INNOVATIONS

Project Silk’s patient-driven approach engages clients and elicits their advice on program design and service delivery. Providing a stigma-free space is a core component of Project Silk’s successful peer–driven community health model.

Program Features

• Safe space
• Youth Advisory Board
• House Ball events
• Shower facilities
• Educational workshops
• HIV/STI counseling, testing, and referral services
• Mental health counseling
• Food pantry
• Linkage to care
• Outreach and recruitment
• PrEP (pre-exposure prophylaxis) referral services

Project Silk provides a safe and supportive environment in a community-based setting. In addition to recreational/artistic activities, Project Silk provides on-site HIV/STI testing and counseling; implements behavioral interventions related to youth development and sexual-health education; offers mental-health counseling and skills-based programming for youth to actualize their goals; and provides case management and linkage to medical care and ancillary services to promote overall wellness among people living with or at risk for acquiring HIV and other marginalized, hard-to-reach groups.

The Youth Advisory Board

The Youth Advisory Board (YAB) has been active since 2013 and exists as an informal mentoring/volunteer program.  There are currently nine elected members who range between the ages of 21–25.  Kenny Leon, Project Silk’s Sexual Health Specialist, facilitates and oversees monthly YAB meetings and activities, while core members of the group serve in leadership roles. The YAB follows group by-laws, voting protocols, and has a formal mechanism to provide feedback on service provision.  In fact, as a result of YAB feedback, Project Silk has initiated on-site testing for syphilis. In addition, Project Silk relies on the YAB members to assist with event planning and to coordinate outreach strategies for disseminating sexual-health messaging and to recruit new members into the program.

Project Silk recognizes that individual development opportunities increase youth involvement and impact self-efficacy, health knowledge, and valuable community engagement. Youth members are encouraged to invest in their individual personal and emotional development.  Project Silk hosts a life-skills group on Wednesdays, "Silky Thursdays," and "Freestyle Fridays."

SERVICES

HIV Counseling and STD/STI Testing Services

Free and confidential HIV and STI counseling and testing services are offered Tuesday–Friday, from 1:00–8:00 PM.  Members and clients are encouraged to use risk-reduction strategies, as well as to talk to their partners about their HIV/STI status.

Linkage to Care Services

Project Silk defines linkage to care services (LTC) as any client linked to any service.  The agency focuses on client engagement, building rapport, retention in care, and decreasing barriers to accessing services and care.

It is agency protocol to link clients to care within 90 days after a confirmatory HIV-antibody test.  Project Silk staff regularly accompany clients for medical appointments and referral services, and they give a lot of attention to patient engagement and retention.

Referral Services

• Educational enrollment/Re-engagement
• Employment service linkage
• Food stamp benefits
• Housing linkage to services and shelters
• Medicaid coverage
• Medical services via local hospitals and clinics (Central Outreach Wellness Center, University of Pittsburgh Medical Center, etc.)
• Mental health services
• Youth Independent Training Program (Life Skills)
• Wellness and physical activities

PrEP Provision

Project Silk is not a medical facility, but the organization is exploring options for offering PrEP on site or at another CHS location.

Annually, approximately 8.6% of the Project Silk cohort seroconverts from HIV negative to having HIV.  There are currently no established community-based models for offering PrEP to at-risk individuals within the local community.  Considerations for Project Silk PrEP implementation include securing an on-site physician, lab interpretation specialist, and a phlebotomist, as well as establishing a specimen and safety transport system. 

Project Silk is assessing barriers clients may face in trying to access PrEP and provider liability for implementation.  The agency would also like to establish a coverage mechanism for kidney function testing associated with PrEP.  Project Silk staff are exploring viable opportunities of partnering with federally qualified health centers and other community-based organizations.

Project Silk Mental Health Services

Project Silk offers client-centered mental health support services, and social work staff support clients to develop individualized mental-health treatment plans.

Project Silk staff members are able to acquire consent to access clients' mental health records, which streamlines the provision of mental-health services.  Staff offers members psycho-education by providing information on mental health wellness, local services, and connecting clients to care.