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					Peer Education and Training Sites (PETS)
 Resource and Evaluation Center (REC)

                                Health Watch
       The REC/PETS Project
                Funded by the
           Minority AIDS Initiative

 The HIV/AIDS Bureau of the Health Research
     and Services Administration (HRSA)
                    of the
U.S. Department of Health and Human Services
                                      Health Watch
 Peers Take the Spotlight:
 Working and Supporting
      Peer Educators

Rita Sondengam, MPH - Technical Assistant Coordinator
        The Research Project
 The REC (Resource and Evaluation
 Center): Health Watch in partnership with
 the Health and Disability Work Group at
 Boston University's School of Public Health

               which supports

 The PETS (Peer Education Training Sites):
 three peer training sites

                                      Health Watch
                  The Structure
                  Resource and Evaluation
                       Center (REC)

              Health Watch/Boston University

     PETS                 PETS
Harlem Hospital      Center for Health
                                            St. Louis Red Cross
   New York              Training

                                                   Health Watch
 In collaboration with HRSA and the PETS to
 develop a prominent national profile for the
 PETS and peer education in the following
     Monitoring and Evaluation
     PETS Curricula

     Technical Assistance

     Knowledge Center

                                      Health Watch
    Monitoring & Evaluation
 Develop and provide a program
  monitoring/evaluation skills building training
  for the PETS

 Work with each PET site to develop an
  individualized action plan related to
  strengthening program monitoring and
  evaluation infrastructure

 Establish Quality Assurance Plan for National
  Cross-site Evaluation

                                            Health Watch
       PETS Curriculum
 Identify Core of Elements of PETS

 Confirm the Inclusion of these Elements
 in the PETS Curricula

 Review PETS Learning Objectives

                                 Health Watch
   Technical Assistance
 Capacity Building Assessment

 Tools have been developed and have
 been administered to each of the PETS
 to identify additional program and
 evaluation needs/gaps

                                 Health Watch
Technical Assistance (con’t)
 Service Delivery

 Results from the Capacity Building
 Assessment have been reviewed and
 addressed during phone meetings, e-
 mail and during the 1st PETS Working

                               Health Watch
 Technical Assistance (con’t)
 Establish a Criteria for Identifying AIDS
 Service Organizations (ASOs) and Look-
 a-Likes also known as secondary project

 Develop Standards for Recruiting ASOs
 and Look-a-Likes

                                      Health Watch
 Technical Assistance (con’t)
 Capacity Building Assessment –
 Secondary Project Users

 A Capacity Building Assessment Tool
 will be Administered to Organizations
 Partnering with the PETS and a plan for
 Delivering Services Developed and

                                   Health Watch
        Knowledge Center
 An Internet Domain Name for the
  Knowledge Center has been obtained:
 The Knowledge Center website is in
 New National Logo has been Developed
  for this initiative

                                    Health Watch
       Knowledge Center
 Design and Administer Anonymous
 Website Survey to Evaluate Website

 Develop Marketing Plan to Raise
 Awareness of the Knowledge Center

                                    Health Watch
        Knowledge Center
 General Access
  Newsletter, Training Calendar, Conference
  Information, Funding Opportunities,
  HIV/AIDS Updates, and User Survey

 PETS/REC-Only Access
  On-line Library, Cross-Site Instruments,
  Technical Assistance

                                             Health Watch
   Contact Information
Program Manager: Mapple Walker
212-564-7199 x106

Technical Assistance Coordinator: Rita Sondengam
212-564-7199 x118

Program Assistant: Milenka Jean-Baptiste
212-564-7199 x105


                                             Health Watch

                       Health Watch
The Lotus Project
Shailey Merchant, MPH
(Center for Health Training)

Shalini Eddens, MPH

August 28, 2006
Lotus A Symbol of Peer Advocacy

          Each day the beautiful Lotus flower
           enacts rebirth and renewal of life
  as it dips below the surface of the water at night
            only to be reborn with the sun
              at the dawn of the new day.
WORLD and CHT Collaboration

