Centering the Experiences of Persons Living with HIV [Competency 4: Critical Thinking; 6: Negotiation and Conflict Resolution]
MCH Leads Health Equity Edition – In order to advance health equity for MCH populations, beginning January 2023, MCH Leads will feature trainees’ health equity-focused work. We look forward to highlighting trainees’ experiences supporting the health and well-being of vulnerable and underserved populations and communities. Also, their work assessing and addressing the underlying causes of health disparities–and their efforts to promote diversity, equity, and inclusion–ultimately improving MCH outcomes. In addition, we encourage trainees to reflect on how the MCH Leadership Competencies are applicable to their health equity-focused stories.
Kiela Karina Moreno (she/her/hers) is a second year Master of Public Health candidate at the University of Illinois at Chicago (UIC). She will be graduating from UIC in May 2023 with a concentration in Maternal and Child Health (MCH) from UIC’s Center of Excellence. She received her Bachelor in Psychology from the University of Chicago in 2020. Kiela is passionate about addressing the systemic barriers and inequities faced by the Black community through culturally respectful and comprehensive programming, and her interests specifically lie in understanding how access to reproductive and sexual health services can be improved in communities of color. Kiela currently works as a graduate assistant for UIC’s Collaboratory for Health Justice and the Chicago Fetal Infant Mortality Review (FIMR) Community Action Team. Follow Kiela on LinkedIn!
For my Applied Practicum Experience, I had the wonderful opportunity of interning with CityMatCH. CityMatCH is a national membership organization of city and county health departments’ maternal and child health (MCH) programs and leaders representing urban communities in the United States. “CityMatCH’s mission is to strengthen public health leaders and organizations to promote equity and improve the health of urban women, families, and communities” (CityMatCH, n.d.). In addition to assisting with conference planning logistics for CityMatCH’s 2022 National Conference, I spent a majority of my time engaging with CityMatCH’s Perinatal HIV Task Force.
The Perinatal HIV Task Force
“Since September 1999, CityMatCH has been one of several national organizations funded by the Centers for Disease Control and Prevention’s (CDC) National Center for HIV, STD, and TB Prevention to advance the elimination of mother-to-child transmission of HIV (EMCT) in the United States.” (CityMatCH, 2017).
As an intern for CityMatCH, one of my deliverables consisted of performing a literature review exploring current policies and gaps in knowledge around the following four topics: (1) postpartum health outcomes in states that have implemented Medicaid expansion versus states that have not, (2) existing models of HIV partner testing in the prenatal care setting, as well as successes and challenges, (3) existing guidelines and research around breastfeeding/chestfeeding for persons living with HIV, and (4) existing and projected insurance coverage for telehealth services and feasibility/acceptability of telehealth for those living with HIV. The purpose of this research was to gather current information that would inform the development of educational resources that would be integrated into an online platform for persons living with HIV known as the Roadmap Project. I had an amazing opportunity to present my work at a Task Force Summit in Washington D.C. and explain how I conducted my literature review, how to navigate this resource on DropBox, and give instructions on how other workgroup members could add resources.
[Competency 4: Critical Thinking]
Critical thinking is the ability to identify an issue or problem, frame it as a specific question, consider it from multiple perspectives, evaluate relevant information, and develop a reasoned resolution. For this competency, I specifically want to highlight the project that is being developed by a subset of individuals in the Perinatal HIV (pHIV) Task Force: the Roadmap Project. The problem that this project highlights is the current gap in resources for women/persons living with HIV (PLWH) which makes it difficult for them to identify and access quality care services throughout the life course. The goal of the Roadmap Project is to address this gap by creating a high quality and professional website that will become an easy-to-use knowledge resource for persons living with HIV in order to provide them with support and guidance on the multiple aspects of health at different points in their life course. Key components of this project include storytelling (e.g. lived experiences from those living with HIV around care), science (e.g. recommendations and guidelines to women about what care and treatment they should be receiving from their providers), and the intersection of these two components to educate on best practices when providing care to those living with HIV.
In conducting research in the four priority areas that would help inform content development for this platform and the Task Force, I was able to evaluate various sources of information, highlight successful policies that had been implemented in other cities to address challenges in these priority areas, and synthesize my findings to determine what barriers were still unaccounted for by current studies and practices.
[Competency 6: Negotiation and Conflict Resolution]
CityMatCH’s pHIV Workgroup is diverse – it not only consists of more than 40 experts within the fields of perinatal HIV, HIV, public health, medicine and research, but community members with lived experiences. During my applied practicum, I attended several workgroup meetings centered around different priority areas (e.g. behavioral health, surveillance), and I was able to understand how various perspectives could result in challenges in the ongoing implementation of identified action items. One example of conflict that I want to highlight is an instance that I encountered at the Task Force Summit. During this summit, many professionals referred to individuals who have acquired HIV perinatally as “Verticals.” As the conversation continued, one of the community members spoke up regarding this term, indicating that most of those living with HIV who had acquired this perinatally did not understand or prefer this term. I enjoyed the dialogue that occurred after, during which a team member mentioned how this term was used at a previous conference and how this terminology was common in health conferences.
From this experience, I learned how potential conflicts could arise in terminology and concepts in the interdisciplinary setting, and how these situations present a unique opportunity for us to understand different perspectives. As we embark on this journey to center the experiences of the population we hope to serve, we must prioritize their experiences and feedback.
CityMatCH. (n.d.). About Us. https://www.citymatch.org/about/
CityMatCH. (2017, March 17). Eliminating Mother to Child Transmission of HIV. https://www.citymatch.org/eliminate-perinatal-hiv-transmission/