Abstract
Background:
Baltimore is an urban center that has been highly impacted by HIV and hepatitis C virus (HCV), however, many individuals are unaware of their infections. In 2013, the Johns Hopkins Center for AIDS Research developed Generation Tomorrow, an HIV and HCV education, testing, and counseling program with community input and collaboration.
Objectives:
The aims of Generation Tomorrow are to increase HIV and HCV awareness/detection in Baltimore and engage the next generation of health professionals (students) and community members (peers) in HIV and HCV outreach services.
Methods:
The Generation Tomorrow educational component includes formal HIV and HCV testing and counseling training and a lecture series for students and community members after which the participants engage in field assignments and outreach events with Johns Hopkins associated programs or community-based organizations.
Results:
Generation Tomorrow trained 71 students and peers in three cohorts, 70% of whom reported that they planned to stay in HIV and/or HCV related work. From October 2014-May 2015, which represents the first year that Generation Tomorrow ran with the full academic calendar, Generation Tomorrow students and peers worked with partner organizations to conduct 1,104 HIV rapid antibody tests and found 19 (1.72%) individuals to be HIV positive. Additionally, 778 HCV rapid antibody tests were conducted and 175 (22.5%) individuals were HCV antibody positive.
Conclusions:
Generation Tomorrow has been successful in engaging students and community peers in HIV and HCV education, testing, and counseling and has documented HIV and HCV positivity rates well above general community prevalence.
Introduction
The Centers for Disease Control and Prevention estimates that 1.2 million individuals are living with HIV infection and approximately 2.7–3.9 million are chronically infected with hepatitis C virus (HCV) in the United States.(1, 2) Baltimore is an urban center that has been highly impacted by both HIV/AIDS and HCV due in part to high rates of injection drug use.(3) The Baltimore-Columbia-Towson metropolitan area prevalence of diagnosed HIV infection was 678.5 per 100,000 population at the end of 2013 which was the tenth highest of any metropolitan area in the United States.(4) Additionally, it is estimated that 14% of HIV infected individuals in Baltimore remain undiagnosed and that of those diagnosed, 34% have not been linked to HIV care.(5) With respect to HCV, estimates suggest that 50–80% of HCV infected individuals remain undiagnosed and fewer than 20% of those diagnosed have been linked to care.(6–8) With excellent treatments available for HIV and with cure possible for HCV with all oral agents, these data signify the need to develop mechanisms to successfully identify patients infected with HIV and/or HCV and link them to care. The framework to engage individuals in HIV and/or HCV care is described by the care continuum which includes testing, linkage to and retention in care, treatment, and viral suppression/sustained virologic response (SVR).(9, 10) The National HIV/AIDS Strategy and the US Action Plan for the Prevention, Care, and Treatment of Viral Hepatitis call for improvements in the HIV and HCV care continuums respectively in order to combat the epidemic of HIV and HCV by treating individuals and decreasing viral transmission.(11, 12) The initial entry into the HIV and/or HCV care continuum involves testing which has become a key focus area nationally and locally in Baltimore. The Johns Hopkins Center for AIDS Research (CFAR) recognized the need for testing support across Baltimore and in the fall of 2013 established Generation Tomorrow, an HIV and HCV education, testing, and counseling program for students and community members with community input. The program aims to increase HIV and HCV testing in at-risk populations in collaboration with Johns Hopkins associated programs and community partners.(13) This paper describes the development of Generation Tomorrow along with program data from October 2013-May 2015.
Methods
Program Development
The Johns Hopkins Center for AIDS Research
The Johns Hopkins CFAR promotes high priority research, transdisciplinary innovation, integration, and collaboration on HIV and its related co-infections across the university. Additionally, the CFAR aims to develop a new generation of HIV/AIDS researchers, recruit under-represented minorities into the HIV/AIDS field, and mobilize the capabilities and capacity of Johns Hopkins University to combat the HIV epidemic in Baltimore through training, outreach, and community-based intervention studies.