     A Women-Centered HIV+
 Peer Education Training Program
    Center for Health Training
 National organization founded in 1977
 25 years experience developing curricula &
  planning & delivering training
 Training organization with national capability
  for serving low-income & minority women
       Title X Family Planning Regional Training Center
       CDC Integrating HIV Prevention Services in
        Reproductive Health Sites
       East Bay AIDS Education & Training Center
        (EBAETC) local performance site
 Women Organized to Respond to Life
  Threatening Diseases, founded in 1991 by & for
  women living with HIV.
 Provide support, information & advocacy for
  HIV + women, families, friends, & loved ones.
 Programs:
       Retreats & support groups
       HIV University
       International newsletter
       LINC’s outreach program
       Peer advocacy program.
Collaborative Program Process
   Project Directors at CHT & WORLD
       Joint collaboration & coordinating

   Executive Committee
       WORLD & CHT executive directors & project
       Meet bimonthly

   WORLD Peer Advocates (4)
       Meet weekly
       Provide ongoing input to project
       Receive training & mentorship to train & facilitate
Collaborative Program Process
   Community Advisory Board
       Organized by WORLD
       Meet quarterly
       Made up of 5 HIV positive women
       Provide ongoing input to project

   Curriculum Committee
       Organized by CHT
       Includes CHT staff, WORLD staff, local AETC
        Medical Director, consultants
       Provide input & direction to curriculum
       Create & write curriculum
      Presentation Overview
   Project Partners

   Lotus Project Overview

   Curriculum Overview

   Evaluation Component
       National Partner Sites

   Christie’s Place- San Diego, California

   SisterLove - Atlanta, Georgia

   The Women Rising Project -Austin,

   Mujeres Unidas, San Antonio, Texas
                 Program Goals
   To expand the number of peers providing
    support to women living with HIV
       to provide outreach, education, & support as part of a
        care team

   To enhance the effectiveness of HIV peer

   To train HIV+ women to be able to assist other
    HIV + women get into and/or continue care &
       Increase treatment adherence
     Who Do We Work With?
   HIV positive women

   Health-care providers

   ASOs

   Women’s organizations
Lotus Project Training Approach
    Train
      HIV positive women on peer advocacy
      Clinical staff who work with HIV positive
       women on the value of peers
      Providers on integrating peers into their
       health care teams
    Provide capacity building & TA to
     organizations to create or expand peer
     advocacy programs for women
        3 Levels of Training

   Level I –Didactic presentations &

   Level II – Peer Education Training

   Level III – Capacity Building and
    Technical Assistance
    Level I Trainings
 Local service area
 2 hour to 1/2 day didactic presentations
 Already trained peers -Update skills &
  HIV information
 Non-clinical ASO staff- HIV updates
 Clinical ASO staff – How to work with
  peers in a clinic setting, value of peers,
  tools for peer programs
       Level II Trainings
 National focus
 5 full days with 1 day as field visit
 For women living with HIV- recruitment
  through local partner agencies
 Provide knowledge & skills to be a peer
 Interactive, empowering, skill building
            Level III Trainings
   Recruitment through Level 1 presentations

   Capacity building for organizations who are
    providing peer advocacy
       Support & supervising peers
       Tool-kit
       Funding

   Training clinical staff at ASO’s & health-related
       Improve utilization of peer educators in
        multidisciplinary team
     Training Goals Year 1, 2
Location                 Level 1   Level 2   Level 3
Northern California        59        17
San Diego
                                     22        2

