Harlem United Community AIDS Center – New York, NY
As part of the HOME department’s Support Services unit, the PrEP Health Educator/Navigator will be responsible for the successful linkage to PrEP treatment at Harlem United’s primary care clinic, of all High-Risk YMSM and YTG youth of color in the HOME program and those identified through targeted outreach services. The position will serve as key liaison between program and the primary care clinic, responsible for maintaining client flow and follow-up engagements through PrEP treatment. Additionally, the PrEP Health Educator/Navigator is responsible for identifying client needs that may prevent adherence to treatment through connections to other support services (i.e., housing, mental health, etc.). In support of program enrollment, the PrEP Health Educator/Navigator is also responsible for conducting targeted outreach to identify potential candidate in need of PrEP treatment. Working as part of an interdisciplinary team, the PrEP Health Educator/Navigator will provide assistance to clients through escorts, education, and supportive counseling. He/she will screen clients seeking services for eligibility, provide escorts to appointments, and program record-keeping. Under the supervision of the Program Coordinator, he/she will be responsible for assisting peer-led case finding activities and provide navigation services to ensure successful outcomes to care.
PrEP Health Educator Navigator
Essential Job Functions
The following duties are mandatory requirements of the HOME PrEP Health Educator/Navigator:
- Work to link high-risk YMSM and Young Transgender to PrEP treatment at Harlem United’s primary care clinic.
- Required to interface with primary care team, learn and support clinic flows, and engage with clinical team to address any barrier/challenges that reduce access to care.
- Conduct preliminary interviews/screening for program to assess client’s immediate needs, including medical, housing, insurance, mental health and other supportive services.
- Accompany client to appointments to each PrEP medical encounter; provide case finding activities to identify new clients, and locating clients to ensure program participants are accessing of services.
- Coordinate medical appointment for all individuals. Coordinate escort services to ensure client attendance at initial PrEP, and during subsequent follow-up appointments. Refer clients to case management, mental health and other support services as required by client.
- Engage clients in PrEP, PEP, and HIV education including health education/risk reduction planning and supportive counseling.
- Facilitate a biweekly educational support group on PrEP for HOME participants.
Other Responsibilities
The following duties are to be performed as assigned by the supervisor:
- Assist PrEP program development and operations for the HOME department.
- Assist in administrative work. Monitor completion of forms, records, and documentation.
- Coordinate clients and programmatic related activates with internal and external service providers.
- Advocate on behalf of the client to ensure that they receive all necessary services.
- Conduct service delivery entry into AIRS database
- Perform other duties as assigned.
Education and Certification
A minimum of a Bachelor’s degree or commensurate work experience of five years working in HIV prevention programming is required. NY state driver’s license. Experience working with Gay and Transgender youth of color. Knowledgeable about LGBT, HIV infection, transmission, treatment, risk reduction, and sexuality issues; knowledgeable in local, state, and federal laws regarding HIV and other relevant issues of providing health care, especially the right to privacy and confidentiality.
Special Skills and Knowledge
In addition to the above-listed job responsibilities and educational requirements, the ideal candidate for this position possesses most or all of the following:
- Valid Driver’s License is required or will be acquired within 90 day probationary period.
- History of working with Gay and Transgender youth of color.
- Able to provide culturally competent services and demonstrate respect for the community to be served by our program.
- Ability to pay attention to details, with strong organizational skills.
- Knowledgeable about LGBT, HIV infection, transmission, treatment, risk reduction, and sexuality issues; knowledgeable in local, state, and federal laws regarding HIV and other relevant issues of providing health care, especially the right to privacy and confidentiality.
- Excellent verbal and written communication skills.
- Bilingual in Spanish or French is preferred.
Harlem United is an Equal Employment Provider. To apply, please email resume and cover letter to Expedito Aponte at eaponte@harlemunited.org
Promise of PrEP: A Local Perspective.
Let’s Start with the basics: What exactly IS PrEP?
PrEP stands for Pre-Exposure Prophylaxis and is an HIV-prevention method in which people who do not have HIV can take a pill daily to reduce their risk of becoming infected. The treatment named Truvada© contains two of the medications that can be used to treat people who already have HIV. The FDA approved this treatment in July 2012 as PrEP after large-scale clinical trials showed that it was effective.
