In this video, the director of the 360 Positive Care Center at UCSF talks about the challenges of providing care and the success of the center's Men of Color Program.
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When I came here to Sans Francisco 10 years ago, I notice that there was no specific clinical space that was specifically geared towards African-Americans. Yet in the city like of the nation African-Americans were disproportionally affected with HIV. We have on our floor a partner group, a woman's clinic I was seeing a lot of African-American women; I wanted to start an African-American men's program. And we did that and over the years we have been able to recruit and retain patients in care who had not had a successful relationship. And in fact our retention or rather our last follow up grade is about 3%. And here in the city funded programs 12%, or 14% is sort of standard or acceptable. So we have actually had a high retention rate. Now why is that part of it is, I think it does help to have the sort of multicultural or ethnic staff that's well trained in culture competencies. So yes we have an African-American Case manager who is a primary contact. But we also have Caucasian woman who is a main case manager. Well the point is they are all well-versed culture competency. The other piece is the the multidisciplinary approach. So having the ability to have nurses, nurse practitioners physicians dietitian, pharmacist, we have a psychiatrist; and so far all around the table discussing a case and saying each of us contributing to the overall management plan identifying which of us have the best relationship with that patient. And using that trust, which is often through peer advocates, or case managers. But it can't be through the pharmacist, or nutritionist, or the physician to share to transfer that trust to the other providers. Meaning if the patient really connects with me, I would introduce them to the nutritionist; and say here is someone you should see now, even while you are healthy. Alright so that you don't lose weight and get sick later as oppose to now see them when I am really sick. Because they don't understand what that job is about why do I - that distrustful of people. So I think that that's why we've been successful at least some part. One of the things I'll say upfront is that they have shown that providers who are not African-Americans sometimes underprescribed to African-Americans. And I think part of that is just having a discourse with African-Americans in a manner that acknowledges the challenges of being positive, of being positive African American, in the African American community that doesn't really support or acknowledge much HIV; or certainly address populations for HIV. And to explain fully what the potential side effects are, and how you might work with the patient to prevent that. I think really just patients are really respective to information more than I think is appreciated. But the other piece is really cultural competency getting people who look like the patients among your staff and providers makes a difference. I think establishing a presence in the community whether its through health fairs, or reaching out to community groups, whether its churches which can sometimes be challenging in different areas, or other business that support HIV care, just to create a presence in the community that people start to establish your trust. Here in Sans Francisco one of the most trusted providers as a tall Caucasian male. It doesn't have to be that of you are person of color, to provide that down at Southeast Community Health Center. It's just being in that neighborhood, being very straight shooter when it comes to care, and I think people appreciate that.
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