Re-instate AIDS Outreach & Prevention sign now

Recently, after 23 years of operations the Center for AIDS Outreach and Prevention (AOP) at NDRI has been notified that OASAS will terminate our contract for prevention intervention services as of March 31st, 2009. This early and abrupt termination of our contract will have untold negative affects on the population we have served continuously since 1985. I am writing to ask you to reconsider these actions in light of the continuing problems of substance abuse and HIV infection in the communities in which we have conducted intervention activities.


Background and History

The AOP intervention was initially funded in the fall of 1985 as part of what was then a HIV seroprevalence study by NIDA. In subsequent years, the contractual funding shifted from the New York State Department of Health (NYSDOH) to the New York State Office of Alcoholism and Substance Abuse Services (OASAS). In those initial years, the interventionЇs primary focus was to identify active injection drug users, 18 years and older, and bring them in for HIV testing so as to monitor and assess the impact of HIV infection in this at-risk population. Associated with this engagement was, and still is, a dominant emphasis on education and skills building to help the active drug user protect him or her from HIV infection and the harms associated with oneЇs substance use and abuse. In short, the activities that comprise a major part of what our outreach staffs do each day is the provision of:


с Educational Messages and Information

с Behavioral and Normative Change and Skills Building

с Referrals to Substance Abuse, Medical, Clinical and Social Service

Providers

с Provision of Risk and Harm Reduction Materials

с Prevention Supportive Services Groups

с Consistent Intervention Engagements and Interactions with Program Participants


Although the methods and approaches AOP utilizes have changed somewhat over these twenty-three years, the core mission has changed little if any. The AOP intervention targets, as its primary goal, the active substance abuser not currently involved in drug and or alcohol prevention treatment. And the intervention serves as a bridge or means for our participants to access and gain admission into programs best suited to meet their individual and or family needs. The vast majority of the AOP program participants are those that are homeless, living in unstable and/or unsafe living conditions and environments.


In addition, associated with the primary objectives listed above we target non-substance abusing sexual partners of active drug users, their significant others, those engaged in commercial sex work and those at risk for other health related conditions (e.g. TB, STDs, etc.). Specifically, AOP staff engages:


Substance Abusers: Injection Drug Users, Crack Cocaine Users, Alcohol Abusers, and Abusers of other licit and/or illicit substances (e.g. methadone, inhalants, steroids, intranasal users of heroin and/or cocaine powder).


Non-Substance Abusers: Those at risk due to unprotected sexual activities and/or activities with multiple sexual partners.


Locations

The AOP intervention operates in four of the five boroughs of New York City. These areas include:


с Manhattan: Harlem, East Harlem, Washington Heights, Lower East Side, Upper West Side, Clinton and Chelsea.


с Brooklyn: Williamsburg, Fort Greene, Bushwick, Brownsville, Bedford-Stuyvesant, East New York, Red Hook, Sunset Park, Gowanus and Coney Island


с Queens: South Jamaica, Jamaica, Astoria, Corona and Far Rockaway


с Bronx: Fordham, Bedford Park, South Bronx, Mott Haven, Hunts Point, Tremont, Eastchester, Soundview, West Farms and the Webster/Fordham Hub.


2007-2008 Demographic and Program Data:


During the previous contract year AOP staff engaged:

с Total Annual Contacts: 74,991 non-unique contacts. Described as


♦IDUs: 17,812 non-unique contacts

♦Crack /Cocaine Users: 19,937 non-unique contacts

♦Alcohol Users: 45,338 non-unique contacts

♦Marijuana Users: 25,373 non-unique contacts


These numbers indicate the continued problem with participants that are poly-drug addicted and users of multiple licit and illicit substances. Outreach staff regularly engages participants, not currently in treatment, that use pills, inhalants, snort powdered drugs and find even newer and/or different modes of ingestion or ways to seek a high.


с Gender Breakdown: Approximately 66\% Male and 34\% Female


с Age Breakdown: 18 Years or LessЁC2\%; 18-35 Years OldЁC23\%; 36-50 Years OldЁC57\%; 50 Years and overЁC18\%.


с Race and Ethnicity Breakdown: Dominantly Participants of Color. African-AmericanЁC57\%; Latino/HispanicЁC37\%; CaucasianЁC5\%


Drug and Alcohol Treatment Referrals

с Hospital Based Drug Detox ЁC 65\%

с Hospital Based Alcohol Detox ЁC 20\%

с MMTPs ЁC 4\%

с Substance Abuse Rehabilitation Programs ЁC 1\%

с Long Term Drug Treatment ЁC 3\%

с Outpatient Drug Free Programs ЁC 7\%


These numbers are indicative of problems participants have in accessing immediate treatment slots in many OASAS provider agencies. Lack of appropriate Identification, medical clearances (TB, HIV, etc.), working with those that are dually diagnosed (mental illnesses and substance abuse) all serve as barriers to getting program participants immediate access to treatment.


Further, since the injection drug using population is aging and becoming more and more difficult to locate and access, drug using program participants are not interested in seeking long term programs and/or methadone maintenance as in past years.


Other Referral Services Outreach Staff Provide:

с HIV, HCV, TB, STD Testing

с Medical Services

с Assistance with Public Entitlements

с Employment and Vocational Training

с Food and Clothing

с Housing Shelter

с Mental Health Screenings and Assistance

с Syringe and Needle Exchange Services

с Case Management and Social Services


The costs in closing this intervention can not be estimated. The break in the continuum of care that once was a principal plank in OASAS thinking and policy will not facilitate getting people into treatment but will further isolate and marginalize them from treatment. Dr. McCorry used to speak about the on ramp to treatment and the off-ramp from treatment and the importance interventions such as this had in helping participants get into treatment and in helping them after treatment with aftercare and early recovery.


We recognize that we are in difficult financial times but the costs associated with terminating this contract will not in the short term save money -- nor sadly -- lives. What this intervention does -- is in fact -- core treatment because we work directly with those individuals most in need of our help who are addicted to drugs and HIV infected/affected. I ask that you re-visit this decision and allow us to continue this important work. AOP staff has spent 23 years developing relationships of trust and a reputation of service in communities severely impacted by drugs, alcohol and other health related diseases. It would be disastrous to have all this (the AOP intervention activities) end in a few short months without someone giving this decision to terminate our contract some serious re-consideration.

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Violet FergusonBy:
Nature and EnvironmentIn:
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OASAS

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