Valley AIDS Council
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Mission Statement
VAC is a non-profit HIV service organization that delivers culturally appropriate sexual health and wellness services in South Texas and advocates for the Latinx population at the local, state, and national level.
About This Cause
VAC | Westbrook Clinic (Valley AIDS Council) is the primary provider of HIV prevention, education and testing services; and the only Ryan White funded agency providing medical care and supportive services for people living with HIV in the Rio Grande Valley. VAC’s service area covers a 3,057 square-mile area (roughly the size of CT and DE) and is home to more than 1.4 million people roughly the population of VT and WY. Most VAC clients are Latinx at or below federal poverty levels. HIV has disproportionately affected the Latinx community since the first case was reported in the US in June 1981. Racism, discrimination, HIV-related stigma, language barriers, limited access to and fragmented high-quality healthcare, homophobia, economic disparities, and other longstanding barriers continue to be major drivers of the disproportionate impact. Many people in Cameron, Hidalgo, and Willacy County count on Ryan White as their primary or only source for medical care. This includes non-citizen legal residents who are not yet eligible for other forms of public assistance and undocumented residents who are barred from accessing most other non-emergency health care programs. Local safety net programs are only partially meeting the need for health care among the residents. HIV stigma and discrimination continue to be major barriers to prevention and care even with community health centers and hospital emergency departments. In an area that is defined as medically underserved, people living with HIV/AIDS face these additional barriers. Many VAC clients are undocumented immigrants from Mexico and increasingly from Central America. Despite the feminization of the migrant flows to the US over time, unattached men continue to represent a significant proportion of the immigrant population into south Texas. Limited proficiency in English affects some Latinx’s ability to seek and obtain health care and reduces access to health information. Studies have found that language barriers between providers and patients may result in decreased use of primary care, increased use of the emergency department, and inadequate follow-up. The unique sociopolitical immigration status poses considerable barriers to health care access as well with status within families often varying, with children being US citizens and parents being undocumented immigrants. Individual-level barriers may include low literacy/health literacy, English proficiency, familiarity with health care system, immigration status, low income, no insurance, transportation challenges, and child care issues; clinician-level barriers (i.e., stigma, discrimination, and cultural insensitivity); organizational-level barriers (i.e., scheduling, appointment wait time); system-level barriers (i.e., coordination across multiple organizations, partnerships, coordinating across states for migrant agricultural workers, coordinating across US/MX border for immigrants, lack of providers, distance to provider); and community-level barriers (i.e., stigma, discrimination, county indigent care costs, no public hospitals in area). Two key barriers to health care access are not having health insurance coverage and not having a usual source of care. Health insurance reduces the out-of-pocket costs of health care and has been shown to be the single most important predictor of utilization. Without health insurance coverage, many people find health care unaffordable and forgo care even when they think they need it. Having a usual source of care reduces non-financial barriers to obtaining care, facilitates access to health care services, and increases the frequency of contacts with health care providers. Having a usual source of care provides a locus of entry into the complex health care delivery system when care is needed and serves as the link to more specialized types of care. Compared with people who lack a usual source of care, people with a usual source are less likely to have difficulty obtaining care or to go without needed care. Hispanics rank poorly on both barriers to access. In 1987, VAC’s response to the growing incidence of HIV was to provide information to help prevent the spread of HIV and to coordinate medical, educational, and social services. VAC’s services and mission have changed as the treatment, prevention, and testing landscape has evolved. VAC has grown from a small, collaborative, grassroots response into a comprehensive, multi-site, one-stop, community-based status-neutral response to HIV. The FDA approved AZT (azidothymidine) as the first antiretroviral medication for the treatment of HIV in 1987. This medication delayed the development of stage 3 HIV (AIDS) in patients living with HIV and proved that HIV was treatable. The first test to diagnose HIV was approved for use in 1985. These developments brought about a decrease in the death rate due to HIV; however, the cost was prohibitive to