HIVAIDS: Respond to the Cry in the Wilderness in the U.S. and in the 'Troubled Sea' of SubSaharan Af

1
"HIV/AIDS Respond to the Cry in the Wilderness
in the U.S. and in the 'Troubled Sea' of
Sub-Saharan Africa"

• Sharon McKinley, Deputy Director
• Baltimore Pediatric HIV Program, Inc. Shirley
  Tellington, Relative Caregiver

2
Basic Facts

• HIV/AIDS is on the rise in the United States and
  in Africa.
• Substance abuse is the principal factor
  contributing to HIV/AIDS in the U.S.,
  specifically in Baltimore Area.
• Substance Abuse and HIV/AIDS has contributed
  significantly to the reason why children being
  raised by grandparents and other relatives.

3
United States HIV/AIDS Statistics

• The cumulative estimated number of diagnoses of
  AIDS through 2003 in the United States is
  929,985.
• Adult and adolescent AIDS cases total 920,566
  with 749,887 cases in males and 170,679 cases in
  females.
• Through the same time period, 9,419 AIDS cases
  were estimated in children under age 1
• Glynn M, Rhodes P. Estimated HIV prevalence in
  the United States at the end of 2003. National
  HIV Prevention Conference June 2005 Atlanta.
  Abstract 595.
• CDC HIV/AIDS Surveillance Report HIV Infection
  and AIDS in the United States, 2003

4
Maryland At A Glance

• As of June 30, 2006 Maryland had a total of
  28,226 people living with AIDS
• Maryland ranks 19th among the 50 states and the
  District of Columbia in total population, and 9th
  in cumulative number of AIDS cases (28,111 as of
  June 30, 2004) and 3rd in AIDS incidence rate
  (28.5 cases per 100,000 population during 2003).
• Baltimore has the fifth highest incident AIDS
  case report rate of any major metropolitan area,
  39.3 cases per 100,000 population during 2003.

5
Maryland at a Glance

• Fifty percent of all reported living HIV and AIDS
  cases in Maryland were residents of Baltimore
  City at the time of diagnosis.
• Maryland living HIV and AIDS cases are
  predominantly African-American (82), male (65),
  and middle-aged (68 of cases are 30-49 years
  old).
• Thirty-five percent of all HIV cases in 2004 are
  female.

6
Maryland By Transmission
National HIV
Maryland HIV
MSM Men who have sex with men IDU Injection
drug users MSM/IDU Men who have sex with men
and are injection drug users HetSexPR
Heterosexual contact with a person who has or is
at risk for HIV HetSexPI Heterosexual contact
with a partner of indeterminate risk for HIV (not
a CDC exposure category) Other Hemophiliacs,
transfusion recipients, pediatric transmissions,
and occupational exposures
7
Children In Care Statistics

• In Maryland, there are 98,836 children living in
  grandparent-headed households (formal and
  informal).
• 30,651 children are living in households headed
  by other relatives.
• 54,323 are living there without either parent
  present.

8
Children In Care Statistics

• Maryland has 1,956 in formal kinship care.
• Of that number, 1,611 of children are in
  Baltimore City.
• 3,288 children are in foster care which consist
  of children living with kinship caregivers who
  are receiving restricted foster care funds.
• Of that number 2,034 live in Baltimore City.
• Baltimore has over 80 of the kinship care and
  foster care cases.

9
Basic Facts

• Baltimore City is ranked as having the fourth
  largest incidence of HIV/AIDS in the nation.
• Baltimore City also has the highest proportion of
  African American women with HIV/AIDS.
• Children are impacted as a result.

10
What Are The Challenges?
11
Unstable Family Situations
UNCERTAIN ABOUT RELATIONSHIPS
Stigma
DEPRESSION
FEAR
DISCLOSURE
ANGER
Acceptance
Medication Adherence
12
The Challenges

• Individuals impacted by HIV are often faced with
  an array of complex challenges.
• Lack of medical care, including primary and
  specialist physician services, nutrition
  counseling, home health care, dental care, and
  hospitalization.
• Substance Abuse Treatment
• They need assistance with basic living needs
  which included the acquisition of independent
  housing, housekeeping services, transportation
  arrangements, and food-related services
• Financial support and benefits and
• Legal issues

13
The Challenges (contd)

• Women infected with HIV tend to be poorer than
  their male counterparts.
• Women with children living at home are without a
  high school diploma and have more needs than
  other groups.
• Depression and other mental health problems are
  also issues for women infected with HIV.
• Women with depression or poor mental health are
  less likely to use medications prescribed for HIV
  infection.
• Children infected with HIV have a high rate of
  emotional and psychological problems, such as
• Attention deficit/hyperactivity,
• Oppositional defiant disorder,
• Anxiety,
• Depression and
• Problems in social functioning relative to their
  peers.

14
What Can Service Providers Do to Help?
15
Comprehensive Services

• It is important to provide services that address
  these issues and that nurture the relationship
  between the individual who is HIV positive and
  their family network
• Comprehensive and coordinated care is crucial if
  HIV positive individuals and their families are
  to remain in care over time.
• Comprehensive services include
• Outreach
• Medical treatment,
• Mental health treatment,
• Substance Abuse treatment
• Case management
• Support Services, i.e. support groups, child
  care, self management training
• Care for the entire family

16
Family Matters Grandparents Other Relatives
Program

• Provides support for grandparents and other
  relative caregivers of children infected or
  affected by HIV/AIDS and those impacted by
  substance abuse.

17
Objectives

• To strengthen child-rearing skills.
• To become more knowledgeable about the impact of
  HIV and substance abuse on children and families.
• To learn family intervention techniques when
  communicating with parents who may be substance
  abusers and/or HIV positive.
• To increase their knowledge of how to access
  resources.
• To learn about and to establish stand-by
  guardianship

18
Family Matters

• Case Management
• Support Groups
• Information and Referrals
• Educational Workshop Sessions
• Social Activities
• Special Events
• Grandparents Day Programs
• Health Care Events
• Pamper Me Day

19
Contact Information

• Family Matters
• 2800 Maryland Avenue
• Baltimore, Maryland 21218
• 410/ 235-3220 phone
• 410/ 235-7991 fax
• 443/226-1577 cell-phone
• Bphivp_at_aol.com
• Shamckinley_at_aol.com