Interview Guide - Community Leaders

Form Approved

OMB No.: 0920-0840

Expiration date: 02/29/2016

“Local Effectiveness Assessment Project (LEAP): A Case Study of a Local Jurisdiction Providing HIV Services to MSM”

2b. Interview Guide Community Leaders

Public reporting burden of this collection of information is estimated to average 60 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Reports Clearance Officer; 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; Attn: OMB-PRA (0920-0840)

Study Instruments

Structured Response Questions

Participant ID:________ Data Collector ID:_______

Date:_________ Start time: __:__am/pm End time:__:__am/pm

Instructions: Please complete the demographic questionnaire to the best of your abilities. If there are any questions you would prefer not to answer, you can skip to the next. Remember that your participation is voluntary. These questions are being asked in order to provide context to the interviews.

DEMOGRAPHICS (2 min)

1. What is your age in years? ______________

2. Are you Hispanic or Latino/a?

No, not Hispanic, Latino/a…………………. ……..		0
Yes, Mexican, Mexican American Chicano/a…….		1
Yes, Puerto Rican………………………………….		2
Yes, Cuban………………………………………….		3
Yes, Another Hispanic, Latino/a.. …………………		4

3. Which racial group or groups do you consider yourself to be in? What is your race? You may choose more than one option category. (Select all that apply.)

American Indian or Alaska Native ………. 1

Asian ………. 2

Black or African-American ………. 3

Native Hawaiian or other Pacific Islander……. 4

White ………. 5

REFUSED ………. 6

4. What was your sex at birth?

Male 1

Female 2

5. How do you currently identity?

Male… 1

Female 2

Transgender Male…………………… 3

Transgender Female 4

Other 5

6. Do you think of yourself as?

Homosexual, gay, or lesbian 1

Heterosexual or straight 2

Bisexual 3

Other 4

7. What is your current HIV status? (This question is optional. Respondent may choose not to respond.)

Negative…………. 1

Positive………… 2

No Response…….. 3

8. Which of the following groups includes your total annual income

Less than $20,000	1
$20, 000-34,999	2
$35, 000-59,999	3
$60,000-99, 999	4
More than $99, 999	5

Respondent BACKGROUND (4 min)

9. How long have you been working in the Philadelphia area? ____________ years _________months

10. How long have you been working in the HIV field? ____________ years _________months

11. How long have you been working in the MSM community? ____________ years _________months

12. What is your profession?

Program Director/Manager in HIV prevention or treatment……..	1
Policy Administrator…………………………………………………	2
Health Department Administrator………………………………….	3
Mental Health Provider……………………………………………..	4
Substance Abuse Counselor ……………………………………...	5
Social Worker………………………………………………………..	6
Health Educator in HIV Prevention………………………………..	7
Community Advocate……………………………………………….	8
Other …………………………………………………………………	9

13. What is the highest level of education you have completed?

No schooling completed, or less than 1 year……………………….	1
Nursery, kindergarten, and elementary (grades 1-8)………………	2
High school (grades 9-12, no degree)……………………………….	3
High school graduate (or equivalent)………………………………..	4
Some college (1-4 years, no degree)………………………………..	5
Associate’s degree (occupational or academic degrees)…………	6
Bachelor’s degree …………………………………………………….	7
Master’s degree ………………………………………………………	8
Professional school degree ………………………………………….	9
Doctorate degree ……………………………………………………...	10

Interview Guide

Participant ID:________ Data Collector ID:_______

Date:_________ Start time: __:__am/pm End time:__:__am/pm

Overview and Background of Study

INTRODUCTION AND PURPOSE OF INTERVIEW

Hello my name is ___________ and I work for [Atlas Research or Abt Associates]. My company was selected by the Centers for Disease Control and Prevention (CDC), Division of HIV/AIDS Prevention (DHAP) to better understand the current successes and challenges in the response to the HIV epidemic among the MSM in your local jurisdiction.

We’d like to begin with a discussion of the landscape of addressing the HIV epidemic among MSM in [name of local jurisdiction].

Local HIV prevention and care efforts, activities and context of the jurisdiction (_min)

1. What does the HIV epidemic look like in your local jurisdiction?

2. How is the HIV epidemic affecting specific groups in your local jurisdiction?

• Probe:

• Age groups?

  • Youth

  • Older adults

• Race/ethnicity?

• MSM?

• Injection drug users?

• Others?

3. What are the needs in your jurisdiction (specific to MSM) related to HIV prevention and care?

• Probe:

• Are the needs being met? Why or why not?

• How are the needs being met?

4. What are the programs or policies in place that are addressing these HIV prevention and care needs?

5. What resources have been most helpful in the fight against HIV and AIDS among MSM in the local jurisdiction?

• Probe:

• Trained local providers and staff?

• Engagement of local advocacy groups?

• Specific local HIV prevention and treatment programs?

• Policies?

6. What resources could you use that are not available or being offered?

• Probe:

• Why are these not available?

Local HIV prevention and care efforts, activities and context of the interviewee’s role/organization (_min)

PROGRAMS

For purposes of this interview, we’d like to define continuum of care as including the following steps [INCLUDE AS HANDOUT]:

• Preventing new infections

• Identifying cases through HIV testing an diagnosis

• Connecting HIV-positive people to quality HIV care

• Keeping HIV-positive people in quality HIV care

• Effective drug treatment of HIV

• Treatment success-suppressed viral load

7. Referring back to the HIV continuum of care, can you describe your role and your organization’s role in addressing the HIV epidemic in your local jurisdiction (e.g., screening and testing, diagnosis, linkage to care, retention in care, treatment, treatment success; outreach; partnership building) among MSM?