Texas (Austin, San
  Antonio)                           15        2

Northern California
                           60        15        4

Atlanta/South Carolina
                                     15        2

Spanish Training

           Totals         120       109        10
          Curriculum Design
   Women-centered approach
   Positive women training positive women
   Tools & skills
   How to use personal experience as a tool for
    work with clients
   Case studies, interactive activities, role plays,
    reflections, field work
   5 Modules that are interchangeable & flexible
   Translation into Spanish
    Curriculum Modules 1, 2
Day 1 -What Does                Day 2 - ABC’s of
  It Mean To Be                  Peer Advocacy
  a Peer                           Advocacy
  Advocate?                        Believing in what you do
                                   Concepts to address
   Stages of Change Model
                                    challenges of peer
   Warrior Women                   advocacy.
   Role and                        1.   Communication
    responsibilities of Peers       2.   Countertransference
                                    3.   Confidentiality
                                    4.   Creating Boundaries
 Curriculum Modules 3, 4, 5
Day 3 - Field Visit     Day 5 - Bringing It
Day 4 - HIV/AIDS,         All Together
STD, Treatment 101       Practicing
 HIV life cycle          peer/client role plays
 Immune System          Challenging Case
 HIV/STD facts,          Scenarios
   myths, disease        Am I ready to be a
   management             Peer Educator?
 Treatment basics       Closing Ceremony
 Female Reproduction
 Goal: Develop realistic long term outcomes
  with project partners & stakeholders, e.g.
  Community Advisory Board (CAB) & peer
  network input.
 Long term outcomes include:
       Increase in HIV positive women attending regular
        medical appointments
       Improve knowledge & understanding of disease
        progression & anti-HIV medications
       Reduce isolation & build community involvement
       Increase effective coordination among health &
        other agencies addressing HIV positive women’s
       Evaluation (cont.)
 Evaluation team is inclusive at all project
  levels: Evaluation Expert, Project
  Directors, Consumers/Peers via the CAB,
  Clinical Consultant
 Baseline pre/post test with Level I
 Baseline, 6 mt, 12 mt follow-up with Level
 Baseline and 1year follow up with Level
       Baseline Data From
        1st Peer Trainings
 17 women
 Age range: 26-59
 65% African American
 70% Some education beyond high school
 13 Heterosexual, 2 Bisexual, 1
 82% Medicaid, 29% Medicare
 11 currently on HIV medications
       Background Information
   Over three-quarters of the trainees indicated their health
    was good or very good.
   Three women indicated they were in recovery from
    alcohol or other substance use problems.
   Eight of 10 respondents reported they were heterosexual
    and fully 41% (n=7) indicated they had not had any sex
    partners during the past six months.
   About a third of the sample was not taking medications
    related to HIV/AIDS.
      For the remaining 11 women, 73% (n=8) indicated
       they were remembering to take their medicines all the
Work or Volunteer Experience
   71% had other HIV training in the last 2 years

   Most worked as volunteers in past 6 months

   77% reported being unemployed in past month

   12/17 worked with people living with HIV
             Level 1 Data
 Spring 2006
 Collaborated with local AIDS Education
  & Training Center
 1 day HIV/AIDS update conference
 59 participants (Non clinical ASO staff)
     45 female, 14 male
     29% Black, 24% Hispanic
     97% post secondary education

   85% had had other HIV training in the
    past two years.
      Challenges and Barriers
   Funding for peer programs
   Follow-up with trained participants – very
    transient, low SES population
   Not enough paid or volunteer peer advocate
   Support and supervising of peers
   Need for peer network event - $
   Stigma, mis-information about HIV
   Curriculum and training material has to be low
    literacy and simple
   Great need for Spanish Peer Advocacy
                   Future Plans
   Spanish Translation
       Participant Materials (end of year 1)
       Curriculum (end of year 2)
   Level II Trainings
       Fall 2006- San Francisco training
       September 2006- Texas in collaboration with Mujeres Unidas
        & Women Rising Project
       Spring 2007-Atlanta in collaboration with Sisterlove & Aniz,
       Summer 2007- Spanish training in Northern or Southern
   Level III capacity building 2 day seminar with
    all collaborating agencies - Spring 2007
   Curriculum Committee: Judy Leahy,
    Sandy Rice, Janie Riley, Amanda Newstetter,
    Gracie Askew, Paula Runnals
   EDs of WORLD and CHT: Maura Riordan
    and Pat Blackburn
   Peer Advocates: Sylvia Britt-Raven, Sylvia
    Young, Margaret Giodarno, Anna Jackson,
    Alejandra Cano
   Lead CHT evaluator: David Fine
   Consumer Advisory Committee
   Lotus Medical Consultant: Kathleen
    Clanon, MD
Contact Lotus Project Staff
     Shailey Merchant, MPH
          Lotus Project Director
        Center for Health Training

      Shalini Eddens, MPH
       Education, Training Director

                    Health Watch
Missouri AIDS Alliance
Peer Education
Training Site
Missouri AIDS Alliance
         American Red Cross
        St. Louis Area Chapter
• Chartered in 1917
• Began providing HIV/AIDS Education &
  Prevention Certification in 1985
• The American Red Cross has the only
  Nationally Standardized HIV/AIDS
  Education & Prevention Program in the
  country, developed under a cooperative
  agreement with the Centers for Disease
  Control and Prevention.
• .
    American Red Cross
   St. Louis Area Chapter
• Has nationally recognized Instructor
  Trainers on staff full-time in all three ARC
  prevention programs

• Has certified “SISTA”, “RAPP” and
  “L.I.F.E.” program facilitators on staff.

