syringe services Program progress report
Syringe Services Program Progress Report
Year:20XX ☐January-June☐July-December
Agency name:
Program name (if applicable):
HIV rapid testing method:☐Preliminary Rapid Testing ☐Confirmed Rapid HIV Testing:
Syringe Exchange
Syringe Exchange / ☐Jan-July ☐July-DecTotal number of exchanges projected (full year):
Total number exchanges
Total number clean syringes out
Total number used syringes in
People Reached/Served / ☐Jan-July ☐July-Dec
Total number of clients projected (full year):
Total number of clients reached/served
Total number of participants enrolled
Based on your SSP goals for the year, are you on track?
Did you make any substantial changes to your syringe services project during this reporting period? If yes, please describe the changes made. (e.g. location changes, total hours, methods, etc.):
Share an example of a challenge you faced and how you successfully addressed it during this reporting period. What was the situation, what action did you take and what was the outcome or result?
Engagement & Recruitment
Describe how you have engaged and recruited participants during this reporting period. Please describe any changes made. (e.g. location changes, total hours, methods, etc.):
Share an example of a challenge you faced engaging and recruiting your intended population and how you successfully addressed it during this reporting period. What was the situation, what action did you take and what was the outcome or result?
Syringe Disposal
Describe any issues with syringe disposal (sites, capacity, etc.) for your project:
Hormone Use & Sex Work
Describe how you are working with the unique issues facing sex workers and/or hormone users:
Overdose Prevention
Number of overdose (naloxone) doses distributed:
Number of reported client overdose reversals:
Describe overdose prevention for your project, including naloxone distribution, education:
Law Enforcement
Describe the current condition of your relationship with local law enforcement and any changes:
MSM/IDU
Describe your experiences in working with MSM/IDU during this reporting period:
Drug of Choice Trends
Describe the drug(s) of choice you are seeing among your participants:
MN Syringe Access Law
Describe the experiences your clients report purchasing syringes at pharmacies:
HCV Testing
Total Number of Tests Projected (Full Year):
HCV Testing / ☐Jan-July ☐July-DecNumber of HCV Tests Conducted
Number of Individuals Who Tested Positive
Positivity Rate: (#positive tests/total # tests) x 100
Describe your experiences connecting those testing positive for HCV to confirmatory testing and care:
Did you make any substantial changes to your HCV testing during this reporting period?
☐Yes☐No If yes, please describe the changes made? (e.g. location changes, total hours, methods, etc.):
Was your Hep C testing data spreadsheet emailed to Kath Chinn, Capacity Building Coordinator at ?☐Yes ☐No
HIV Testing
Total Number of Tests Projected (Full Year):
▪Positivity rate is calculated as: (# positive or confirmed positive tests/# total tests) x 100
▪Example: 250 total tests, 1 positive test
- 1/250 = 0.004
- 0.004 x 100 = 0.4 positivity rate
▪Positivity rate is calculated as: (# positive tests/# total tests) x 100
Confirmed Rapid HIV Testing Program (Rapid-Rapid Testing):
▪Positivity rate is calculated as: (total # HIV tests/# confirmed positive HIV tests) x 100
Confirmed Rapid HIV Testing / ☐Jan-July ☐July-DecNumber of HIV Tests Conducted
Number of Preliminary Positives
Number of Confirmed Positives (use this # for positivity rate)
Positivity Rate: (total # tests/# confirmed positive tests) x 100
Based on your HIV testing goal for the year, are you on track? If not, share any substantial changes made to your HIV testing program during this project period. (e.g. location changes, total hours, methods etc.):
Share an example of a challenge you face and how you successfully addressed it during this reporting period. What was the situation, what action did you take and what was the outcome or result?
How many clients did you connect to a confirmatory test or link to HIV primary care, as reported in Evaluation Web?
If you had clients with a reactive rapid test that you could not connect to a confirmatory test or link to HIV primary care during this reporting period, describe the situation (s):
Condom Distribution
Share an example of a success or a challenge you faced in distributing condoms to people at highest risk for transmitting/acquiring HIV and how you successfully addressed that challenge during this reporting period.
CondomDistribution / Number during:☐Jan-July ☐July-Dec
HIV Positive Individuals
High risk individuals who are HIV negative or unknown HIV status
All others (e.g. individuals whose level of risk is unknown)
Total
STD, Hepatitis, Condom, PrEP, & U=U Integration
Share an example or examples of successful integration of sexual health education, risk reduction regarding STDs and hepatitis A,B,&C, condom messaging, PrEP, or U=U education and referral you did during the reporting period.
How are you currently referring or integrating PrEP, U=U with other HIV Prevention strategies?
Target Population Input
Share an example of something you learned from target population input and how you used it to improve your program.
Monitoring & Evaluation Web
If the data listed in this report does not match the data entered in Evaluation Web explain the reason.
How did you use the results of program monitoring to enhance your project?
For each preliminary positive and/or confirmed positive result, was an HIV case report submitted to MDH HIV Epidemiology and Surveillance as well as faxed to the HIV Testing Coordinator?
Capacity Building & Technical Assistance
Request technical assistance from MDH:
▪EvalWeb:
▪Other:
Request data, a presentation, or a training from MDH:
▪STD/HIV/TB Data & Presentation Request (
Identify any training or technical assistance you need to address challenges or to enhance your knowledge/skills to implement the program.
Staffing
Per contract, MDH must be notified in writing within 5 (five) days of changes in staff or staff responsibilities and submit resume of new staff.
☐ Check box if there were changes in staff or staff responsibilities in this reporting period.
List all current staff positions funded by this grant in the table below
Name / Title / FTE on program**Must match FTE in Budget Plan and Narrative
Additional Comments
Describe any additional information that you think is important for MDH to know:
Minnesota Department of Health
651-201-5414 | 1-877-676-5414
02/05/2018
To obtain this information in a different format, call:651-2015414. Printed on recycled paper.
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