The CDC NPIN Featured Partner resource offers HIV/AIDS, viral hepatitis, STD, and TB prevention-focused organizations a platform to showcase their services, programs, and materials. Our goal is to highlight the work of CDC's prevention partners and encourage partners to connect with each other to share information and strategies. Organizations are nominated by CDC or their peers, or are self-nominated. Those selected are featured on the NPIN Web site for the month.
Positive Impact's mission is to eliminate the risk of HIV transmission and empower those affected by HIV through culturally competent and inclusive prevention, education, mental health, and substance abuse treatment services. Positive Impact is a nonprofit, community-based organization incorporated in 1992. Its prevention services include HIV testing, STI screening, risk counseling, linkage to care, navigation and support services, and community outreach. It also offers behavioral health care, including mental health counseling, psychiatric services, and outpatient substance abuse treatment. In addition, Positive Impact provides trainings for community partners and clients, housing services, and mental health and prevention case management services.
CDC funds Positive Impact to provide prevention services and two behavioral interventions: CLEAR (Choosing Life: Empowerment! Action! Results!), a one-on-one intensive risk reduction counseling program; and Personalized Cognitive Counseling, an individual-level intervention targeting high-risk individuals.
Positive Impact has a documented history of addressing health disparities, especially among at-risk populations such as the homeless, men who have sex with men (MSM), racial and ethnic minority clients, sexual minority clients, high-risk women of color, and heterosexual minority men. The Georgia State Community Planning Group has identified the greatest-need populations in Georgia to be HIV-positive persons; black, Hispanic, and white MSM; and black heterosexual women. Positive Impact serves all of these core populations and works to minimize and eliminate disparities.
Positive Impact also offers housing assistance, intensive prevention case management, and HIV prevention counseling opportunities. Positive Impact offers all its services in one location for the convenience of clients and has plans to begin implementation of primary HIV care onsite to provide a complete continuum of co-located services for HIV-positive individuals.
The United Way recognized Positive Impact's commitment to cultural competency when it awarded the agency its Valuing Diversity Award in 2006. The agency facilitates an annual 2-day cultural diversity workshop for professionals in the community who service clients affected by HIV in some capacity.
Positive Impact focuses on risk behavior characteristics across a range of populations. The agency learned a significant lesson years ago through its prevention program—the target focus needs to be on the risk associated with HIV transmission and not on a generalized physical or demographic characteristic. In Positive Impact's model, for example, rather than targeting all young MSM of color, it only focuses on those young MSM of color who are engaging in unprotected anal sex or sharing works, thereby alleviating pressure on its limited financial and human resources while achieving a greater reach into the population that needs the risk reduction services.
Positive Impact's prevention program is marketed in the community as the MISTER Center. The MISTER Center houses the HIV testing program; the STI screening and treatment program; the health and wellness program, which provides linkage to HIV care, as well as client navigation and support services; and the risk counseling program. The programs focus on gay, bisexual, and other MSM, with one focusing specifically on racial and ethnic minority men.
The MISTER Center takes a sex-positive, risk-reduction approach to the work of lowering HIV transmission rates, grounded in sound theoretical principles that merge behavioral health and public health and utilize a strengths-based model. The sex-positive approach enables agency staff to address potential risk behaviors without judgment or making decisions on the client's behalf. The risk-reduction approach enables staff to effect staged behavior changes rather than an unrealistic expectation of total behavior change. The theoretical foundations utilized (primarily transtheoretical/stages of change and cognitive-behavioral), when combined with a client-centered strengths-based approach, meets the client at their present risk level and helps them make at least one step forward to safer behaviors. This leads Positive Impact to a better understanding of why clients make the choices (both healthy and not healthy) that they do.
Positive Impact's MISTER Center has provided no-cost rapid HIV testing in metropolitan Atlanta since 2008; during this time, the agency has provided testing both onsite as well as off-site at various venues. Positive Impact has created three unique service delivery elements during the past 5 years:
- Instead of hiring phlebotomists to draw blood for confirmatory HIV testing and additional screenings such as syphilis, the agency provided support for HIV test counselors to attend phlebotomy training. Now, all the agency's HIV test counselors are certified phlebotomy technicians and can conduct blood draws for testing and screening.
- The Fulton County Department of Health and Wellness struggled with getting clients eager to engage in Partner Services. Positive Impact made an agreement with the health department to provide Partner Services onsite at the agency. Prior to this time, approximately 60–70% of newly diagnosed HIV-positive clients agreed to participate in Partner Services. Today, by having health department staff see the client at Positive Impact, that participation rate has increased to more than 90%.
- Clients at highest risk of HIV transmission and who need routine HIV testing can enroll in a free texting service to receive reminders when it's time for their next HIV test 3 or 6 months from the last test day. The agency offers HIV testing days, evenings, and weekends, as well as testing at local bars and sex clubs to make the service as accessible and convenient as possible.
Positive Impact started in 2008 by testing several hundred individuals, with a 2% positive rate. Throughout the past 5 years, the agency has continued to expand services annually, including the number of clients served. During 2013, the MISTER Center staff conducted more than 4,600 HIV tests and identified 239 new cases of HIV (a 6.2% positivity rate). During that same time, the agency conducted 947 screens for syphilis, gonorrhea, and chlamydia, with 77 new cases of at least one STI identified (an 8% positivity rate). Positive Impact anticipates this trend will continue in 2014.