• The ARC HIV/AIDS Education & Prevention
  Instructor Programs; Basic, African
  American & Hispanic, were developed
  specifically to address the needs of the
  community being served
  Kansas City Free Health Clinic

The purpose of Kansas City Free
 Health Clinic is to promote health
 and wellness by providing quality
 services, at no charge, to people
 without access to basic care.
Kansas City Free Health Clinic

• Founded in 1971 by a group of
  concerned citizens to serve uninsured
• 400 volunteers drive services totaling
  $2 million plus 30,000 hours service in
• Services include-general medical care,
  dental care, mental health services, and
  comprehensive HIV prevention and
  treatment for anyone who is uninsured,
  underinsured or lack the financial
  resources to pay for care
Kansas City Free Health Clinic

• HIV services include:
  –   Primary Care
  –   Counseling and Testing
  –   Case Management
  –   Behavioral Health
  –   Prevention
  –   Peer to Peer Treatment Adherence
• Cross site evaluation for the Alliance

• Jan Russell – MATEC-MO Co-
Midwest AIDS Training and Education Center, Missouri

• Located at the UMKC School of Nursing
• MATEC-MO is charged with providing education to
  all professionals within the State of Missouri on HIV
  and building capacity to increase the numbers and
  types of HIV providers within the state.
• MATEC-MO directors and staff work
  collaboratively with all state and federally funded
  organizations to provide education, technical
  assistance and individualized clinical training, in
  addition to general information and skill building
  programs that ultimately increase and improve the
  care provided.
    Peer Education Training Site

Populations Grant Encompasses:
• HIV+ persons who have a desire to become a peer

• Organizations that will design and implement HIV
  Peer programs

• Begin in St. Louis and Kansas City, then progress to
  out state areas, focusing on Ryan White funded
• Both peers and organizations will receive training to
  support Peer Education on 3 Levels over 12 months
     Peer Educator Training
    Level 1 Training (1 day)

Raise Awareness of Project
Provide Basic HIV knowledge
Basic concepts regarding Peer Education and
 the role of a Peer Educator
      Peer Educator Training
         Level 2 (3 days)

• Knowledge and Skills Building
  – HIV Disease and Treatment
  – Information on Transmission, CATS,
  – In-depth review of HIV viral life cycle,
    HAART, Pharmokinetics-how the drugs
  – Understanding resistance and cross-
  – Understanding laboratory values.
   Peer Educator Training
       Level 2 (cont)
• Treatment Adherence Strategies
   – What is Adherence?
   – Barriers to and factors that support adherence
   – Adherence issues related to mental health and
     substance abuse
   – Developing adherence strategies.

• Managing HIV Disease
   – Common side effects
   – Working assertively with Health Providers
   – HIV and HAART
   – Impact of heart disease, diabetes, cholesterol,
 Peer Educator Training
 Level 2 (3 days)
• So you want to be a Peer Educator?
  –   Definition
  –   Goals of the Program
  –   Roles and Responsibilities
  –   Benefits
  –   Boundaries
  –   Self Care
• Communication Skills for the Peer Educator
  –   Effective Communication Skills
  –   Effective Listening Skills
  –   Conflict Management
  –   Cultural Competency
  –   Values and Beliefs Issues
         Peer Educator Training
        Level 3 (40hr/12 month)

• Workplace Skills
  –   Professionalism, collaborating/networking
  –   Confidentiality
  –   Documentation
  –   Development of client centered goal plans
• Peer Shadowing/Reverse Shadowing
  – Done in work place setting in a TBD timeframe
  – 1:1 role modeling with clients (peer learner and
    experienced treatment adherence peer)
  – Reverse shadowing in peer learners organization
         Peer Educator Training
        Level 3 (40hr/12 month)
• The Learning Environment
  –   Presenting information effectively
  –   Facilitating discussions
  –   Providing feedback
  –   Facilitation strategies including:
• In-Depth Communication Skills
  – Skills Building Activities
  – Understanding Interpersonal
    communication, Passive, Aggressive and
    Assertive communication
  Organizational Training-Level I
                       Part 1
• Target Audience
  – Ryan White CARE Act HIV Primary Care Clinics
  – Ryan White CARE Act funded service providers
     • Case Management
     • Housing
     • Behavioral Health