But wait, isn’t there a treatment called PEP? Is it different?
There is! PEP stands for post-exposure prophylaxis and can be used in emergencies when you think you have been exposed to HIV. It’s similar in that they are both used as prevention interventions, but one is before and the other is after.
Does PrEP Work?
Studies have shown that PrEP provides a high-level of protection against getting HIV for gay and bisexual men, heterosexual men and women, transgendered women and injection drug users IF the daily medication is taken consistently. In fact, the FDA approval was based on three clinical trials, two of which showed that Truvada worked to reduce HIV by upwards of 90 percent when taken as prescribed.
The Centers for Disease Control and Prevention has issued guidance on PrEP and recommends that PrEP be used in combination with condoms and other recommended risk-reduction practices. Just last month, our very own New York State Department of Health AIDS Institute issued its guidance for the use of PrEP to prevent HIV transmission – again emphasizing that PrEP should not be offered as a sole intervention for HIV prevention.
So wait … are people taking advantage of PrEP? Why aren’t more people talking about it?
That’s a great question! I don’t know. Folks in the HIV prevention community are excited and optimistic, but the uptake of PrEP has been slow. This might be partially due to the fact that PrEP has not been widely advertised.
Also, let’s be real: PrEP is not a panacea for HIV. It really can’t replace all other HIV prevention. It needs to be combined with other prevention, and it’s really for the super high risk – those for whom traditional HIV prevention is not currently working.
Finally, adherence is critical. Before we shout PrEP from the mountaintop, we need to make sure we have the programs and supports in place to help folks who need and can access PrEP adhere to it. It will only work if you take it.
What is PrEP? from Pre-Exposure Prophylaxis on Vimeo.
Speaking of access, how can you get it and how much does it cost?
Theoretically, you can access PrEP from your primary care physician, but that’s another barrier we recognize. Many physicians are not yet familiar with the protocols on PrEP. We’re hoping the NYS guidance will help with this. Also, PrEP is not cheap. The monthly cost of Truvada can be more than $1,000. With some pushing, most insurance providers will cover Truvada as PrEP. The PrEP user would need to pay their co-pay. Because New York State is so progressive, our Medicaid formulary covers PrEP. Gilead also has a program for those without health insurance. You could call 1-800-505-6986 or visit www.gilead.com/prep to get more information.
Question: Who Should Consider PrEP?
PrEP has been approved for HIV-negative adults (over 18 years old) who are at high-risk for HIV infection through sexual contact. It’s recommended for HIV negative men who have sex with men (i.e. gay, bisexual and transgendered); HIV negative heterosexual men and women who are in a relationship with an HIV-positive partner and active intravenous drug users who are HIV negative. If you have unprotected anal sex or have multiple partners or you are negative and your partner is positive or you don’t use condoms or you have a history of STI or you inject drugs without clean needles or you engage in sex work … you might consider PrEP.
Are you administering PrEP at Harlem United? What’s Harlem United’s plan for PrEP?
I am not a doctor, so I am not administering anything. Our Chief Medical Officer, Dr. Bookhardt-Murray, reports that she’s really only made one prescription for PrEP in the last year or so. But we are getting ready! Harlem United is optimistic about the promise of PrEP as yet another powerful prevention intervention for the HIV prevention toolkit. We are working at the programmatic, operational, clinical and policy level to make sure PrEP can be available for those who need it in our community. In addition, we are partnering with a handful of academic and research institutions to create studies that will be able to tell us more about how PrEP should and could be “rolled out” in the real world. Right now, we don’t have enough experience to know what really works, but we will learn.
Because we are at the forefront, Harlem United convenes a citywide PrEP for NYC Task Force that is grappling with all of these very issues. If you are interested, you can email me a ksmith@harlemunited.org to get more information.
We are working really hard at Harlem United to make sure to “do PrEP” right and take things like adherence and safety seriously. There are a lot of challenges. Many compare PrEP to oral contraception. Oral contraception – or the pill – survived a decade of controversy about its safety, cost, impact on risk behavior and society, and acceptability to become an essential part of daily life for many women. So, too, should be the fate of PrEP. With the communities we serve bearing so much of the burden of the HIV epidemic, PrEP represents an opportunity we cannot afford to waste.
For more information on Harlem United and PrEP, download our recent report:
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