many patients in south Texas, including many uninsured patients. There are now several classes of HIV drugs designed to block the virus at specific points in its life cycle. These drugs are used in combination and lower the virus’ ability to reproduce and be transmitted. These drugs can be used to prevent infection as pre-exposure (PrEP) and post-exposure prophylaxis (PEP). Medications have gone from multiple pills several times a day to one pill once a day to long-acting injectables – all of which are available at VAC to meet client need. Today, VAC provides a comprehensive list of status-neutral services across the HIV continuum - including health promotion and community engagement, community mobilization, HIV/STI testing, pre-exposure prophylaxis (PrEP), linkage to care, retention in care, case management, support services, support groups, community advisory board, housing, pharmacy, lab, dental care, behavioral health care, gender affirming care, and medical care. VAC provides testing and health promotion services onsite, special events, schools and other organizations, as well as home testing by mail. Health promotion services also include CLEAR (Choosing Life: Empowerment, Action, Results!) and sin buscar escusas, interventions to reduce likelihood of transmission. VAC co-created Drag Out HIV, a program of drag performers that are trained to go out and speak about safe sex, importance of knowing your status, PrEP and nPEP. This program trains participants to address stigma, provide HIV testing information, and build leadership skills. Condoms are distributed at numerous community partner sites across the RGV, by mail, or for pick-up at all VAC sites and events. VAC provides health promotion including social media and advocacy that address health inequalities and social determinates of health. VAC works closely with several media outlets which allows the consistent reach to the 1.4 million people in the area. (Please note that does not include the 2 million living on the border - in Mexico - who also share our news outlets). Not every person receives their information the same way. Information is shared in both English and Spanish. Stories are presented in a status-neutral approach and promote VAC services. Staff have presented on regional and national panels including the Texas HIV Medication Advisory Committee and The Presidential Advisory Council on HIV/AIDS (PACHA). VAC started providing telehealth and other remote services during COVID, those service options continue as permitted. Clinics are in Harlingen, McAllen, and Brownsville. Some patients from Laredo, Corpus, and other areas outside of the RGV also access VAC’s services. VAC started a local training for VAC and other HIV-interested professionals is now the only national conference in the United States that addresses a variety of topics regarding the treatment of Latinos for HIV, HCV, and SUD. This Conference continues to grow and has host several hundred attendees who work with Latinos across the US in the fields of HIV/HCV/SUD prevention, care, and advocacy. Participants include physicians, executive directors, program managers, mid-level providers, social workers, educators, and case managers from across the United States and its territories, Mexico and Canada. The Conference provides a space for National, regional, and community leader to share strategies and best practices for working with Latinx populations across the spectrum of HIV status-neutral continuum. Additionally, we dive into the challenges the Latino community faces when accessing treatment and care, including barriers to obtaining PrEP, cultural and societal stigma, and the challenges Latinos face when linked and retained in care. The Conference has been hosted in South Padre Island and San Antonio Texas, in Albuquerque, New Mexico, and will be hosted in New Orleans, Louisiana in 2023. RGV Pride, previously known as Pride in the Park, is a celebration that creates spaces that are comfortable, memorable, and inspiring for members of the LGBTQIA+ community of the Rio Grande Valley. In 2013 local community members, activist, and LGBTQIA+ leaders created one of the first ever PRIDE events in the Rio Grande Valley. Aside from the bars/clubs, the Rio Grande Valley never had anything like PRIDE in the Park. This first event focused on the LGBTQIA+ community at a community park in Harlingen. An estimated 400 were in attendance. Over the years PRIDE grew bigger, leading to the McAllen Convention Center and hosting more than 3,000 community members from across the Rio Grande Valley and a few out-of-town guests. Unfortunately, due to the COVID-19 pandemic of 2020, we were unable to meet in person. In 2022, the event was rebranded as RGV Pride and hosted at South Padre Island. Stopping stigma is important to making all communities and community members safer and healthier. Everyone can help stop stigma related to HIV and sexual health by knowing the facts. Stigma is brought to bear on individuals or groups both for health (e.g., disease-specific) and non-health (e.g., poverty, gender identity, sexual orientation) differences, whether real or perceived. Stigma and discrimination can trap people in a cycle of illness.