PROJECT ABSTRACT

The border between the United States and Mexico extends for almost 2,000 miles from the Gulf of Mexico in the East to the Pacific Ocean in the west. The border region is 100 kilometers (62 miles) deep on either side of the border. The Texas border comprises roughly half of the United States – Mexico border, is defined by the Rio Grande River and meanders for 1,254 miles on a path from El Paso-Ciudad Juarez to Brownsville-Matamoros. Border residents fare poorly in comparison to the rest of Texas residents and their fellow Americans experiencing a significantly higher rate of poverty, infection, and disease. More poor residents live in the Texas border region than in at least ten other states and the District of Columbia combined. Struggles of daily survival outweigh the ability to plan for the future as well as take preventive measures to ensure good physical and emotional health and well being. Seventy-three percent of the population is Hispanic and more than half lack health insurance. Providers of health and social services face tremendous challenges in addressing the basic health care needs of the population – much less the needs of under served populations with HIV.

The goals of the Juntos Project are designed to: 1) To Increase Access To Locally Delivered Primary Health Care For Persons Living With HIV In The Lower Rio Grande Valley Of The U.S. – Texas – Mexico Border and 2) To Organize Health Care Networks With Capacity To Provide a Comprehensive Array Of Health And Enabling Services To Persons Living With HIV Along The U.S. – Texas – Mexico Border. The partner agencies are the Valley AIDS Council, Brownsville Community Health Center, Nuestra. The centers are all major providers of primary health care to medically under served populations in the target area.

The Juntos Project Model will designate a physician and nurse (clinical care coordinator) at each of the community health centers to serve as the local point of entry for newly identified cases of persons with HIV/AIDS seeking local medical care. Nurses will be located at each center to coordinate care and referrals across the partner agencies. The Juntos clinical staff will also provide HIV primary health care to existing persons with HIV disease that chose to access the community health centers’ services closer to where they live where capacity to provide this care has previously been limited. Clinical staff will have extensive training regarding the provision of quality and culturally competent HIV primary health care. The Valley AIDS Council will provide full case management services to all clients.

Project evaluation will include a mix of quantitative and qualitative methods required to appropriately assess project outcomes and longer term project effects. The evaluation will be participatory in nature and involve stakeholders in the conceptualization, development and implementation of measures and indicators required for the evaluation. The CDC’s Framework for Evaluating Public Health Programs will be utilized to guide all aspects of evaluation activities. Findings and lessons learned from project activities will be disseminated and tailored to the needs and potential uses of identified target audiences including providers of health and social services, policy makers, planning bodies, and the general public.

 Clinica del Valle, and United Medical Centers of Eagle Pass. The centers are all major providers of primary health care to medically under served populations in the target area.