The Establishment of Generation Tomorrow
Generation Tomorrow was launched in October 2013 by the Johns Hopkins CFAR with community input and collaboration. It was designed to be a unique training and field experience for Johns Hopkins University students and community-based health workers (known as peers) with the aim of increasing awareness and detection of HIV and HCV infections in Baltimore. It is the only student outreach opportunity at Johns Hopkins with a focus on both HIV and HCV. CFAR program leadership met with Johns Hopkins HIV and HCV clinical, research, and outreach programs and community-based organizations to get input on the development of Generation Tomorrow and the essential components needed to build an education and training program focused on HIV and HCV. It was agreed that the philosophy of the program would be to train students and peers to offer non-judgmental, compassionate, and culturally competent care and to foster positive interactions in the community. With this underlying philosophy, the following aims and training components were established for the program. The program was deemed exempt by the Johns Hopkins University School of Medicine Institutional Review Board.
Program Aims
The established program aims are as follows:
To increase awareness and detection of undiagnosed HIV infection in at-risk populations in Baltimore;
To increase awareness and detection of undiagnosed HCV infection in at-risk populations in Baltimore;
To engage and involve the next generation of health professionals in HIV and HCV work by training and deploying them to conduct HIV and HCV counseling, testing and outreach services; and
To increase participation of community members in HIV and HCV outreach services by training and deploying them to conduct outreach as peers.
Program Components
Recruitment and Selection of Students & Peers
Generation Tomorrow recruits students through networks in the Johns Hopkins University medical institutions, specifically the schools of public health, nursing, and medicine. The training opportunity is also promoted to the Hopkins undergraduate campus, specifically in the Krieger School of Arts & Sciences as well as through our partner agencies. Peers are recruited through community outreach to community-based organizations and online advertisements placed on the Generation Tomorrow website. While not a requirement, Generation Tomorrow program leadership encourages applications from peers that have extensive knowledge about Baltimore and that live in the east Baltimore community surrounding the Johns Hopkins campus. Participants are selected after submitting resumes, program applications and undergoing an interview process with program leaders. The goal of the interview process is to identify students and peers that have an interest in learning more about HIV and HCV and who will also serve as positive ambassadors in the Baltimore community. The current program is designed to encompass the academic school year in order to provide students and peers with a more in-depth experience at their partner agency. This is based on partner feedback in 2014 and is reflected in Cohort 3, which participated from October 2014 to May 2015. Previous cohorts took place from October 2013 to January 2014 (Cohort 1) and February 2014 to April 2014 (cohort 2).
Training Overview
Each cohort of Generation Tomorrow program participants underwent mandatory training in HIV and HCV counseling and testing at the beginning of their program period. The HIV training consisted of a two-day Level 1 HIV Counseling and Testing training through the Maryland Department of Health and Mental Hygiene. The HCV training consisted of a one-day HCV counseling and testing training conducted by the California based Hepatitis C Support Project or by The Johns Hopkins Division of Infectious Diseases/Sisters Together and Reaching, (STAR) Inc., a local community-based organization that has participated in the development of Generation Tomorrow. After the trainings, participants received testing/counseling certifications. The participants also received additional hands-on training with supervisors at their field assignments before engaging in HIV and HCV education, testing, and counseling at their field assignment site.
Lecture Series
During the 2014–15 academic year, the Generation Tomorrow lecture series was comprised of 20 lecturers that conducted a total of 14 presentations. Guest lecturers included leaders from the CFAR, health professionals from Baltimore City, and other content experts. Meeting over lunch, the lectures discussed the latest trends in HIV and HCV prevention, testing and treatment. The goal of the lecture series was to provide additional knowledge about the complex relationship between HIV and/or HCV in Baltimore communities and the social determinants of health and to also provide a curriculum that would promote non-judgmental, compassionate, and culturally competent care. Lecture topics included are as follows: HIV Treatment and the Cascade of Care, HIV and HCV Social Marketing Campaigns, Civic Engagement and Service Learning in Baltimore City, Hepatitis C in Baltimore: Progress & Challenges, Transgender Health in Baltimore & the Fenway Health Guide to LGBT Sensitization, Hot Safer Sex, Through an Ethnographic Lens: the HIV Risk Environment of Exotic Dance Clubs, An Overview of HIV Prevention Work at the Lighthouse, STAR TRACK: Adolescent HIV Prevention Services in Baltimore, Connect to Protect: A Model to Enhance Structural HIV Outreach Efforts among Baltimore Youth, Diverse Responses to Hepatitis C: Notes from the BCHD STD Clinics, Opioid Overdose Response Training, Mr. Friendly and Other Community-Based Anti-HIV Stigma Efforts in the Baltimore Leather Community, and Public Speaking 101.
