Increasing provider awareness of PrEP on HBCU campuses and beyond: A case study of the HBCU HIV prevention project (H2P).

BACKGROUND: The HBCU-HIV Prevention Project (H2P) is a culturally-tailored, targeted intervention at Historically Black Colleges and Universities (HBCUs) aimed at training health care providers as key players in reducing HIV infections and improving healthcare outcomes among HBCU students. METHODS: A cross-sectional purposive sample of health care providers at health centers on HBCU campuses and invited health care professionals from partnering organizations in their surrounding communities participated in an 11-module series on the CDC's evidence-based HIV prevention strategy for high-risk individuals, pre-exposure prophylaxis (PrEP). The intervention was aimed at increasing provider awareness and knowledge about PrEP and the importance of HIV testing and counseling as well as promoting provider intentions to use PrEP (initiating discussions with students and prescribing). Pre- and post-module quizzes served as awareness and knowledge assessments and providers also received online surveys about their intentions and uses of PrEP at 30 and 60 days post-training. RESULTS: Both on-campus and off-campus providers showed trending gains in awareness and knowledge for information in all modules. The off-campus providers appear to be more willing to use the information for initiating discussions and prescribing PrEP; however, HBCU providers also expressed similar intentions, although at lower rates. CONCLUSIONS: The project successfully increased provider awareness of pre-exposure prophylaxis (PrEP), effective HIV testing, and strategies for reducing HIV infection among HBCU college students. Findings highlight the project's impact on enhancing provider training and the potential of this impact on addressing HIV disparities among African Americans on HBCU campuses and their surrounding communities. The success of the H2P Project provides valuable insights for future interventions, reinforcing the importance of targeted, systems-level approaches in mitigating health disparities among marginalized populations. Implications are also drawn as to the potential for expanding such provider-level interventions to address other health conditions and informing policy development in African American communities.

A review of the risks and relationships between oral health and chronic diseases.

Advances in medical science and in preventive dentistry have changed the context of oral health. The American population is living longer with numerous complex chronic diseases. This paper is to raise awareness about the impact of multiple chronic diseases and their associations with oral diseases. Comorbidities can worsen the course of dental treatment. Inflammation has been the connecting factor in the bidirectional pattern of oral and systemic diseases. High occurrences of chronic diseases generally occur in aging as well as disadvantaged populations. Serious infections, slow healing, prolonged bleeding, and hospitalizations can escalate in patients with uncontrolled chronic diseases. A multidisciplinary team-based approach to patient management can minimize complications and unexpected challenges.

HBCUs' preparedness planning and responses to reopening campuses safely during the COVID-19 pandemic: Needs, assets, and insights for future emergencies and disasters.

Managing the health and safety risks surrounding COVID-19 in congregate settings, such as on college campuses, and minimizing viral transmission should be on the dashboard of Higher Education Leadership. Understanding that the risk will not be zero, like other academic institutions, Historically Black Colleges and Universities (HBCUs) have given great thought to making their campuses, which are considered high-risk settings, safe enough to warrant returning to campus. We queried HBCU leadership via an online survey sent to all 102 HBCUs about their safety plan for the fall 2020 resumption of on-campus activities. While data show that there are 102 HBCUs, we were informed that two HBCUs were permanently closed during our data gathering period. Thus, the sample size was 100. Specific areas queried included risks management plans, mitigation steps, policy changes, and human capacity resources. We also asked these leaders to identify vulnerabilities and other factors they considered in planning a safe reopening. Findings indicated that as these academic institutions grappled with balancing between risks and benefits of reopening, they also had to recognize the numerous scenarios and multifaceted approaches required. Recommendations are presented for supporting HBCUs in the future to surmount obstacles and implement culturally responsive solutions that best serve their campuses and surrounding communities in which these academic institutions are anchored.

Developing an effective HIV/AIDS response for women and girls in the U.S. Virgin Islands.

