San Francisco AIDS foundation by tlindeman


									San Francisco AIDS Foundation
    Black Brothers Esteem
     Building Community, One Brother at a Time

                May 2007
      Black Brothers Esteem
– Historical Research
– SFAF Ends Statements
– Community Programs Goals
BBE   Goals
BBE   Staffing
BBE   Activities
BBE   Successes
– Spirituality Project
– Lessons Learned
BBE Historical Summary
Qualitative Interview Survey
 SFAF Funded
 Qualitative interviews with 200 MSMs
  –   Substance Users
  –   White, African American, Latinos
  –   HIV positive and Negative
  –   Safe men
 Condom used sometimes but not always
 Sex fulfilled nonsexual need or difficulty--loneliness --Fantasy Island

 High-risk sex and drugs used to help feel desirable and   accepted
 Indigent men used sex as currency
 -- sex drug exchange
 Disclosing HIV status discouraged
 Guessing/assumption strategies. to
 determine HIV serostatus
 Target additional middle class
 African American American, Latino,
 HIV positive and negative
 Safe men
 Substance users
QIS II Findings:

 Difficult to navigate sex culture
 Anonymous sex discouraged information
 sharing, including HIV
 Body image complicated sexual choices
 Situation dictated risk strategies
 100% condom use useless message
 Expectation on partner to disclose HIV status
 New drugs not primary influence
QIS II Findings:
  Gay cultural racially segregated
  Men of color objectified
  Men of color de-racialized
  More focus on broader cultural, social influences on
  sexual behavior
  Address broader life issues
  Accept that men are not going to use condoms at times
  Men looking for seroconcordance to have sex without
  Men using calculation to determine partner HIV status
  but faulty
Prevention Strategies:

 Gay Life and BBE launched in

 Community gatherings,
 workshops, I:1 counseling,
 media campaigns
      SFAF Ends Statements
Decrease the impact of HIV in SF and the Bay Area
Create programs that are innovative, measurable, and
replicable grounded in the intersection of evidence,
research and practice.
– Utilize sound research methodologies to discover
  programmatic opportunities where SFAF can deliver innovative
  solutions for care and prevention
– Rationalize programs with metrics
– Package and extend programs to other communities locally,
  nationally and globally
Exhibit leadership in the Science & Policy arenas
– Research is stimulated and effected as an external force and
  on the pandemic
– Public policies promote and public funding supports ending the
  pandemic and human suffering caused by HIV
Community Programs


Black Brothers   Latino Support
                                  Speed Project
   Esteem           Services
    Community Programs
Mission: Promote health and
community-wide well being among
sexually active and substance using
men (MSM) in San Francisco and the
Bay Area who are living with or
affected by HIV/AIDS.
Community Program Goals
To reduce health disparities influenced by race, ethnicity,
socioeconomic and immigration status and substance use
behaviors for MSM populations in San Francisco & the Bay

Community-Wide Well-Being
To increase community well-being through the development
of positive social capital by confronting multiple stigmas,
negative community norms, and lack of social support
systems for MSM populations in San Francisco & the Bay Area.

Intervention Development
To improve department programs through the adaptation of
evidence-based interventions, implementation of additional
research and appropriate theoretical application and
dissemination of current programs designed for MSM
populations in San Francisco & the Bay Area
                       BBE Goals
    Sexual Health
–      Decrease exposures to HIV
–      Increase awareness & practice of sexual harm reduction strategies
–      Increase access and awareness of STD screening, HIV testing, and
–      Increase people’s ability to have embodied, consensual, and pleasurable sex

    Mental Health
–      Decrease isolation for high-risk groups
–      Increase awareness and utilization of culturally competent MH services
–      Decrease social stigma associated with utilization of MH services
–      Increase individual positive self-esteem, self-efficacy and self-concept
–      Increase awareness of interrelationship among mind, body and spirit (Bio-
       Psycho-Social-Sexual health)

    Physical Health
–      Increase access to and utilization of primary medical care
–      Increase utilization of and adherence to HAART and other HIV care regimens
–      Increase utilization of and adherence to other preventative and life-
       enhancing regimens
–      Decrease the negative consequences of substance use
      Community Well Being
Community Health
– Decrease in social stigma associated with sexuality
– Decrease in stigma associated with HIV/AIDS, Substance use,
  Race/Ethnicity. Gender Identity, Immigration status or
  linguistic ability, Age, and physical appearance.
– Increase social support for discussing sexuality
– Promote community norms that support community health
– Enhance community-wide capacity to negotiate complex
  sexual health and substance use issues