Field Assignments
Generation Tomorrow leadership publicizes the opportunity to become a partner site (JHU-associated program or community-based organization) at the beginning of each program term and selects sites after an application review process and an in-person meeting to discuss program components. Each partner site signs an agreement which explains the aims of Generation Tomorrow and site expectations for the students/peers. Generation Tomorrow program participants are matched with our partner agencies based on their interests, schedules, and the particular needs of the agency. Students and peers perform a variety of tasks during their field assignments including outreach and recruitment, curriculum development, educational outreach, HIV and HCV testing, HIV and HCV counseling, event planning, and social marketing. Students are expected to average 3–10 hours of work per week at their field assignment site depending on their schedules. Peer community health workers are allowed to work up to 20 hours per week during the academic year and sites can specifically request a peer. Both students and peers are paid for their work hours. Partner sites are also eligible to receive financial support from Generation Tomorrow in the form of project support and HIV and HCV antibody test kits.
Special Events
In addition to field assignments, Generation Tomorrow students and peers have supported outreach initiatives in Baltimore that encouraged HIV and/or HCV testing and linkage to care. Generation Tomorrow program leaders acted as the organizational leads for most of the community outreach events, but all were implemented in collaboration with community and university partners. Appendix A provides information on the special outreach events.
Program Data
The Generation Tomorrow participant application collects demographic information as well as information on prior HIV and HCV experiences. Program partners also submit an application which includes information about their organization. During the field experience, Generation Tomorrow partners are asked to report the total number of HIV and HCV antibody tests conducted along with the number of positive tests and are additionally asked to submit information on highlights from their field experience. During the 2014–2015 academic year (Cohort 3), post program brief written surveys were conducted which inquired about aspects of the program that the participants enjoyed the most or least. In addition, open space was left on the post-program survey for participants to leave any quotes or comments. Generation Tomorrow leadership also obtained additional program reflections from the discussions during lecture series as well as in close-out meetings/interviews with leadership from partner agencies.
Statistical Analysis
Descriptive statistics were used to characterize the students and peers in Generation Tomorrow by demographic information and previous HIV and HCV experience.
Results
There were a total of 137 applicants including students and peers for years 1 and 2 of the program and 71 participants (61 students and 10 peers) were accepted for the training program (Table 1) based on the application and interview process. The total number of slots for the program were dictated by training capacity and partner needs. The average student age for cohorts 1–3 was 25 years and the group was overwhelmingly female. The racial breakdown of the students is as follows: 32% Asian, 30% Black/African-American, 10% Other/Mixed, 2% Hispanic, and 26% White. Among peer health workers, the average age was 27.5 years and they were equally split between males and females. The vast majority of peer health workers were Black/African-American. Program leadership accepted participants with a range of experience in HIV and HCV. 54% of students reported previous HIV experience but only 26% reported any previous HCV experience. 60% of community peer health workers reported previous experience in HIV and HCV. Participants in all three cohorts boasted impressive credentials with many having advanced degrees in addition to their current undergraduate or graduate curriculum including 1 dentist, 6 phlebotomists, 12 credentialed medical officers, 3 registered nurses, and 5 students earning PhDs or in medical school. Additionally, the peer community health workers included individuals personally impacted by HIV and HCV and with a wide range of interest including a harm reduction specialist and a young woman looking for a new skill set with which she could make an impact on her community.
Table 1.
