By: Kayla Gamino (UNIFIED Tobacco Treatment Specialist)
An ample part of UNIFIED’s tobacco reduction program includes creating quit kits for clients. During the initial assessment, we bring out the quit kit while discussing possible quit dates. Each client accessing tobacco reduction services receives 1 quit kit for their time working with the tobacco treatment specialist. Each quit kit includes: a journal, pens, candy/gum, educational tools, and fidget toys.
Journal- The journal is an especially important piece of the quit kit. The journal is a good tool to help keep track of a person’s smoking habits prior to their quit date. Many clients use it to write down when they have cravings, what they are doing when they have cravings, and how they are feeling when they have a craving. This will help the tobacco treatment specialist and client to better come up with coping mechanisms and a quit plan together for when the client experiences cravings. For example, if Mike records that he has a craving every time he is feeling bored then coming up with things for Mike to do while he is bored can help combat cravings.
Pens- The pens are good for when the client needs to journal. We put 2-3 different colored pens in each quit kit to make it easier for the client to be able to journal. Pens can also act as a fidget toy.
Candy/Gum- Each quit kit comes with a variety of candy. We use Twizzlers, Life Savers, and mints normally. The Twizzlers can help with the hand to mouth habit of smoking. It is a similar shape to a cigarette. The Life Savers, mints, and gum are good at combating the oral fixation that often comes with smokers.
Educational Tools- In each quit kit, we put a pamphlet for the Michigan Tobacco Quit Line. In the pamphlet, it gives little facts on how smoking affects the body as well as the number to the Quit Line for clients to utilize. We also include a UNIFIED Tobacco Services palm card that has contact information and HIV and Tobacco use facts. As an added bonus, we include the Michigan HIV/STD Hotline number.
Fidget Toys- Each quit kit includes rubber bands that are used by switching wrists when a craving occurs. It helps to keep the hands and mind busy. Additionally, each client gets to choose another fidget toy. We have two different options. One is a bike chain fidget toy that is small enough to fit in a pants pocket. The other is a Bendeez toy that can be molded into different shapes. Both are used to help combat boredom and keep the hands and mind busy.
All of these items have gotten positive feedback from current tobacco clients. If you are a current tobacco user and you think that a quit kit would be beneficial to your quit/reduction attempt, please contact UNIFIED- HIV Health and Beyond to meet with a Tobacco Treatment Specialist!
By: Kayla Gamino (UNIFIED Tobacco Treatment Specialist)
A session with the tobacco treatment specialists is different for everybody. We meet you wherever you’re at and will continue to be there for you every step of the way. It all starts with a referral from your case manager. At each visit, they will ask about your tobacco use and assess your readiness to quit. If you both decide that you are a good candidate for the tobacco program, the case manager will fill out a referral form with you and give it to the tobacco treatment specialists (TTS).
So how is your readiness to quit determined? Through The FIVE A’s; ask, advise, assess, assist, and arrange.
Ask- Your case manager is required to ask every client about their tobacco use at each visit and record it in our records.
Advise- If the client answered that they were a tobacco user, then the case manager will advise them to quit their tobacco use and discuss the benefits of doing so.
Assess- Next, the case manager will assess the clients willingness and readiness to make a quit attempt. If the client is interested in talking to the TTS about tobacco reduction, the case manager will then make the referral to the tobacco treatment specialist. In some cases the case manager will refer the client, with the client’s consent, to the TTS before they are considered “ready” in order to get the client thinking about quitting and to help establish the relationship between the client and the tobacco treatment specialist.
Assist- At this point, the case manager and the tobacco treatment specialist have touched base and the client is now being assisted by completing sessions with the TTS. During the sessions, the client and TTS will discuss reduction strategies and possible nicotine replacement therapy options. These sessions can go many ways depending on the clients needs. Some clients need to talk about outside sources that are affecting their tobacco use, while others simply want information on tobacco and health.
Arrange- The TTS will arrange follow-ups with the client. Depending on the clients stage of change and the client’s schedule, the TTS will likely meet weekly or biweekly with the client. These follow-ups can be by phone or in person. In some instances, the TTS will also meet the client at their home or a local business. This is the point in the treatment where the TTS tries to meet the client wherever is easiest for them in order to help make the client more successful in their quit attempt.
The transtheoretical model is a behavior change model that was specifically created with tobacco cessation in mind. The 5 stages of change are precontemplation, contemplation, preparation, action, and maintenance. It is important to know that the stages of change are not linear (that they don’t go in a single straight order). Someone can go from being in action to contemplation in an instance.
Precontemplation- the client is not ready to quit or is not even considered quitting.
Contemplation- the client is considering quitting in the next 6 months.