8. Can you describe the steps and approaches that your organization takes to engage MSM in HIV prevention and care?

9. How does your organization communicate HIV prevention and care services available in the local jurisdiction?

• Probe:

• In person? Online? Print? (e.g. ads on billboards, buses, clinics)

• Through partnership engagements?

• Are there primary and secondary HIV prevention campaigns?

POLICIES AND PROCEDURES

10. Are there policies or procedures in place that help local agencies or organizations provide HIV services to MSM? If so, can you describe how some policies that have been implemented?

    • Probe:

      • Staff and provider training?

      • Recruitment experienced healthcare staff in working with MSM community?

      • Others?

      • How have they been received by the local jurisdiction?

      • All MSM should be screened for HIV/STDs?

      • Sexual orientation or the gender of men’s sexual partners is requested?

      • Jurisdictional HIV Prevention Plans prioritize MSM?

      • There are non-discrimination policies within the agency?

11. How has funding impacted the way your organization addresses HIV services and care?

• Probe:

• Can you describe any funding challenges the organization faced last year?

• How does allocation of funding to certain programs (e.g. screening, testing, counseling and treatment) impact the HIV services provided?

12. What type of data does your organization track for HIV services and care in your jurisdiction?

• Probe:

• Prevention activities (e.g. awareness, education session, testing and screening)?

• Care/ treatment (e.g. counseling and treatment provided by public/private providers, medical regiments, retention of treatment by HIV + MSM)?

• Other?

• Which systems/data bases?

13. How are the data on HIV testing, counseling, treatment used in your organization?

• Probe:

• For gaps in the data? What’s missing or lacking in the data that would be beneficial to track? Why?

• Are you aware of any criteria/factors/ requirements in place to assure the quality of the data?

PARTNERSHIPS

14. How does your organization integrate the various sub groups of the gay, bisexual, and other MSM community when implementing HIV prevention and care services to this community?

• Probe:

• Does the program staff have a connection to these communities? If so, how?

• Are they aware of cultural nuances and practices of the various sub groups of the gay, bisexual, and other MSM community? How has this influenced success in the delivery of services and care?

15. How actively involved are advocacy groups or leaders in the gay community in building collaboration with your organization (or other providers) and the gay community?

• Probe:

  • How much of an impact does their involvement contribute to improving HIV prevention and care in the local gay community?

16. What types of gay advocacy activities are held/provided for at risks groups in the local jurisdiction?

• Probe:

• Networks and coalitions address HIV services and care for MSM?

• Support groups (small group discussion or forums)?

• Social media activities (online chat forums, tweets, etc.)?

• LGBT community centers?

17. Are you aware of any community level programs that collaborate or partner with local government agencies in providing HIV prevention services or care for MSM? If so, describe the type of collaboration?

• Probe:

  • Are you aware of any challenges this collaboration has encountered? How did they address the issue?

  • Employment, education, housing, clothing, and food services?

18. What types of outreach activities does your organization provide to the local MSM community?

• Probe:

• Local condom distribution at MSM events (e.g. gay pride, gay bars/clubs/ local bookstores/ health fairs)?

• Risk reduction counseling and behavioral change interventions to both HIV +/ HIV negative MSM?

• Outreach to special populations (e.g. homeless, incarcerated)?

Barriers and facilitators that contribute to controlling HIV among MSM within the local jurisdiction (_min)

Now I would like to discuss the barriers and facilitators that contribute in controlling HIV among the local MSM jurisdiction.

19. Using the continuum of prevention and care as a framework, what are some of the barriers you see that contribute to the prevention and control of HIV among MSM in the local jurisdiction?

• Probe:

• Limited resources to address barriers (i.e. housing, transportation, employment, income, etc…)

• Homophobic or discriminatory local laws and policies?

• Restrictive or lack of relevant policies?

• Challenges developing or sustaining partnerships?

• Cost for providing HIV prevention and care services?

• Availability of services /access to services?

• Lack of cultural competency by providers/ counselors?

• Language barriers?

• Denial by target audience? Lack of awareness on the importance of continued care and treatment?

• Are the risks of not getting tested, seeking treatment or continue treatment being properly communicated to MSM?

• Stigma or discrimination?

• Trust or lack of trust?

20. Using the continuum of prevention and care as a framework, what are some of the facilitators (e.g., strategies) you see that contribute to the control of HIV among MSM in the local jurisdiction?

Priorities, gaps, and innovations related to controlling the HIV epidemic among MSM in the local jurisdiction (_ min)

21. Based on current needs of the local MSM community, what are the key priority areas for HIV prevention, care, and treatment?

• Probe:

• Prevention (e.g. screening and testing)?

• Care (e.g. delivery of treatment and retention of care)?

• PrEP?

• Outreach?

• Partnership (e.g. building and sustaining collaboration with providers)

22. Where do you see the biggest gaps in addressing the needs of the local MSM community?

23. Please describe any aspects of the service models used for engaging HIV-positive patients that are available in the local jurisdiction that you consider to be innovative.

• Probe:

• Screening and testing

• Condom distribution

• Counseling

• Early initiation of antiretroviral therapy (ART)

• Social support systems (e.g. domestic violence, housing, mental health)

• Allocation of funding in certain areas of HIV prevention and care?

• Knowledgeable and well trained counselors and service providers?

• Engagement of local stakeholders?

CLOSING QUESTIONS (_min)

24. Is there anything else you would like to share today regarding HIV prevention and care among MSM that we have not addressed?

25. Are there other individuals that LEAP should consider interviewing for this effort?

26. The following map of Philadelphia is divided by neighborhoods/zip codes. Can you please identify the areas that have:

• HIV prevention events (e.g. HIV testing events)

• Locations known for HIV/STD risk behaviors (e.g. injection drug use, MSM sex work, sex clubs, etc.)