Alliance of Border Collaboratives: Public Health Leader Helping to Reframe Health Equity in El Paso

Alliance of Border Collaboratives (ABC) in El Paso brings together organizations and individuals to advance the practice of public health and promote social equity, affordable housing, and community development. ABC delivers programs and services in Mexico and the United States, particularly in El Paso.

ABC’s work aligns with Achieving Together’s guiding principles of social justice and equity as well as the focus area of Collaborating, cooperating, and coordinating across systems. We recently interviewed Dr. Susana Villalobos, Interim Executive Director, to learn more about ABC, its mission, and its activities.

How does the Alliance of Border Collaboratives help prevent HIV or support people living with HIV?

The Alliance of Border Collaboratives (ABC) was established as a community based public health non-profit agency in 2009. Since then, ABC’s Executive Board and Staff has worked to ensure that marginalized populations (e.g., homeless, gay and bisexual men, sex workers, transgender people, people with substance use disorders, and others) can exercise their right to receive prevention, intervention, and treatment services for infectious diseases, substance use disorder, and mental health.

Our activities include extensive outreach with our trans community. This includes outreach to highway underpasses, abandoned buildings, and queer bars. Additional prevention activities include passing out condoms, referrals to STI/HIV testing, and encouraging  PrEP.  Grant funding also allows payment of co-pays related to medical consultations for PrEP/PEP as well as transportation to and from appointments for our trans clients.

What would you like people to know or understand about Trans-Fronterizxs?

Trans-Fronterizxs is a peer case management program for transgender individuals in the border region; due to various factors, transgender individuals in our region tend to be isolated from their communities and forced to navigate the world alone, which can lead to lack of knowledge of local resources available. Additionally, some trans folks may not follow-up with appointments due to stigma, fear, and judgment. Ignorance is also a factor that can lead to transgender folks feeling misunderstood and forces them into having to teach service providers in order to receive appropriate care. To this end, peer case management catering to trans individuals, such as Trans-Fronterizxs, can help improve the health outcomes and follow through by providing services in a safe space for transgender folks. Filling out applications, setting up appointments, and navigating the bureaucracy of the local healthcare and social services systems can be daunting for some trans-people (many of whom might not have legal documents that are in agreement with their identity). We assist individuals in these processes and help them navigate the system. For this reason, we believe in meeting the client where they are – whether they are in El Paso or in Juarez – and no matter their current situation. We hope that through our work we can create a tomorrow that is vastly improved from the difficulties and struggles of today.

Our Impact on the Trans Community:

Our trans community has received personalized case management that has helped them enjoy a better quality of life through services such as preparation of name and gender marker applications, referrals, financial assistance for hormone replacement therapy, and transportation through our partnership with Uber health. We’ve carried out this essential work; quarantine or no quarantine. We believe that words fail to capture the relief clients have felt being able to have their identity legally recognized so they can participate in society in a safer way. It opens all kinds of doors to employment and other opportunities; it’s hard to quantify the impact of living your life as a trans woman with documentation that doesn’t match your identity.

For instance, one client had lived more than 20 years openly as a trans-woman and had stopped applying to jobs because of how humiliating it feels to be called by her “dead name.” Trans-Fronterizxs has made an enormous difference; a client reports that, “we’ve changed her life forever.” Other clients have remarked how they were able to do things they never thought they would be able to do, such as getting on hormones and getting their name changed.

What aspect of your work are you most proud of?

Many of our trans clients expressed their frustration on the emphasis of research studies and awareness versus direct client services. As an agency, ABC advocates for direct services funding. Our best efforts focus on a direct response to our community’s needs, and nothing is more important than having people feel comfortable in their own skin, particularly our trans community living on the border.

What keeps you motivated to do this work?

Unfortunately, the trans population often only have each other to rely on. The world is a cruel place when there is fear and misunderstanding. ABC strives to befriend the trans community and advocate for their needs wherever they are needed. We are determined to leave a positive footprint for our trans clients, and make a path to a life well-lived, without fear and judgement.

