CBA Request for Technical Assistance (TA)

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Organizations (indirectly funded and non-funded) and HIV planning groups (HPGs) that provide HIV prevention services can ask the Colorado Department of Public Health to submit a CBA request on their behalf.

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E-Mail-Adresse *

Please complete the information below to assist with the submission of your TA request. If you have any questions, please contact Jennett.Bezdek@state.co.us.

Describe the TA that you are requesting: *

What would you like to accomplish as a result of this TA (what aspects of your program do you want to strengthen or improve)? *

Please select one topic for which you would like TA. If you have more than one topic, select the most important/highest priority topic for this request. You can submit another request for additional topics: *

Clinical HIV Testing (This track supports HIV testing providers in public and private clinical settings and includes routine screening, repeat testing for persons at risk, and screening for STDs, hepatitis, and tuberculosis. It also supports referrals to prevention services and to care and treatment.)

Nonclinical HIV Testing (This track supports HIV testing providers in nonclinical settings where medical or treatment services are not routinely provided. It includes targeted HIV testing, recruitment, integrated screening for STDs, hepatitis B, and C, and referrals to prevention services and to care and treatment.)

Integrated HIV Activities (Activities that involve teamwork across HIV prevention, care, and surveillance, notably related to the Respond pillar of the Ending the HIV Epidemic Initiative. The can be data-to-care using pharmacy/care services date; cluster, outbreak detection and response; and combined (integrated) HIV planning.)

Prevention for Persons with HIV (PWH) (Among persons with HIV, this track supports linkage or retention in HIV medical care and treatment and provides support for prevention services.)

Prevention for HIV-Negative Persons (Prevention with HIV negative persons includes PrEP, PEP, evidence-based community-, small group, and individual-level behavioral interventions.)

Structural Interventions (Interventions that change the social or physical environment to enable changes in determinants of risk. These approaches move beyond individual behavior change to alter the environment and can be used to enhance the effectiveness of biomedical and behavioral interventions. These interventions often address social determinants of health.)

Is this CBA request related to Ending the HIV Epidemic activities? *

Yes

Is this CBA request related to a cluster response? *

Yes

What type of audience will receive this TA (such as management staff, outreach staff, etc.)? *

When would you like the TA to begin? Note: The start date for the requested TA should be at least 15 business days after the date the request has been submitted in CTS. *

Datum

How would you like to TA to be delivered? *

In- Person / Onsite

Telephone

Webinar

Teleconference

Sonstiges:

Organization Information (name, address, city, zip) *

Primary contact for this request Information (name, email, phone) *

Secondary contact for this request Information (name, email, phone) *

Organization Type: *

Health Department

CBO

Clinic/Health Center/FQHC

Hospital

University/College

Faith-Based Organization

Non-Funded CBA Provider

Sonstiges:

Funding Type: *

CDC Indirectly Funded

Nonfunded by CDC

Any other information you would like to add?

Senden

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