Preparation- the client is ready to quit within the next 30 days.
Action- the client is currently on their quit attempt.
Maintenance- the client has successfully quit for 6 months.
Because the transtheoretical model is not linear, a client can attempt to quit many times before being successful. It is important to know that the tobacco treatment specialists are aware that not everyone will be successful right off the bat. The specialists are there to help the client every step of the way in a completely non-judgmental environment. Whether you’ve been working with them for months and relapse, or you met with them once and decided the program isn’t for you, they will always be there for you when you are ready to talk again.
“Sweating, heart palpitating; suddenly I’m awake, sitting up in bed. “My body, something is happening inside my body.” The spot where I was sleeping is soaked. It’s 4am in the morning. Kenny is laying sound asleep next to me. “Something is happening inside my body.” Thoughts of AIDS rush around my mind: Flu symptoms, night sweats, high risk, enlarged lymph nodes, no cure. My anxiety is replaced with a decision to get tested immediately.
I try to go back to sleep, but when Kenny wakes at 7am I’m still wide awake. “We’ve got to get tested.” Kenny doesn’t know what I’m talking about. I show him the soaked spot on my pillow, and explain this dread fear that I have. “I may have AIDS and I need to know.” Now, Kenney is the type of man who feels that as long as he isn’t sick, he doesn’t want to know, or need to know, whether anything’s wrong. It’s important to me so after a couple of days of discussion he agrees to go with me to get tested for HIV.
It’s early October, 1989, the leaves on the trees are emblazoned with colors ranging from lush browns to bright yellow, vibrant red and orange. The air is crisp and clear. On the way to Henry Ford Hospital, where HIV/AIDS anonymous testing is done, I look out of the car window at natures kaleidoscope of color as if I’m looking at it for the last time.
When we arrive at the hospital we’re directed to an isolated wing where one person is drawing blood and counseling. Very little is known about HIV at the time. We’re told that we would have the results of our blood test in two weeks. “Two weeks.” Needless to say those two weeks are filled with visible anxiety for me. Kenny on the other hand appears apathetic. I call Kenny’s apathy invisible anxiety.
The phone is ringing. It’s 9am October 27, 1989. “Hello.” “Hello, Mr. Skipper, this is Bill Townsend. We need for you and your partner to come in to the clinic to receive your test results.” It’s the counselor from the testing center at Henry Ford Hospital. “Can’t you give them to me over the phone?” “No,” is the response, “Against policy.” I knew that. I don’t know why I asked. “OK, we’re on our way.”
The Palmer Park area off of Woodward Ave. and six mile road in Detroit was once a predominantly Jewish neighborhood. Now it’s a predominantly gay neighborhood. Most of the gay black males and females in Detroit pass through Palmer Park at some time in their life. The rent for apartments and housing surrounding the park range from moderate to very expensive accommodating tastes for the simple as well as the sublime. The park is about six miles in diameter, with a wooded area, a pond and an old log cabin with some historical merit. Summer art fairs are held there, the Hotter Than July Gay Pride picnic is also held there. There are areas for family picnics, a playground, golf course, tennis courts and a swimming pool for the children. The parks diametrically round landscaping makes it ideal for inner city joggers. Its large parking lots also make it a superb cruising spot for straight and gay cuties eager to show off their sexy bodies, and their array of wonderful new cars that only Detroit can produce.
After leaving the appointment at the Henry Ford Hospital clinic, Kenny and I drive to Palmer Park and park in one of the lots under the canopy of the magnificent autumn sky. We finish of a fifth of rum and coca-cola, and smoke a joint. Our HIV test results came back positive. We don’t discuss how we got the virus or who infected us. We don’t accuse one another because we have always practiced safe sex. We must have had the virus when we met. At this point where we got the virus from is not important. What to do next is. Although the doctor told us that we would be dead in a year, I’m not depressed. I’m a child of the sixties, the generation that questioned the inherent value of everything, and believed that we could achieve anything. “Pass the joint Kenny.”
That was twenty-five years ago. I watched and waited for death while my friends and lovers passed away before my very eyes. Kenny passed away in 2005. I woke up one day and realized that I had survived what they now call the “AIDS Generation,” those of us who contracted HIV over twenty years ago when it was a death sentence. We helped to build the successes that the newly infected now enjoy through years of advocacy and caring. We are the last of our generation. We hold all of its memory, all of its history. In the throes of a plague no one thought about those of us who would survive. How do you deal with life after expecting to die?