• Purpose
  – Raise Awareness of Project
  – Increase interest in providing peer porgrams
Organizational Training-Level I
                Part 2
• Organizational Capacity Building
  – One on one interview with ‘Peer
    Champion’ at organization
  – Assess readiness for a peer program
  – Determine resources available
  – Identify potential strengths and
  Organizational Training-Level II
       20 hours over 3-6 months
• Targeted toward clinics/agencies interested
  in implementing peer program
• Support clinic/agency in designing peer
  – Defining roles and responsibilities of peers
    within organization
  – Application of program principles
  – Identify organizational changes needed to
    integrate peer program
  – Develop action plan to address anticipated
    barriers to initiating and integrating a peer
 Organizational Training-Level III
        40 hours over 12 months

• 1:1 modeling of system integration of peer
  program at existing peer program
• Provide reverse shadowing opportunities to
  assist in the application of principles
  learned to the participant’s own organization
• Provide ongoing technical assistance
     Lessons Learned
• Allow more ‘getting to know you’
  time for Alliance members
• Start ups take longer than you
  think—be patient
• It’s worth it!!
           Contact Information
• American Red Cross – St. Louis Area Chapter

• Kansas City Free Health Clinic

                  Health Watch
 Peer Advanced Competency

Tara Herlocher, MPH
Director of Education and Training
PACT Project
Harlem Hospital
               Project goals
   The PACT Project targets experienced
    and new peer workers working with
    PLWHA from traditionally underserved,
    minority, hard-to-reach and marginalized
   The primary target area is the five
    boroughs of New York City.
             Targeted Areas
   Economically and medically
    disadvantaged communities
   Highest rates of HIV/AIDS in NYC
          Targeted Populations

   African -American: 25% of NYC pop; 44% of
   Latino: 27% of NYC pop; 31% of PLWHA
   Women: 30% in NYC; 18% of US PLWHA
   Reported transmission risk factors, NYC
       MSM (27%)
       Injection drug use (24%)
       Heterosexual contact (17%)
      Targeted Sub-populations
Peer workers to address needs of HIV+
populations that may face elevated barriers
health care:
   Substance use
   Mental illness
   Homelessness or instable housing
               Training Needs
   Peer trainee perspective
     Pre-training interview of applicants
     Focus groups with experienced peers

   Programmatic perspective
       Prior experience of Center with HIV and TB
        Adherence Training Programs
          HATS – Harlem Adherence to Treatment Study
          TAPAS – Tuberculosis Adherence Partnership
           Alliance Study
          PTI – Peer Training Institute
       Peer Trainee Perspective
    Identified priority needs for training in

   Roles of Peer Worker
   Working on Multidisciplinary Teams
   Communication Skills
         Stand Alone Trainings
   Three trainings for home agency peers
     Roles of Peer Worker
     Working on Multidisciplinary Teams

     Communication Skills

   Useful for marketing our program
   Useful for refining our training plan
        Peer Feedback from Prior
   In-depth sessions with experienced
    clinicians are highly valued
   Networking opportunity helps to maintain
    motivation and morale over time
   Specialized training to address specific
           Appropriate Training
   Pre and Post session “quizzes” measure
    changes in knowledge and skills
   Comprehensive course includes
    continuous participant evaluation
       Pre-training assessment
       Participatory Evaluation
       Individual anonymous evaluation at end
        Pre-training assessment
   Self assessment of:
     HIV- and peer-related knowledge
     Experience in peer skills

   Can be used as a training evaluation tool
    to assess increased confidence in
    knowledge and skills from training
        Participatory Evaluation
   Each session is evaluated by a different
    pair of trainees
   Trainee-evaluators review objectives at
    beginning of session
   Complete a short questionnaire
    summarizing group experience of the
    session at end
     Recruitment of Participants
   Using published lists, websites, staff
    knowledge we compiled lists of agencies.
   Contacted 270 ASOs/CBOs and hospitals
    in the 5 boroughs.
   Phone calls to obtain basic information on
          PACT Core Training

   6 week training
   3 mornings a week
   4 hours a day (9 a.m. – 1 p.m.)
   Adult education learning principles
   Draw on knowledge of participants
   Active learning with problem solving and
    skills practice
   Highly interactive, many small group
   Lectures - followed by hands on practice –
    case studies etc.
   Staff Trainers
   Physicians and other clinicians
   Nutritionists
   Peer Mentors
   Lawyers
   Social Workers
Organized by topic area:

