Harris County Website
The purpose of this project to be conducted through the Harris County Public Health and Environmental Services Department, is to engage HIV seropositive YCMSM into care, link them into appropriate services, and facilitate retention in care using existing locally defined categories of RWCA services.     

A new approach to case management will be evaluated which coordinates a variety of relevant services into one Client Management Team (CMT)—a wide-ranging and intensive service which provides outreach, medical care coordination, service linkage, peer counseling, health education, and other services to engage and retain high risk youth in care. Evaluation includes use of existing client data, and comparison with previously enrolled clients.

[click here to see Site Presentation given at January 2005 Grantee Meeting]

Intervention

• Consolidated case management based on combination of existing services.
• A multidisciplinary team will provide case management, outreach, peer counseling, medical care coordination, and health education risk reduction using a Client Management Team (CMT) approach
• Outreach is not for testing individuals at large, but rather outreach to existing or newly diagnosed HIV+ YCMSM
• During outreach clients come for services every week in 4-8 hours.
• Counseling and testing as needed, and individual sessions on education, services, etc.

Outputs 

• Enroll 10 to 15 HIV+ by 8/05; enroll 85 by end of project
• A minimum of 50 to 80% of newly-identified HIV+ clients will enter primary care and/or case management
• A minimum of 50/60/90% of HIV+ clients will use primary care during 6 month period per year

Short Term Outcomes

• Increase proportion of HIV+ who know their serostatus
• Increase knowledge of HIV risk reduction and practice of safer sex
• Increase proportion of HIV+ that are identified, linked to care, and remain in care
• Increase client use of primary care and support services
• Improved or maintained CD4 counts
• Improved or maintained viral loads
• Increase knowledge of care system and how to use it
• Increase adherence to treatment regimens

Long Term Outcomes 

• Reduce new HIV cases among YCMSM
• Slow and stabilize disease progression in HIV+

Proposed Local Evaluation Strategy 

• Comparison group of those in system not enrolled in the program. ni=85; nc=30 
• Client assessments from case management requirements (e.g., assessment form within ten working days of assessment and linked to service within 30 days). Centralized Patient Data Management System (CPCDMS) to collect data, with one face to face interview visit q30 days and at least one visit to natural environment every 90 days 
• Comparison group is those clients enrolled into CPCDMS within two years of project start and those enrolled by other agencies meeting the inclusion criteria