What does success look like to you?

At the risk of sounding idealistic, I think the ultimate success would be trans organizations becoming obsolete, this would entail having all their needs met. The little victories for the present include improving health outcomes, preventing HIV, funding hormone therapy, clothing and feeding trans people, and helping trans folks update their legal identity documents. Every single trans identified person we help as an agency is a success story.

Are there any myths or misconceptions you would like to address?

Visibility does not equal public support. Often, it results in increased risk for violence. The public support is not there yet. Especially in any place that isn’t a major city.

Another myth that prevails is the notion they were born in the wrong body. Many trans folks have no desire to medically transition. It is society that drives the message that their bodies are incorrect.

Another misconception is that “they” all want “the surgery.” There are several surgeries one might undergo for medical transition. Gender reassignment surgery is increasingly not necessary to update legal identity documents.

Stigma related to sexual promiscuity is another misconception on the trans community. Higher rates of HIV in our community does not equal labeling our trans community for the cause.

Is there anything else you’d like to tell us?

I encourage folks who are interested in being allies to look up local trans folks on their Go Fund Me pages, to contribute directly. For the trans people in your lives, defend them when they are harassed, and stick up for them even when they are not in the room.

Despite the circumstance of the pandemic, our services for our trans community never faltered.  ABC in El Paso, Texas, supports our trans clients with direct financial aid, clothing and legal assistance. Our community agency collaborations help to ease the economic situation our trans people face in their day to day lives.

ABC also integrates evidence-based harm reduction strategies to address the risks associated with syringe sharing and recurrent use of a single syringe, such as HIV, HCV, and soft-tissue infections. ABC provides peer-driven education on HIV, HCV, and soft-tissue infections, in conjunction with access to syringes and injection drug use equipment. 

These initiatives resulted in ABC being recognized by peers as an underground syringe program. It has been challenging to maintain these services, but ABC has strived in the face of adversity continuing to secure and provide both Narcan and sterile syringes (as needed) during the SARS-CoV-2 pandemic implementing protective measures for staff and clients as well as continuing with street outreach throughout the ongoing pandemic.

Law Harrington Senior Living Center: A Place for LGBTQ Seniors to Live with Dignity & Pride

There is strong evidence that housing impacts health. Housing stability, quality, safety, and affordability all affect health outcomes. Housing is “one of the best-researched social determinants of health, and selected housing interventions for low-income people have been found to improve health outcomes and decrease health care costs” (Health Affairs).

The Montrose Center’s Law Harrington Senior Living Center (LHSLC) represents one venture to improve housing options for seniors in Houston, Texas. The Center hosted its grand opening on June 24. As an LGBTQ-affirming center, the LHSLC offers specific programs and policies to support LGBTQ residents and protect them from discrimination. Since one of Achieving Together’s focus areas is cultivating a stigma-free climate of appreciation and inclusion, we interviewed staff from the new Senior Living Center to learn more about the program.

Photo by Alex Rosa for OutSmart magazine

How did the Senior Living Center get started?

For over 40 years, the Montrose Center has empowered our community of primarily lesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals and their families to live healthier, more fulfilling lives by providing a number of critical programs to LGBTQ Houstonians.

Housing is one of the greatest financial challenges and, correspondingly, one of the greatest needs for older adults across the nation. One in eight LGBQ adults and one in four transgender adults in the U.S. say they have experienced housing discrimination on the basis of their sexual orientation or gender identity.

According to the National Coalition for the Homeless, there are at least nine seniors waiting for one occupied unit of affordable elderly housing nation-wide. In some cases, a senior can spend three to five years on the wait list for access to affordable housing. As in the Montrose neighborhood, many long-time senior residents of the larger Third Ward area are seeing their rents and property taxes increase beyond their means.

Unfortunately, there are few options for those who seek to downsize and remain independent, save for very poorly maintained and unsecured apartment complexes. The Greater Third Ward is currently undergoing rapid demographic shifts due to redevelopment trends and increased interest in the area’s comparatively affordable real estate, creating gentrification.

