The Work
Positive Pathways:
Increasing Access to HIV/AIDS Medical Care in the District of Columbia
Positive Pathways is a new program in the District of Columbia that assists HIV-positive African Americans living in Wards 5-8 to participate in HIV medical care and supportive safety net services, with a particular focus on women and their partners. The project is led by Washington AIDS Partnership, in collaboration with over 15 community partners and the DC Department of Health. CommonHealth ACTION's Institute for Public Health Innovation helped design Positive Pathways and serves as the primary coordinating entity, working closely with Washington AIDS Partnership and all the partnering community organizations to implement and evaluate the overall effort.
Using Trained Peers to Complement Conventional Medical and Outreach Strategies
Through a network of 12 trained peer Community Health Workers (CHWs) placed in community and primary care settings, Positive Pathways works to support program participants to take full advantage of HIV medical care and other community services to improve their health and quality of life. Community Health Workers work at their employing organizations and in the community to identify individuals who are HIV-positive and not receiving HIV medical care in order to build trust and inform them about living with HIV, to provide personalized assistance to help them enter medical care, and to support them throughout the early part of their care until they are fully involved. Peers utilize their unique position to address barriers to care that can present challenges for other medical professionals. These professionals provide trust-based information and education; help clients overcome fear, denial and stigma; conduct outreach and support deep in the community; take the time to walk clients through the often overwhelming healthcare system; and help clients strategize to manage the logistics of caring for oneself in the context of a complicated life.
Working in DC Communities with the Highest Need
Community Health Workers hired through the project are placed at community and medical organizations throughout Wards 5-8 – areas of D.C. that have high prevalence of HIV/AIDS and intersecting challenges of high unemployment, lower education levels, and poverty. These organizations include Unity Health Care, United Medical Center, Family & Medical Counseling Services, Whitman-Walker's Max Robinson Center, The Women's Collective, and Our Place, DC. Dozens of other organizations serve as outreach sites. Positive Pathways Community Health Workers focus their recruitment primarily on African-American women within these wards, but also on high-risk African-American men, including injecting drug users, because data shows that these groups have the highest unmet HIV care needs in DC.
Continuing Education and Ongoing Training & Support
Positive Pathways includes a significant education opportunity for Community Health Workers. All 12 Community Health Workers received a scholarship to participate in a new 8-month Community Health Worker training course at the Community College of DC, which began in May and ends in December 2011. This is the first Community Health Worker Course offered in Washington, DC. The more general course is complemented by a robust training program led by IPHi to prepare CHWs to work as HIV care navigators specifically. Community Health Workers also benefit from significant ongoing training and education opportunities to help them succeed in their new positions.
Positive Pathways is funded in part by a prestigious Social Innovation Fund grant through AIDS United and Washington AIDS Partnership. Other supporters to date include M.A.C AIDS Fund, Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc., World Bank, and Consumer Health Foundation.