   HIV/AIDS Knowledge
   Peer Role

   Communication Skills
            HIV/AIDS Knowledge
   Advanced HIV 101: HIV Transmission, HIV life cycle, Disease
    Progression, Counseling and Testing
   Care and Treatment, ART, side effects,
   STDs, OIs
   Adherence, Adherence Support and Resistance
   Mental Health
   Substance Use and Harm Reduction
   Prevention for Positives
   Clinical trials, Consumer Advisory Boards
   Complementary and Alternative Medicine
   Nutrition and HIV
   Populations: Adolescents, Women, Aging, Transgender
                  Peer Roles
   Roles and Responsibilities
   Who do You Represent?
   Boundaries and Workplace Issues
   Working as a Member of a Multidisciplinary
   Communicating with Other Providers
   Professional Standards and Confidentiality
   Benefits
   Coping with HIV: Self care, Disclosure, Stigma
         Communication Skills
   Listening Skills
   Expressing Yourself
   Conflict Management
   Cultural Competency
   Counseling Skills and Motivational
    Interviewing/Stages of Change
   Communicating Health Information
PACT Core Training
           Week One
Introduction to PACT Core Training and
Role of the Peer: Overview
HIV/AIDS: Advanced HIV 101
HIV/AIDS: Care and Treatment
            Week Two
Communication Skills: Listening

HIV/AIDS: Adherence

Role of the Peer: Boundaries
Communications Skills: Expressing Yourself
            Week Three
Communication Skills: Counseling Skills

Current Issues - Emerging Populations
Role of the Peer: Coping with
              Week Four
HIV/AIDS: Substance Use and Harm Reduction

HIV/AIDS: CAB and Clinical Trials
Communication Skills: Conflict Management
Role of the Peer: Multidisciplinary Teams
                Week Five
HIV/AIDS: Complementary/Alternative Medicine
Role of the Peer: Professional Standards
HIV/AIDS: STIs and Hep C
Communication Skills: Communicating Health
Communication Skills: Cultural Competency Skills
               Week Six
HIV/AIDS: Prevention for Positives
Role of the Peer: Benefits
HIV/AIDS: Mental Health and HIV
HIV/AIDS: Nutrition and HIV
Wrap up and Evaluation
                 Lessons learned
   Time formats
   Level I Core Training
   Stand alone trainings
   Strong need for this kind of training
   Feedback: Peers love
       practicality of training
       interweaving of themes
       mix of styles
       experts
                   The future
   Two ½ day Level I trainings
   One 2-day workshop for Level I (highlights from
    Core training)
   Fourteen Level II stand alone trainings
   Three Level II PCT Core Trainings
   Three Supervisor Workshops
   Four 3-week Preceptorships
   “Lookalike” activities
   Capacity Building for HIV peer programs
   Level III training, required to have
    completed a prior Level II training
   1-3 peers at a time
   Supervised by PACT Peer Mentors
   8 hours per week
   Checklists
                          Sample Checklist
Review with trainee following individual session with client

   Did I establish rapport in my greeting and opening conversation?
   Did I ask open-ended questions?
   Did the client speak as much or more than I did?
   Did I get information about the client’s perspective on his/her illness and treatment?
   Did I give information in response to goals, concerns, and problems that the client expressed?
   Did the client show that s/he understood the meaning of information provided?
   Did I provide too much information?
   Did I assess whether the client has adequate social support?
   Did I discuss referral needs and options with the client?
   Did we agree upon a plan of action for the immediate future?
   Did I deal with the client’s and my own emotional reactions?

Modified from: Quality Assurance Measures
for Voluntary Counseling and Testing Services
            Technical Assistance
   Work with local agencies and hospitals to
    start or improve peer programs
   Use of existing manuals:
     Peer Support for HIV Treatment Adherence: a
      Manual for Program Managers and
      Supervisors of Peer Workers, 2003
     Supervising Peer Workers in HIV Treatment
      Adherence Services: A Practical Guide in
        final revisions
   Tailored TA plan
   Training of Trainers: potential peer training
    sites to be identified from pool of area and
    national Ryan White Title I and Title II
    recipients (See notes)
   PACT core training curriculum will be
    foundation of training of trainers
          Contact Information
   PACT Project
   Harlem Hospital
   506 Lenox Avenue
   Room 3101A
   New York, NY 10037
   212-939-3922

             Health Watch