This article focuses on specific culturally and socially based gender issues that enhance HIV risk and complicate access to care and services for women and girls in the U.S. Virgin Islands (USVI). Literature review and interviews with clinicians providing HIV care in the USVI were used to examine causative factors for the high HIV prevalence rates among USVI women. Although the USVI population is almost evenly split between men (48%) and women (52%), females represent 46% of all USVI residents living with HIV and 33% of all people with AIDS. A primary barrier to adequate HIV/AIDS care for these women and girls is the insufficient number of clinicians available to provide that care. A primary barrier to adequate HIV prevention is the fact that, although the USVI are a territory of the United States, their cultural practices are those of the Caribbean. Thus, HIV programs developed on the U.S. mainland are often ineffective in USVI. A lack of consistent and accurate reporting to HIV/AIDS surveillance staff on the part of clinicians also hinders early trend detection efforts, as well as effective HIV management. Strategies to address HIV among USVI women and girls include: 1) increasing awareness of issues that impact them negatively and increase their vulnerability to HIV, 2) developing and funding delivery of effective, culturally appropriate HIV-related interventions, and 3) increasing the size and technical capacity of the USVI clinical workforce. Simultaneously updating current health care professionals on best practices for HIV screening, treatment, risk-reduction counseling and support could also substantially strengthen the USVI's response to HIV among women and girls.

The use of emerging informatics techniques to evaluate the delivery of NMAETC programs to address HIV and AIDS disparities.

BACKGROUND: Information technologies are employed to evaluate health program and better target recruitment of health care workforce for underserved communities, where needs for providers are greatest. With increased resources in reducing human immunodeficiency virus (HIV)/AIDS disparities and provider training, it may be important to know whether training is delivered in geographic areas where HIV/AIDS demonstrates high prevalence. The present study employs an informatics approach to identifying effectiveness of AIDS educational intervention in minority populations adversely affected by the disease. We seek to assess the National Minority AIDS Education and Training Center (NMAETC) on whether training activities are delivered appropriately in areas with high AIDS prevalence. METHODS: A geographic information systems application was developed to relate NMAETC provider training activities to its spatial relationship of AIDS prevalence of 4 major US racial/ethnic groups (fiscal years 2005-2006). Trainees' locations were geocoded by zip code. We overlaid AIDS prevalence of major demographic communities by state with the US Census region and division boundaries to visually inspect the patterns of distribution and potential spatial association. RESULTS: NMAETC training better targeted providers in 3 US Census regions and census divisions. The regions with higher provider training level generally corresponded to geographic areas with high AIDS prevalence for some minority populations. Additional efforts could be extended to recruit providers in the areas where the incidences were high for some communities. CONCLUSIONS: Most NMAETC provider training activities occurred in the states with a high AIDS prevalence. Additional efforts could be extended to recruit the providers in those regions where HIV/AIDS are more prevalent for some minority populations.

Managing mentally and physically challenged HIV patients.

Management of mentally and physically challenged patients is complex, as it can involve ethical, social, and medical issues, and adding the provision of human immunodeficiency virus (HIV) care further complicates management. There continues to be limited information in the literature in caring for these types of patients. We provide 2 unique HIV cases--one who is mentally challenged and the other who is blind--and how management was approached. A list of select resources to aid both providers and patients is provided.

Food and water safety for persons infected with human immunodeficiency virus.

Public health and food safety experts estimate that millions of episodes of illnesses annually can be traced to contaminated food and water. Food and water safety is extremely important to persons infected with the human immunodeficiency virus (HIV) or with acquired immunodeficiency syndrome (AIDS). A compromised immune system causes people with HIV or AIDS to be more susceptible to foodborne illness from eating foods that are unsafely handled and poorly prepared and from using water from unsafe sources. Food- and waterborne illnesses can cause diarrhea, nausea, and vomiting that can lead to weight loss. These illnesses can be minimized or prevented if proper precautions are taken.