INTERSECTIONALITY : DISASTER MANAGEMENT AND HIV GOULDA A. DOWNER, PHD, FAND, RD, LN, CNS PRINCIPAL INVESTIGATOR/PROJECT DIRECTOR HOWARD UNIVERSITY COLLEGE OF MEDICINE AUGUST 9, 2018
Test Your Knowledge
Test Your Knowledge Question #1 What percentage of American households have experienced at least 1 emergency? A. 11% B. 21 % C. 51% D. 71%
Test Your Knowledge Question #2 Of the statements below, which is correct? A. 1 in 10 Americans feel prepared for an emergency B. 2 in 10 Americans feel prepared for an emergency C. 3 in 10 Americans feel prepared for an emergency D. 4 in 10 Americans feel prepared for an emergency
Test Your Knowledge Question #3 Of the statements below, which is correct? A. Currently 29% of people with HIV in the US are virally suppressed B. Currently 49% of people with HIV in the US are virally suppressed C. Currently 69% of people with HIV in the US are virally suppressed D. Currently 89% of people with HIV in the US are virally suppressed
Test Your Knowledge Question #4 In your opinion, which of the following is the most effective step to disaster continuity of care ? A. Pre-disaster planning B. Post-disaster planning C. Planning during a disaster D. All of the above
US - From 1980–2016 203 weather and climate disasters Exceeded $1 Billion each Ø 23 drought events Ø 26 floods Ø 7 freeze events Ø 83 severe storms Ø 34 tropical cyclones Ø 13 wildfires Ø 14 winter storms
US – 2017 Temperatures 2017- Third-warmest year on record for the globe 2016 - First 2015- Second https://www.ametsoc.org/ams/index.cfm/publications/bulletin-of-the-american-meteorological-society-bams/state-of-the-climate/
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DID YOU KNOW? Ø About 54 percent of Americans don't prepare Ø Only 1 in 10 American households - appropriate preparedness steps. Ø About 82 percent of Americans - “I’d do it.” Ø About 51 percent of Americans have experienced at least one emergency Ø Only 2 in 10 Americans feel prepared Ø Close to 60 percent of Americans are unprepared
WHY FOCUS ON HIV NEEDS IN EMERGENCY/DISASTER SITUATIONS
HIV - FAST FACTS Ø More than 1.1 million people in the U.S. are living with HIV today. Ø % of people infected with HIV who do not know it: 14%. Ø An estimated 38,500 Americans became newly infected with HIV in 2015. Ø HIV diagnoses are not evenly distributed across states and regions. Ø People in southern states accounted for more than half of new HIV diagnoses in 2016, while making up 38% of the nation’s population. Ø % of people with HIV who are virally suppressed: 49% https://www.hiv.gov/hiv-basics/overview/data-and-trends/statistics https://www.kff.org/hivaids/fact-sheet/the-hivaids-epidemic-in-the-united-states-the-basics
RATES OF HIV DIAGNOSES AMONG ADUL TS AND ADOLESCENTS IN THE US BY ST ATE, 2016 HIV Diagnoses, by Race/Ethnicity, Region, and State The rates (per 100,000 people) of HIV diagnoses in 2016 were 16.8 in the South, 11.2 in the Northeast, 10.2 in the West, and 7.5 in the Midwest. https://www.cdc.gov/hiv/statistics/overview/geographicdistribution.html
10 states reporting the highest number of HIV diagnoses in 2016 Number of Diagnoses of HIV Infection, 2016 State/Dependent Area California 4,972 Florida 4,957 Texas 4,472 New York 2,877 Georgia 2,716 North Carolina 1,414 Illinois 1,391 Louisiana 1,153 Pennsylvania 1,152 New Jersey 1,146 https://www.cdc.gov/hiv/statistics/overview/index.html
http://kff.org/hivaids/fact-sheet/
THE CLINICIAN’S ROLE: Adaptations to Practice
PHYSICIANS’ OBLIGATION IN DISASTER PREPAREDNESS & RESPONSE Because of their commitment to care for the sick and injured, individual physicians have an obligation to provide urgent medical care during disasters. • https://www.ama-assn.org/delivering-care/physicians- responsibilities-disaster-response-preparedness
Adaptations to Practice Plan with your patients Ø What help is likely to be needed during a disaster Who can provide that help Ø What resources are available and Ø where to access them
Adaptations to Practice Step 1: Get Ready Step 2: Evacuate when instructed Step 3: The 6 M(s) Ø Make a plan Ø Medication (s) Ø Medical History Ø Meals Ø Money Ø Mementos & Memorabilia Adapted from www.dshs.texas.gov/hivstd/meds/disaster.shtm
STEP 1: GET READY Encourage Patients to: Ø Keep prescriptions up-to-date. Ø Keep copies of helpful medical information you have provided to them and take it with them should they need to evacuate. Ø Keep track of approaching storms via weather forecasts, and be sure to refill prescriptions a few days before a storm arrives; do not wait until the last minute! Ø Build a kit - resources are available on Ready.gov , an official website of the Department of Homeland Security. https://www.ready.gov/build-a-kit
STEP 2: EVACUATE WHEN INSTRUCTED Encourage Patients to take: Ø All medications in their original bottles (with labels attached). Ø A back up list of all current medications and their dosages (use the Hurricane Preparedness form (PDF : 327 kB)). Ø Useful medical information. Ø The name of the clinic along with your name and phone number.