Demographic Characteristics of Generation Tomorrow Cohorts 1–3
| Characteristic | Students (N=61) | Peer Health Workers (N=10) |
|---|---|---|
| Average Age | 25 (Range: 20–50) | 27.5 (Range: 21–46) |
| Race/Ethnicity | ||
| Asian | 20 (32%) | 1 (10%) |
| Black or African | 18 (30%) | 8 (80%) |
| Hispanic/Latino | 1 (2%) | 0 (0%) |
| White | 16 (26%) | 1 (10%) |
| Other/Mixed | 6 (10%) | 0 (0%) |
| Gender | ||
| Female | 45 (74%) | 5 (50%) |
| Male | 16 (26%) | 5 (50%) |
| Previous HIV Experience | ||
| Yes | 33 (54%) | 6 (60%) |
| No | (46%) | 4 (40%) |
| Previous HCV Experience | ||
| Yes | 16 (26%) | 6 (60%) |
| No | 45 (74%0 | 4 (40%) |
In terms of partnerships, Generation Tomorrow increased the number of partner agencies for the field experience to 9 in year 2 (Cohort 3) from 6 in year 1 (Cohorts 1 and 2), comprising a variety of community-based organizations and Johns Hopkins associated programs that focus on HIV and/or HCV. Program partners for year 2 along with notable partnership highlights are described in Table 2. From October 2014-May 2015, four Generation Tomorrow partners (STAR, Project Re_, SPOT, and STAR Track) were involved in HIV community-based testing. Through field assignments and special events, Generation Tomorrow along with partners tested 1,104 individuals for HIV with 19 of those individuals found to be HIV rapid antibody positive, a 1.72% positivity rate. From October 2014-May 2015, Generation Tomorrow worked with partners through student/peer field assignments and special events to increase hepatitis C testing across Baltimore. Four program partners/groups were involved in hepatitis C outreach testing including the Baltimore City Health Department, Sisters Together and Reaching, Inc., Project Re_, and the Special Projects and Outreach team. While other sites supported HCV research protocols, education, and linkage to care, these four partners launched HCV outreach testing programs. Through partners and special events, Generation Tomorrow supported HCV testing with student/peer organization manpower and financial resources and tested 778 individuals for hepatitis C with 175 of those individuals being hepatitis C antibody positive, a 22.5% positivity rate. Prior to the implementation of Generation Tomorrow, none of the partners were participating in hepatitis C testing, however, the Baltimore City Health Department had a plan to launch hepatitis C testing and the Generation Tomorrow interns were included in this work. Generation Tomorrow worked with STAR and Project Re_ to launch a hepatitis C testing initiative and additionally launched the SPOT team to work at special events focused on hepatitis C education, testing, and counseling.
Table 2.
Generation Tomorrow Partners and Program Highlights for 2014–2015 Academic Year
| Partner | Partner Site Summary | Program Highlights |
|---|---|---|
| AIDS Linked to the Intravenous Experience (ALIVE) | A Hopkins-based prospective cohort study of HIV-positive and HIV-negative persons launched in 1988. It aims to characterize access to and impact of highly active antiretroviral therapy, incidence and impact of co-infections (HCV), and the natural history of drug abuse | Generation Tomorrow students averaged 6–8 weekly work hours and helped the staff conduct 680 HIV tests from October 2014 to May 2015. Students also conducted fibroscans and delivered HIV/HCV results. |
| Baltimore City Health Department STD Clinics | Two public clinics that provide HIV and HCV testing on site. Generation Tomorrow students assisted with a hepatitis C screening program developed by the Department and the Johns Hopkins Viral Hepatitis Center | Generation Tomorrow students averaged 3–5 weekly hours and helped the clinic staff conduct 401 HCV tests from October 2014 to May 2015. Students also developed an HCV resource guide for the clinics, which created a structure for linkage-to-care procedures |
| Johns Hopkins Hospital Adult Emergency Department | This site was home to a new HCV linkage to care program, which aimed to inform HCV+ patients about new treatment and link them to HCV care | Generation Tomorrow students and peers averaged 6–10 weekly hours as they helped launch the hospital’s HCV testing and linkage-to-care program and created the Official Manual of Operations. In phase 1 of the program, Generation Tomorrow participants conducted over 2,000 electronic medical reviews to identify patients living with HCV. All patients found to be HCV positive were offered linkage to care assistance |
| Older Women Embracing Life (OWEL) | An organization dedicated to supporting the community of women who are living full, productive, and happy lives, despite the challenge of HIV/AIDS | Generation Tomorrow students helped update website content, develop volunteer program protocols, and create an HIV resource list for older female clients |
| Project Re_ | Community HIV testing initiative, which focuses on providing testing services to young men who have sex with men and transgender populations in zip codes with high HIV prevalence through mobile testing units | With the support of Generation Tomorrow, Project Re_ incorporated HCV testing into its outreach efforts. Generation Tomorrow students and peers averaged 7–10 hours weekly and helped conduct 204 HIV tests and 41 HCV tests from October 2014 to May 2015 near LGBT venues |