Community Development
– Provide skills and opportunities for individual to positively
  impact community health
– Promote development of social capital (connectedness,
  common rules/norms, reciprocity, and trust)
  Intervention Development
Evidence based
– Utilize current research and logic models to inform
  development of models, programs, and interventions
– Conduct evidence based evaluation of models,
  programs, and interventions
– Conduct formative research to enhance understanding of
  high-risk populations
– Utilize innovative media and methods to enhance
  program effectiveness
Model Dissemination
– Develop curricula of effective models, programs, and
  interventions to other jurisdictions
– Raise awareness of and disseminate effective models,
  programs, and interventions to other jurisdictions
       Black Brothers Esteem
Provide variety of individual, group and
community focused interventions
 –   Individual counseling
 –   Drop In/Support Group
 –   Substance Abuse Support Group
 –   Workshops
 –   Leadership Retreat
 –   Community Development Projects
 Black Brothers Esteem Staff

                                   CP Director
                            William Bland, MBA, MPH

Black Brothers Esteem Mgr       BBE Comm. Dev.Mgr          BBE Clinical Svcs Mgr
     (Tony Bradford)           (Micah Lubensky, Ph. D)   (Raven Mahosadha, M.S.)
          BBE Staffing

                          BBE Core        BBE Clinical/Eval
Community Dev.        --Support Group         --Colors of
    -- Volunteer    -- Steering Comm.          Recovery
-- Peer Health Ed    --Leadership Inst.    -- Program Eval
-- Comm. Projects       --Workshops             --Client
                     --Edumatainment          Counseling
                  BBE Activities

             Phoenix Rising
                                            Various 4-6 session cycles
               Drop-In Group
                                           Multiple Session Workshop
                                     Topics: Leadership, Brothers in Worship
            Single Session Group

                           Community Events
                          SFAF sponsored – Kwanzaa
                               Juneteenth, Teatro
                        Non-SFAF – MLK, Pride, 6th Street
                          Black Men’s Health Brochure
Secondary Point
of Entry
                                                                                  Spirituality Forum &
                                                            Community             Brochure
                                  LGBT Pride, MLK Rally
Social capital development


                                                                                                            Maslow Hierarchy
                                                          Peer Health Advocates
                                                                Outreach          Healthy Relationships

                                                                                     Colors of Recovery
                             Brothers in Worship               Group
                                                                Retreats                   Many Men, Many
                             Spirituality                       Activities                 Voices

                                                             Phoenix Rising
                                                          Client support/IRRC
              BBE Spirituality Project
Health Outcomes of Project:
Reduced isolation
Increased coping skills
Increased connection to AfAm community
Decreased stress
Decreased substance use
Increased self-esteem

                         Brothers in                                             Community
     Brothers in
                          Worship        Leadership   Post-Institute Project    Forum/Black
                       (Church Visits/    Institute         Selection          Church Week of
 (Pre-Church Visits)
                          Debrief)                                                 Prayer

                                                        Resource Guide
     BBE Lessons Learned
Integrated multi-level programming
maximizes synergies/impact
Community Development has a long
term/upstream impact
Mind-Body-Spirit approach essential for
African Americans
Leverage client assets – resiliency,
spirituality, socialization, intelligence
Client driven programming
Culturally competent staff – all black gay
Teach up, not down
    BBE Lessons Learned
Organizational infrastructure
Consistency and quality are key
   BBE Single Session Group Goals
                                                        BBE Single
                                                      Session Groups

                                                                                                                                Substance Use
Volunteer Opportunities               Steering             Phoenix Rising       Socials                 Peer                       Group
                                     Committee                                                    Health Advocates

                              q Peer Leadership     q Peer Support           q Build Connection       q Health Ed
  q Communication                                                                                                               q Knowledge
                              q Communication       q Build Connection       q Increase cultural prideq Health Training
       Skills                                                                                                                        of sub. use,
                                  Skills            q What’s Happening       q Practice skills        q Communications Skills
  q Connection to ext                                                                                                                triggers,
                              q Leadership          q Food                   q Community visibility q Community Bldg
       community                                                                                                                     etc.
                                  Development       q Processing w/Facilitator                        q Practice Skills
  q Health Ed                                                                Food                                               q Peer
                              q Inform about        Psycho Ed                Peer support             Build connection
  q Leadership Dev                program
  Increase self esteem                              Build Community          Increase trust           Peer support              q Improve
                              Build Connection      Spritual Grounding       Common rules/norms       Food
  Practice skills                                                                                                                    function &
                              Practice Skills       Refuge from TL           Community support        Increase testing
  Increase Trust                                                                                                                     stability
  Community support                                 Intro to BBE             Health Education         Trust                     q Inc. self-
  Build connection                                  Learn how to be in group Increase self-esteem     Common rules/norms             efficacy for
  Inc. care utilization                             Individual counseling                             Leadership Development         self care
  Increase testing                                                                                                              Inc awareness
                                                                                                                                of resources
                                                                                                                                support w/PR
                          Base BBE         Member Svc/QA
                           (Tony)             Raven
                   Support Group

                                         Common Rules
Connectedness    Social Capital           Brothers Pledge
    Retreat                                  Guidelines
                      Via               Rules/Responsibilities
 Support Group       BBE                  Steering Comm.

                 Volunteer activities
                 Brothers Aid Team

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