STEP 2: EVACUATE WHEN INSTRUCTED Encourage Patients to take: Ø All medical and insurance cards. Ø Picture identification, Social Security card and any important legal papers. Ø Medical equipment and supplies (dentures, glucometers & strips, nebulizers, and crutches). Ø Personal hygiene items.
Step 3: The Six M(s) Encourage Patients to: Ø Make a plan Ø Medication (s) Ø Medical History Ø Meals Ø Money Ø Mementos & Memorabilia
HIV EMERGENCY PREPAREDNESS Clinicians Inform Patients that: Ø If HIV medications are running out, do not skip doses to stretch them out. Ø Get refills as soon as possible! Ø Should you run out of one of your HIV medications – stop taking all of your HIV medication until you are able to get refills. Ø Taking incomplete doses of your HIV regimen could lead to therapy complications later
HIV EMERGENCY PREPAREDNESS Ø Encourage patients to think ahead, have a plan and be prepared. Ø Keep the Disaster Distress Helpline number handy (1-800-985-5990 or text "TalkWithUs" to 66746). Ø Provided by the Substance Abuse and Mental Health Services Administration this helpline provides immediate crisis counseling for individuals who experience emotional distress following a disasters.
HIV EMERGENCY PREPAREDNESS Preparedness is a culture that should be embraced by everyone regardless of the condition of their health. Preparedness means doing what is necessary before an emergency or disaster occurs.
HIV EMERGENCY PREPAREDNESS Emergency preparedness should be integrated into patients’ care plan. Efforts to prevent new HIV transmission and support for those already affected is a disaster response. An infectious disease threat anywhere can be a threat everywhere
Test Your Knowledge
Test Your Knowledge Question #5 What percentage of American households have experienced at least 1 emergency? A. 11% B. 21 % C. 51% D. 71%
Test Your Knowledge Question #6 Of the statements below, which is correct? A. 1 in 10 Americans feel prepared for an emergency B. 2 in 10 Americans feel prepared for an emergency C. 3 in 10 Americans feel prepared for an emergency D. 4 in 10 Americans feel prepared for an emergency
Test Your Knowledge Question #7 Of the statements below, which is correct? A. Currently 29% of people with HIV in the US are virally suppressed B. Currently 49% of people with HIV in the US are virally suppressed C. Currently 69% of people with HIV in the US are virally suppressed D. Currently 89% of people with HIV in the US are virally suppressed
Test Your Knowledge Question #8 In your opinion, which of the following is the most effective step to disaster continuity of care ? A. Pre-disaster planning B. Post-disaster planning C. Planning during a disaster D. All of the above
COLLEGE/UNDERSERVED COMMUNITY PARTNERSHIP PROGRAM (CUPP) Michael W. Burns Senior Advisor to the Regional Administrator/ Director of CUPP Program Environmental Protection Agency (Region 4)
COLLEGE/UNDERSERVED COMMUNITY PARTNERSHIP PROGRAM (CUPP) BACKGROUND Met In Hayneville, AL • Limitations on small communities seeking funding; lack of technical support • Detail created in August 2011 to explore extent of the issue, and possible • solution • HOW IT WORKS – COLLEGE/UNDERSERVED COMMUNITY PARTNERSHIP PROGRAM • Communities are identified for support by federal agencies; colleges and universities; or self identified, based on criteria • Issues are identified by the CUPP Program in partnership with the community • Local university is identified that can assist the community via CUPP • Universities agree to which issues they will provide voluntary assistance, and assign the students to assist in providing the technical assistance Each participating school arraigns for academic credits to be earned by • these students for their efforts The federal government (project manager) will coordinate technical • assistance to the schools to assist them in helping communities as needed
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