sponsored by HRSA including: JSI’s “Community HIV/AIDS TA Training” (CHATT) and “Access Care Engagement Technical Assistance Center” (ACE TA Center); the Center for Quality Improvement and Innovation’ s “Training Consumers on Quality Plus;” and Boston University School of Social Work’s “Improving Access to Care: Using Community Health Workers to Improve Linkage and Retention in Care (Among People of Color).” ELEVATE integrates the unique contributions of each of these past programs to provide a state-of-the-art, comprehensive training program for the leadership and inclusion of PLHIV in community decision making bodies and the agencies that serve PWH.

Goals

1. Increase the number of PWH meaningfully involved in the planning, delivering, and improving of RWHAP services
2. Build the capacity of PWH to be meaningfully involved in community planning for HIV prevention, care, and treatment services
3. Build the capacity of PWH to be meaningfully involved in clinical quality management (CQM) activities
4. Build the capacity of PWH to be meaningfully involved in the delivery of HIV prevention, care, and treatment services
5. Develop individualized action plans to increase engagement and involvement in the planning, delivering, and improving of RWHAP services

Audience

Persons with HIV (PWH) aligned with a RWHAP Recipient or Subrecipient

1. Employed by RWHAP
2. Members of Planning Bodies or Planning Councils
3. Members of Consumer, Community, & Patient Advisory Boards
4. Directors from the Boards of RWHAP
5. Members of Clinical Quality Management Teams or Committees
6. Other PWH aligned with a RWHAP seeking greater involvement

ESCALATE is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) and the Minority AIDS Initiative as part of a financial assistance award totaling $1,600,906. ELEVATE is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $796,749 respectively with 100 percentage funded by HRSA/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by HRSA/HHS, or the U.S. Government.

NMAC is proud to support Congresswoman Barbara Lee’s Congressional Resolution to recognize the National Youth HIV & AIDS Awareness Day on April 10.

“Minority and LGBTQ+ youth are a critical part of the fight to end the HIV epidemic,” said Paul Kawata, Executive Director for NMAC. “Young people continue to be at risk of HIV, accounting for nearly 40% of new infections. Young people of color, like the rest of their communities, are at the greatest risk. Bringing attention to the HIV epidemic among young, increasing their knowledge of testing, treatment, and all the prevention options that are open to them, including Pre-Exposure Prophylaxis, will help us reach the goal of ending the epidemic by the end of the decade.”

“NMAC applauds Congresswoman Barbara Lee for her continued leadership on HIV/AIDS related issues,” said Joe Huang-Racalto, Director of Government Relations and Public Policy for NMAC. “Recognizing youth leaders in this movement, especially those most impacted, is important not only to raise awareness but to build tomorrow’s leaders so that public health crises such as HIV/AIDS and racism,are finally epidemics of the past.”

NMAC leads with race to urgently fight for health equity and racial justice to end the HIV epidemic in America. Since 1987, NMAC has advanced our mission through a variety of programs and services, including: a public policy education program, national and regional training conferences, a treatment and research program, numerous electronic and print materials, and a website: www.nmac.org. NMAC also serves as an association of AIDS service organizations, providing valuable information to community-based organizations, hospitals, clinics, and other groups assisting individuals and families affected by the HIV epidemic.

On Saturday, March 20, we recognize National Native American HIV Awareness Day. Many here on the Navajo Nation will be traveling to get weekly or monthly supplies as we “go to town” off the Navajo Nation into “border towns” such as Gallup, N.M. or Flagstaff, AZ. For most of last year, Saturdays were just another extended week of lockdown and social distancing for Navajo people.

We have eased up the Navajo government-imposed lock down as we move into getting our COVID-19 inoculation shots at our Indian Health Service (IHS) facilities. Separation seems to be a part of our life now. But for many others on the Navajo Nation and off, separation has existed for much longer. I’m talking about the invisible and sometimes not too invisible social barriers that exist for many of our people living with HIV.

For those on HIV treatment, medicine was supposed to unlock and break down self-imposed barriers to freedom. In many ways, this has happened. But for many, going publicly to get meds at the IHS on a Saturday represents freedom and secrecy while everyone has “gone to town” when pharmacies are uncrowded. I’m talking about the real effects of stigma.

“Stigma is a mark of disgrace associated with a particular circumstance, quality, or person.” Our previous Director of the Center to Eliminate HIV Epidemic, Ace Robinson, wrote in the ESCALATE narrative, stigma is fed by “a lack of knowledge or misconceptions about HIV among People Living with HIV (PLWH), their service providers, and medical professionals, fear, discomfort, prejudice and negative attitudes associated with HIV and specific groups (often connected to other social prejudices such as homophobia, transphobia, racism, stigma about substance use, etc.). At the core, the drivers of stigma are characterized by an essential lack of understanding or knowledge that manifests in prejudice.” Prejudice is stigma’s twin.

In other words, to do better, we must know better.

Here at NMAC, we are creating a new program that will help clients, service providers, and community how to recognize stigma and the tools how to eliminate it. We are creating ESCALATE, which stands for Ending Stigma through Collaboration and Lifting All to Empowerment.

We, as so many in community and HIV agencies, recognize that stigma is the barrier that limits access to HIV care for patients and family care within families. Living silently alone within a crowd of family creates a poor image of self that further creates a never-ending cycle of stigma and prejudice. Some PLWH then believe that they shouldn’t deserve more or are worth less. Each experience with stigma begins to slowly erase the true individual when caring for oneself and becomes yet another hurdle to overcome to self-care. Enter ESCALATE.

ESCALATE has been designed with three components in mind that will help participants access tools for self-efficacy: Individual training for community members and leaders, Technical Assistance, and Learning Collaborates for Organizational training. Training will help answer these questions: What is stigma? How to recognize it within self and in communities. What tools can you learn to begin eliminating it in your communities? What will you do once you get back into your community and health facility? All three are designed to work together to train those who access health care with those who provide health care, to create a world without stigma.

That’s the goal. It’s not a just noble goal, but a mandatory goal that recognizes the true worth of our family and community members.

Currently, we Native people are under social distancing and waiting for the time for grandma to freely welcome back her family members. Isn’t it time to welcome back family members and those who are living with HIV?

ESCALATE. When we know better, we do better.

ESCALATE is a four-year cooperative agreement funded by the Health Resources and Services Administration HIV/AIDS Bureau. In partnership with HRSA, Abt Associates, NORC, and TRX Development, NMAC will lead trainings for RWHAP providers and grantees to dismantle HIV-related stigma on individual and organizational levels (for more information, visit https://targethiv.org/ta-org/escalate).

Christopher J. Paisano
Navajo Nation – Laguna Pueblo
Coordinator to Indian Country