The vast majority of LGBTQ-affirming neighborhoods, businesses, churches, and service organizations remain centrally located to Montrose and the surrounding areas. However, the lack of affordable housing in Montrose has pushed many LGBTQ low-income seniors, and longtime residents of Third Ward, to seek more affordable, yet less community-centric, areas. These areas may be away from their friends, family, and social support services.

In 2015, led by honorary campaign co-chairs, former Mayor Annise Parker and State Representative Garnet Coleman, the Montrose Center launched the “There’s No Place Like Home” campaign to help fund the Law Harrington Senior Living Center, with a commitment to providing an affordable senior-housing community that is also LGBTQ-affirming. The project was first made possible by a land grant for the 2.87 acre lot from the Midtown Redevelopment Authority, initiated by State Representative Garnet Coleman with the support of Midtown Redevelopment Authority staff.

What are the goals of the Law Harrington?

The goal of the Law Harrington is to provide seniors a place able to age with dignity and pride in a stable, safe, and affirming community, with access to specialized services and support. This project will also serve as the cornerstone of the Montrose Center’s comprehensive approach to support seniors, regardless of their gender identity or sexual orientation. We really see the Law Harrington becoming a hub for our LGBTQ seniors and hope it will become a vibrant community where seniors from all across the city, regardless of sexual orientation or gender identity, can come to enjoy critically needed services and programs.

It’s mentioned on the website that there are services for seniors living with HIV. What sort of HIV services will be available?

We have Legacy Community Health providing onsite primary care services for residents and the larger community. Seniors living with HIV will be able to take advantage of the clinic for check-up appointments and other medical needs. Staff from the Montrose Center will also be available onsite to provide case management, educational programs, advocacy, and service linkage, and can make referrals to other Center staff located at our main building for interpreter services, individual, couple/family, and or group counseling, or other needs.

What would you like for people to know or understand about the Senior Living Center?

The Law Harrington Senior Living Center is named after Charles Law and Gene Harrington. Charles Law was a significant force in the gay and lesbian communities in Houston. He was Co-Chair of the Executive Committee for Houston’s Town Meeting in 1978. He was also the founder of the Houston Committee, a black gay men’s professional organization, active in the late 1970s.

(Eugene) Gene Harrington, a tireless gay-rights activist, worked with the Houston AIDS Equity League, the Houston Gay and Lesbian Political Caucus, and the Texas Human Rights Foundation, receiving honors from all for outstanding volunteerism. 

The complex is the largest LGBTQ-affirming senior housing complex in the nation (137,838 SF) and features 112 one- and two-bedroom, independent living apartments for low-income seniors ages 62 and above. Rental is limited to single older adults and couples whose annual income is below a certain amount, the details of which are based on an annual calculation of income from the Houston area. The Law Harrington provides apartments at the following area median income (AMI) levels:

  • 24 units at 30% AMI
  • 45 units at 50% AMI
  • 43 units at 60% AMI

Additional features of the property include: a social services department managed by the Montrose Center, geriatric primary care clinic provided by Legacy Community Health, a group dining area, meeting and game rooms, a fitness center, dog park, and outdoor recreational spaces.

The most important thing to know about the complex is that it is LGBTQ-affirming, meaning that it is a safe, affirming place for LGBTQ seniors to live with dignity, pride, and without fear of hiding their sexual orientation or gender identity. While the complex is LGBTQ-affirming, it is open to all seniors who meet the age and income requirements.

ThrHIVing: Strong, Resilient, Black Women Taking Action to End HIV & Mental Health Stigma

May is Mental Health Awareness Month, and to honor it, the Black Women’s Affinity Group, in collaboration with Achieving Together, is hosting a webinar to bust myths and offer support for women living with HIV. This webinar, entitled, “ThrHIVing: Strong, Resilient, Black Women Taking Action to End HIV and Mental Health Stigma” will take place on Monday, May 10th, at 11:00 a.m. Central Time both on Zoom and Facebook Live (through the Achieving Together Texas Facebook page). See the link at the bottom of the blog for registration details.

