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Health Sciences
HIV/AIDS threatens to destroy families, communities, and even nations. Constella lends expertise to governments and non-profit agencies to identify and to mitigate risks; to develop infrastructure; and to reach, educate, heal, and support the vast numbers of people affected by this disease. In 1998, Jesse Milan joined Constella Group to lead our HIV/AIDS programs and initiatives. Since then he has written and spoken extensively on the topic, including many international engagements, and in 2003 he was named Co-Chair of the newly created CDC/HRSA Advisory Committee on HIV and STD Prevention and Treatment. In 2005 Milan assumed a new role as vice president for the Center for Global Health Convergence. Milan guides and shapes Constella's domestic HIV/AIDS prevention agenda, forging partnerships with and among local and non-profit organizations, government agencies, and private business. Below we highlight some of our work in the United States. For information on our activities in other countries, please read about how Constella Futures has worked extensively on HIV/AIDS programs throughout the developing world, strengthening systems and building capacity.
Selected Projects
Center for Workplace ExcellenceClient: Centers for Disease Control and Prevention (CDC), Coordinating Center for Infectious Diseases (CCID), National Center for HIV, STD, & TB Prevention (NCHSTP), Prevention Partnerships Office (PPO) The CDC programs Business Responds to AIDS and Labor Responds to AIDS have helped Americans address HIV/AIDS in the workplace since 1992. Designed to build on the success of these programs, the Center for Workplace Excellence in HIV Prevention (CWE) was created by the CDC to recognize that the workplace is more than just the setting in which people work—the workplace is a critical conduit for providing HIV/AIDS prevention, awareness, education, and support to employers, employees, their families, and the communities in which they live. The mission of the CWE is to support increased private sector involvement in HIV/AIDS prevention by providing technical assistance to Health Departments, businesses, and labor organizations, with a special emphasis on businesses in communities heavily affected by HIV/AIDS. Constella’s work to build the Centers for Workplace Excellence program includes:
Exposure to Blood Among Non-hospital Health Care WorkersClient: Centers for Disease Control and Prevention (CDC), National Institute of Occupational Safety and Health (NIOSH) There are nearly seven million health care workers employed in the United States; approximately half work in non-hospital settings. Health care workers are at risk of infection from blood borne pathogens, particularly human immunodeficiency virus (HIV), hepatitis B virus, and hepatitis C virus. Virtually all of the information on the occurrence of needlestick and sharps injuries is based on hospital workers. However, it has been estimated that 600,000 to 800,000 such injuries occur annually. In addition to the serious health consequences of this injury, the emotional impact of a needlestick injury can be severe and long lasting, even when a serious infection is not transmitted. Constella worked with the Centers for Disease Control and Prevention's (CDC) National Institute of Occupational Safety and Health (NIOSH) to conduct a national survey of blood exposure among non-hospital health care workers. The purpose of this survey was to provide the basis for a discussion of how policies and other factors might affect exposure to blood. The long-term objectives of this work were to prevent infection from bloodborne pathogens, including HIV, hepatitis B, and hepatitis C, by characterizing the extent of exposure to bloodborne pathogens among non-hospital workers, developing an understanding of the risks of blood exposure, and contributing to development of effective intervention strategies. The survey was implemented in two phases. Constella completed survey administration for the first phase and, during phase two, quantified and identified the incidence of blood exposure among non-hospital healthcare workers, risk factors for exposure, and preventative measures and their impact on exposure incidence. Constella also identified potential strategies for prevention intervention efforts through analysis of how policies and guidelines affect exposure. Model Performance Evaluation ProgramClient: Centers for Disease Control and Prevention (CDC), Division of Laboratory Systems (DLS) High-quality HIV-1 antibody, HIV rapid testing, Mycobacterium Tb drug susceptibility, and Mycobacterium nucleic acid amplification testing are essential to meeting the public health objectives for the prevention and control of these diseases. Prevention programs, diagnostic clinics, and seroprevalence studies rely on accurate antibody testing results to document HIV infection. Clinicians rely on accurate Mycobacterium nucleic acid amplification and Tb drug susceptibility testing to diagnose infection and develop appropriate treatment regimens. The impetus for developing this program came from the recognized need to assess the quality of retroviral/AIDS-related and Mycobacterium-related laboratory testing and to ensure that the quality of testing adequately met medical and public health needs. The Model Performance Evaluation Program (MPEP), which began in 1986, is a project of the Centers for Disease Control and Prevention (CDC). It is designed to analyze the steps in the total testing process and to identify critical indicators of high-quality testing. Participant laboratories are requested to test performance evaluation (PE) samples in the same manner in which they test routine clinical specimens, and to report their testing results on specially designed forms. Aggregate data are derived from the testing results of the various methods provided by each of the laboratories. The data is compiled and analyzed and the testing results are distributed to all participant laboratories following each PE survey. Since 1997, Constella Group has supported the MPEP. As part of this project, Constella maintains a series of SAS datasets that capture demographic information about participant facilities and the history of their participation in the program. Constella also enters all PE test results received from facilities and works with CDC on performing data analysis and generating final aggregate results reports. Many of the reports produced by the Model Performance Evaluation Program since 1995 are available on the CDC's website at the following web addresses:
OraQuick® Rapid HIV-1 Antibody Test TrainingClient: Centers for Disease Control and Prevention (CDC), Coordinating Center for Infectious Diseases (CCID), National Center for HIV, STD, & TB Prevention (NCHSTP), Division of HIV and AIDS Prevention (DHAP) As part of a major initiative to increase access to HIV testing, the Centers for Disease Control and Prevention (CDC) purchased 250,000 OraQuick Rapid HIV-1 Antibody Tests to provide to its grantees, such as local health departments and community-based organizations. Most of the individuals in these outreach settings were not laboratorians and had never performed a laboratory test. Before these tests could be used, CDC provided training to these grantees as described in the Food and Drug Administration (FDA) restrictions for sale of the test kit. The Division of Laboratory Systems (DLS) in the Public Health Practice Program Office (PHPPO), at the request of the Division of HIV and AIDS Prevention (DHAP), National Center for HIV, STD, and TB Prevention (NCHSTP), agreed to collaborate with DHAP/NCHSTP to provide the laboratory component of the training. Constella Group provided support services to enable CDC to present a series of 3-day training courses on rapid HIV testing using the OraQuick HIV-1 Antibody Test to a large number of its grantees. This effort included support for training of field instructors by:
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