| Sisters Together and Reaching, Inc. (STAR) | Community and faith-based organization that targets HIV and other health disparities through community outreach, large-scale testing events, support groups, and mobile testing units | With Generation Tomorrow’s support, STAR began incorporating HCV testing into its outreach efforts. Generation Tomorrow interns helped the agency develop a new HCV testing protocol. Generation Tomorrows STAR interns averaged 3–8 hours weekly and helped the agency conduct 418 HIV tests and 153 HCV tests from October 2014 to May 2015 |
| Special Projects and Outreach Team (SPOT) | Generation Tomorrow team of students and peers engaged in special community projects, leadership opportunities, and educational outreach sessions for local community-based organizations | SPOT organized most special events coordinated by GT, developed a curriculum for conducting HIV/HCV education sessions in community settings, and also participated heavily in testing opportunities made available by the Vaccine is Prevention study at substance abuse treatment centers and at Needle Exchange Program sites |
| Special Teens at Risk – Together Reaching Access, Care, and Knowledge (STAR TRACK) | A University of Maryland-based program that provides comprehensive, individualized, culturally appropriate primary HIV and psychosocial supportive care to HIV infected and at-risk youth ages 12–24 in Baltimore | Generation Tomorrow interns worked an average of 6–8 weekly hours helping STAR TRACK plan and staff educational community outreach events, updating its website with HIV resource information, and performing HIV testing/counseling |
| Vaccine is Prevention (VIP) | Hopkins research site that targets HCV-negative male and female injection drug users | Generation Tomorrow students worked an average of 9–10 hours weekly assisting the program with targeted outreach, screening, and testing of participants, updating valuable resource guides for injection drug use, and planning HIV and HCV testing events at substance abuse treatment centers. |
Post-Program Data, Surveys, and Interviews
In post-program 2014–2015 evaluation surveys, students and peers noted that they most enjoyed conducting HIV/HCV testing and counseling, educating the public, exposure to Baltimore residents, and exposure to new aspects of Baltimore. During lecture discussions and post-program evaluation surveys, many students and peers noted initial fears about approaching individuals in street outreach efforts but noted that they became much more comfortable with these aspects over the course of the program. Students and peers also became more aware of barriers to HIV/HCV testing, linkage, and engagement in care including competing life priorities, socioeconomic factors, distrust of the medical system, substance abuse, and transportation. Notable quotes from the post-program evaluations of Cohort 3 include:
“I learned how to educate people in a constructive manner about Hepatitis C and HIV. There was some confusion in many of the people I interviewed about the difference in the two viruses. I felt that I learned how to effectively communicate risks and treatment options.”
“We provided a non-judgmental space for people to get HIV and Hepatitis C testing and counseling.”
“The best success was creating an environment where clients felt comfortable talking to me about their lives, risk factors, and any questions about HIV and HCV.”
In post program surveys, 100% of alumni reported that they were working or studying in a field related to public health and 70% planned to continue HIV and/or HCV related work.
After the 2014–2015 academic year, Generation Tomorrow leadership also had check-in meetings with the leadership of each Johns Hopkins associated program and community-based organization that had been involved as a partner. Leadership of partner agencies stated consistently that they valued the capacity building supported by Generation Tomorrow and the new influx of ideas and energy from the students and peers which enabled programs and organizations to increase HIV/HCV testing services, decrease wait times, develop new educational programming, and build social network features in addition to other tasks.
Discussion
The development of Generation Tomorrow by the Johns Hopkins University Center for AIDS Research has led to an increased awareness and detection of HIV and/or HCV in the Baltimore area and has also successfully engaged students, community-based health workers, and Johns Hopkins associated programs/community-based organizations. By placing the next generation of health professionals in community-based settings to gain hands-on experience in HIV and HCV detection and prevention, the project aims to create culturally-competent health professionals and an environment for improved case-detection. Generation Tomorrow has promoted non-judgmental, compassionate, and culturally competent care by formally training students and peers in HIV and HCV testing and counseling and providing additional education through a lecture series, community outreach events, and a field assignment. All of these facets of the program are focused on engaging students and peers in the Baltimore community so that they might began to understand the complex interaction of the history of Baltimore, socio-economic issues, health disparities, and HIV and HCV. Peers were an integral part of the program as they were often able to provide additional perspective on Baltimore to the students. Additionally, the Johns Hopkins University CFAR and community-based organization partnership allows for an exchange of ideas and expertise while also allowing students to gain vital exposure to the community that cannot be learned from the classroom.