It is widely known that receiving a diagnosis for any disease can take an emotional toll on a person’s mental health; however, when that disease has stigma associated with it, the risk for mental health complications increases greatly. One study of over 2,800 individuals living with HIV showed that approximately 36% also experienced serious depression and almost 16% experienced increased anxiety.

In the creation of the Achieving Together Plan, community members decided that eliminating stigma by cultivating a stigma-free climate of appreciation and inclusion would be one of the six focus areas needed to have a high impact on the goals of the plan. The Black Women’s Affinity Group is working hard to eliminate the stigma associated with HIV in Texas, particularly among Black women. This group, in collaboration with Achieving Together, is composed of community members working to address disproportionate transmission rates,  health disparities for Black women, and  access to care. The focus of the Black Women’s Affinity Group is to address gaps in connecting with clients, providers, and community through culturally responsive and affirming messaging, provide culturally affirming and empowering self-care, and to ensure Black women are included as decision-makers in regard to prevention and care programming from a planning, financing, and implementation standpoint. 

As part of their work, the affinity group has hosted a series of Did You Know? webinars entitled, “DYK Dialogues.” Their upcoming webinar, facilitated by group member Mattyna L Stephens, features a number of speakers, including:

  • Shadawn McCants, CEO of Know and Live Counseling and Consulting, PLLC, (keynote address) Mental Health Professional and HIV Advocate
  • Sharonda Lynn,Community Advocate and Activist
  • Mia Porter, Community Advocate and Activist
  • Bonnie Samuel, Playwright/Poet

The webinar will address how Black women respond to and thrive with an HIV diagnosis while often confronting the associated fear, shame, and stigma they might experience. The webinar seeks to not only address these concerns, but also offer support and resources for navigating systems of care and accessing culturally-affirming mental health resources.

We asked the keynote speaker, Shadawn McCants, to share her thoughts on a few questions to give a preview of the wisdom she will be sharing on the webinar.

AT: What motivated you to get involved in mental health advocacy?

SM: My motivation was from my own experiences with mental health since childhood. Since the age of remembrance I have always stated I wanted to be a social worker. As I matured, attended college and began working in the arena of mental health it was inevitable that I would become an advocate due to the disparities and lack of access to culturally competent care for marginalized communities and individuals.

AT: What are some of the biggest challenges for Black Women accessing mental health services?

SM: One of the biggest challenges is the belief that Black Women are Super Heroes or invincible therefore they don’t need mental health treatment. Very often the assumption is that Black Women “got it.” The expectation of Black Women is to live up to the cliché Strong Black Woman…well that is a myth! Far too many Black Women have internalized this mantra. It halts their ability to ask for help when needed or results in their symptoms being ignored when brought to the attention of medical/clinical professionals.  Additional barriers include access to culturally competent professionals (i.e., Black therapist) and affordable services.

AT: Why is it important for people to understand the unique intersectionality of stigma, living with HIV, and mental health? How does the unique intersectionality of stigma, living with HIV, and mental health impact Black Women’s health outcomes?

SM: The intersectionality of stigma, living with HIV and mental health is impacted by the sheer fact that a diagnosis of HIV is PTSD! It is traumatic and requires a level of mental and emotional wellness from the moment an individual is given the (HIV) diagnosis. When stigma becomes internalized shame and is untreated, ignored, or violated by the systems that were built to protect them, it results in mistrust, disappointment and at worst a defeated mindset that may impact their desire and drive to get or stay in care.

Want to hear more from Shadawn and the other presenters? Join us and register here today (and make sure to share widely!)

Empowering & Assisting Homeless LGBTQ+ Youth in Texas

April 10 is National Youth HIV/AIDS Awareness Day. This is a day to educate the public about the impact of HIV and AIDS on young people. The day also highlights the HIV prevention, treatment, and care campaigns of young people in the U.S.