The national strategy to tackle HIV/AIDS now is focused on the youth and prevention, as it should be. The needs of Long Term Survivors are somewhat different and are only beginning to be addressed. Many HIV long term survivors suffer from what is known as AIDS Survival Syndrome (ASS), a form of PTSD. In 2012 Tez Anderson and Matt Sharp launched a grass roots community group for people who survived the early years of the AIDS epidemic, called Let’s Kick ASS. ASS is defined by chronic anxiety, isolation, survivor guilt, depression, substance abuse, insomnia, sporadic anger, sexual risks and a lack of future orientation. Those without partners often have less income making them vulnerable to financial hardship. Some are too emotionally damaged to form new relationships or friendships for fear of being abandoned. Given a year to live some liquidated their assets, signing away their financial future. Between 2009 and 2012 suicide accounted for 4% of all deaths among people living with HIV in San Francisco, far above the national average of 1.5%. Like in the early days of the AIDS epidemic when we rallied to care for each other and ourselves, we must rally once again to understand and overcome ASS.
UNIFIED – HIV Health and Beyond salutes our long term survivors. Since 1983 UNIFIED has been a port in the storm and trusted ally for people living with HIV. UNIFIED remains dedicated to servicing the needs of those infected and affected by HIV by advancing prevention, access to health care, community research and advocacy. After Kenny died I reached out to AIDS Partnership Michigan, now UNIFIED – HIV Health and Beyond. They helped to educate myself and my family about the realities of HIV. For more information about ASS and the Lets KICK ASS campaign visit their website at http://letskickass.org/UNIFIED is available to assist you with any issues you may have. Please feel free to contact us, 313-446-9800. www.miunified.org You are not alone.
Detroit, MI, December 1, 2015. World AIDS Day. Today, on World AIDS Day, AIDS Partnership Michigan (APM) and HIV/AIDS Resource Center (HARC) introduce the name of their newly merged organization:
UNIFIED – HIV Health and Beyond.
In order to strengthen the response to HIV in Southeast Michigan, AIDS Partnership Michigan and HIV/AIDS Resource Center have merged and will now be known as Unified – HIV Health and Beyond. The merger will enhance capacity in key areas, including programming, access to funding, community-based research and delivery of HIV-related healthcare services. Programming will be expanded for greater impact through shared resources, services and expertise to provide a comprehensive network of support for people at risk for or living with HIV across the region. Unified – HIV Health and Beyond will serve ten counties with a population of nearly five million residents and where 63% of people living with HIV reside. Services will be delivered from the three existing offices in Detroit, Ypsilanti and Jackson.
Rooted in the history of its fight against HIV, UNIFIED – HIV Health and Beyond advances prevention, access to healthcare, community research and advocacy. The vision for the future is to become a nationally recognized multi-service center creating positive change through regional impact, innovation, and sustainability to promote HIV health and beyond. UNIFIED will use innovative approaches to help residents of Southeast Michigan living with or affected by HIV achieve optimal health through compassionate direct care, support services, prevention and education. UNIFIED – HIV Health and Beyond will be an effective and powerful voice, providing leadership and advocacy for the communities it serves.
UNIFIED – HIV Health and Beyond will continue to fight HIV at the grassroots level in both urban and rural communities where it is most prevalent, especially for young people, people of color, men who have sex with men, and injecting drug users.
The following comprehensive HIV services remain available and accessible to all who need them.
• Community Mobilization Campaigns
• Healthy Relationships/Prevention for HIV+ Individuals
• HIV Counseling and Testing
• Hepatitis C Testing
• Medical Case Management
• Medication Adherence Counseling
• Behavioral Health Services
• Tobacco Reduction Services
• Health Insurance Enrollment Assistance
• Michigan HIV/STD Hotline/Website
• Syringe Access and Overdose Prevention
• Peer-Designed Prevention Programs
• Prisoner Re-Entry Program
• Housing Assistance and Homelessness Prevention
• Support service including:
o Food and cleaning supplies pantry
o Emergency financial assistance
o Transportation for medical appointments
o Support groups
By joining together, HARC and APM see themselves as being better prepared for the future and proudly embrace their new name: UNIFIED – HIV and Beyond. It is only fitting to share this exciting news on World AIDS Day, a day for renewing our global commitment to fighting HIV.
AIDS Partnership Michigan (APM) was formed in 1996 through a merger between Wellness Networks, Inc. and AIDS Care Connection. APM was established to better address the emerging AIDS epidemic in the Detroit/Metro area. AIDS Partnership Michigan has always worked by providing education and services to help prevent the spread of HIV and to help connect people living with HIV to needed services
HIV/AIDS Resource Center (HARC) was founded in 1986 by a group of volunteers to provide HIV/AIDS related services to the people of Jackson, Lenawee, Livingston, and Washtenaw counties. Over the past decade, HARC has developed into a leading HIV/AIDS services provider in Michigan.