While Generation Tomorrow has been successful in increasing educational outreach and testing in Baltimore in conjunction with partners, the program has noted many barriers to linkage to care and treatment access for both HIV and HCV. In particular, the program has noted several systematic challenges surrounding HCV linkage to care and treatment access including insurance companies requiring primary care referrals to HCV care (as opposed to direct access to HIV care), limited treatment access for patients with low level liver stiffness due to public and private insurance guidelines, and HCV workforce shortages. However, Johns Hopkins has expanded hepatitis C clinic services to allow for increased capacity and also trains primary care clinicians to treat hepatitis C to expand the workforce in collaboration with the Maryland Department of Health and Mental Hygiene through a grant funded by the Centers for Disease Control and Prevention. Moving forward, Generation Tomorrow would like to play a more active role in other parts of the care continuum including an increased role in linkage to care and treatment adherence with partners.
Appendix
Appendix A–
Generation Tomorrow Lecture Series and Special Outreach Events 2014–2015. Generation Tomorrow Lecture Series 2014–15 Schedule
| Date | Speaker | Topic |
|---|---|---|
| 10/1 | Dick Chaisson | HIV Treatment and The Cascade of Care |
| 10/15 | Risha Irvin/Ayesha McAdams-Mahmoud | HIV/HCV Knowledge Assessment Review & HIV/HCV Social Marketing Campaigns |
| 10/29 | Jordan White | Civic Engagement and Service Learning in Baltimore City |
| 11/4 | Dave Thomas Shruti Mehta | Hepatitis C in Baltimore: Progress & Challenges |
| 11/5 | Tonia Poteat Ashley Grosso | Transgender Health in Baltimore & the Fenway Health guide to LGBT Sensitization |
| 11/12 | Jacq Jones | Hot Safer Sex |
| 1/21 | GT Program Leaders | Welcome Back Luncheon: Discussion of Past & Future Experiences in Program |
| 1/28 | Susan Sherman | Through an ethnographic lens: The HIV risk environment of exotic dance clubs |
| 2/18 | Carl Latkin | An Overview of HIV Prevention Work at The Lighthouse |
| 2/25 | Jamal Hailey Michael Franklin | STAR TRACK: Adolescent HIV Prevention Services in Baltimore |
| 3/4 | Marines Terreforte | Connect to Protect: A Model to Enhance Structural HIV Outreach Efforts among Baltimore Youth |
| 3/25 | GT Program Leaders | Meeting: Midterm Check-in (Discuss Final Presentations) |
| 4/1 | Seun Falade-Nwulia | Diverse Responses to Hep-C: Notes from the BCHD STD Clinics |
| 4/8 | Mark Sine | Opioid Overdose Response Training |
| 4/15 | David Pfau Chuck King Greg King | Mr. Friendly and Other Community-based Anti-HIV Stigma Efforts in the Baltimore Leather Community |
| 4/22 | Karen Kidwell Storey | Public Speaking Workshop |
| 4/29 | GT Program Leaders | Meeting: Final Program Wrap-up Mandatory summary meeting for all GT program participants |
| 5/4 | Final GT Presentations | GT Cohort 3 |
Special Outreach Events
October 2014
Project Homeless Connect: Annual event organized by United Way where 2,000 people experiencing homelessness or poverty received free services from local providers. In partnership with Sisters Together and Reaching, Inc. and the Johns Hopkins Division of Infectious Diseases, Generation Tomorrow tested 52 people for HCV and identified 7 people who were positive and connected them to care services.
November 2014
Testing for Turkeys: Annual event organized by Older Women Embracing Life, Inc. where individuals come to get tested for HIV and HCV in exchange for free turkeys and Thanksgiving side dishes. Generation Tomorrow tested 55 people for HCV and identified 10 new positives.
December 2014
B’More Aware Living Red Ribbon: Annual event organized by multiple partners at Morgan State University. Generation Tomorrow hosted an information table and encouraged young people to get tested.
World AIDS Day: HIV is Part of Our Story: First annual event organized by Generation Tomorrow and university partners. More than 102 people attended and 13 people shared personal HIV-related stories.
January-May 2015
HIV/HCV-Needle Exchange Testing: Weekly testing collaboration between Generation Tomorrow, Vaccine is Prevention, the Baltimore City Health Department (BCHD), and Project Re_. Tested 70 people for HIV and HCV at BCHD Needle Exchange Program sites.
April-May 2015
Know More Hepatitis: Annual event providing HCV testing at 5 BCHD senior centers in Baltimore. Despite social unrest that coincided with this event, Generation Tomorrow students and peers tested 77 seniors for HCV and identified 3 new positives.
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