Here in Texas, several organizations work to support a particularly vulnerable population: homeless LBGTQ youth. One of these organizations is Thrive Youth Center, Inc. in San Antonio. Thrive was established as a 501(c)(3) in February of 2015, and their mission is to “provide a safe, effective, and supportive center for homeless LGBTQ youth, so they may become productive, skilled, educated, and successful adults with the ability, opportunity, and possibility of achieving their dreams.” Thrive’s emergency shelter, which is located on Haven for Hope’s campus, opened in 2015, and currently there are 10 beds for LGBTQ young adults ages 18-24. In addition to clients onsite in the shelter, Thrive received a federal grant in 2017 that allowed them to house 20 young adults in their own apartments with rental assistance for up to one year. Through its street outreach program, Thrive strives to get young adults off the streets and into shelter, either at Thrive or through another program.

Services provided by Thrive include:

  • Case management
  • Education services
  • Empowerment resources
  • Mental health services
  • Life skills
  • Medical care
  • Legal services
  • Aftercare support for residents after leaving Thrive

Thrive is one of only a handful LGBTQ-specific programs serving homeless youth in Texas. Others include the Dune LGBT Foundation in Dallas. Dune’s programs offer emergency housing resources, rapid rehousing programs, housing programs offer an expected stay of up to 6 months. Tony’s Place in Houston also works to empower homeless LGBTQ+ youth and helps them “survive on a day-to-day basis by providing services to meet their immediate, basic needs.”

While not a shelter, Out Youth, based in Austin, provides much needed services and care to LGBTQ youth. Out Youth has compiled several resources guides, which can be found here

Reflecting on the “NOTHING ABOUT US WITHOUT US IS FOR US” Webinar on National Women and Girls HIV/AIDS Awareness Day

March 10th is National Women and Girls HIV/AIDS Awareness Day, and we here at Achieving Together Texas would like to honor that day by reflecting on a recent webinar hosted by the Black Women’s Affinity Group of the Texas HIV Syndicate. Black women represent 10% of people living with HIV in Texas and represented 8% of all new HIV diagnoses in 2018 in Texas. The CDC provides an informative fact sheet as well about women living with HIV in the United States.

Since Black women are one of the five vulnerable populations disproportionately affected by HIV in Texas, the Black Women’s Affinity Group and the Texas Black Women’s Health Initiative work to address health issues affecting Black women in Texas. The affinity group recently kicked off a webinar series entitled, DYK (Did You Know?). As part of the series, they hosted a webinar on February 8th addressing medical mistrust in the Black community, medical research for HIV/Covid19 involving Black women, and how to identify “good” research. The webinar included a panel of experts who each presented on different topics. Presenters included:

  • Mandy Hill, DrPH, MPH, Director of Population Health and Associate Professor, The University of Texas Health Science Center at Houston’s McGovern Medical School & Delta Sigma Theta
  • Teriya Richmond, MD, Chief Medical Officer, AIDS Foundation Houston
  • Shanterra McBride, Alpha Kappa Alpha
  • Jennifer Jones, Zeta Phi Beta
  • Camille White, MD, Sigma Gamma Rho
  • Karen Shores, community advocate

The webinar included a mixture of presentations, interactive polls, and open discussions and prompted some great questions and responses from attendees. One organizer, Sattie Nyachwaya, a Community Engagement Coordinator with Prism Health North Texas, shared her thoughts on the webinar afterwards:

“Being a part of this webinar was a huge honor for me. Being in the space with some powerful Black women involved in this work for many years continues to inspire and motivate me in my long term personal and professional development. One of the things I took from this webinar was empowerment behind medical research. I was never aware that Black women are needed to be a part of medical research, and that we take back the power and break barriers by being active in our own health. I believe that mental health is a part of the foundation of Black women’s health, and by having open conversations with our providers and asking questions we make sure we are at the table with conversations of change. I learned that mistrust lives among misinformation, and it is so important in my own health to empower myself to ask and speak up.”

As part of the work of Achieving Together, the Black Women’s Affinity Group works to empower their community through social justice, education, and advocacy, while working towards the goal of eliminating health disparities and HIV in Black women and all Texans.

You can watch the entire webinar below: