Impact of AIDS Education and Training Centers on the US HIV Medical Workforce.

OBJECTIVES: To examine the extent to which the AIDS Education and Training Centers (AETCs) are increasing the number and racial/ethnic diversity of HIV medical providers, in accordance with the US National HIV/AIDS Strategy (NHAS). METHODS: We used administrative data from funding year 2012-2013 to describe AETC trainee characteristics, including the types of medical providers trained, compared with national estimates of available US medical providers to estimate the proportion of providers trained for every 1000 available providers by professional group and race/ethnicity. RESULTS: AETCs trained 56 127 unique trainees, of whom 64.1% were medical providers and 45.5% were racial/ethnic minorities. Compared to national proportions, participation in AETC training was higher among racial/ethnic minorities. The proportions of racial/ethnic minority groups trained differed across regional AETCs. CONCLUSIONS: AETCs support NHAS goals by expanding the HIV medical workforce and strengthening the skills of minority medical providers to deliver high quality HIV care. Public Health Implications. Some AETCs made greater contributions to training different types of racial/ethnic minorities, which indicates varied approaches are needed to best target these efforts in communities heavily impacted by HIV.

Quality of comprehensive HIV care in underserved communities: does clinical training lead to improvement.

The AIDS Education and Training Centers National Evaluation Center led collaborative research to evaluate whether Minority AIDS Initiative (MAI)-funded clinical training changes clinical practice. Chart abstraction and feedback (34 clinics; n = 530) were used to assess adherence to clinical practice guidelines, identify training needs, and assess change in clinical practice (14 clinics, n = 271). Generalized estimating equations were used to account for repeated measures within each clinic. At baseline, clinics displayed 49% (95% confidence interval [CI] = 44-53) adherence to clinical practice guidelines. After feedback associated with the baseline chart review and subsequent implementation of MAI-funded clinical training, an 11% increase (95% CI = 7-16) in adherence to clinical practice guidelines was observed. MAI-funded clinical training was associated with increased adherence to clinical practice guidelines for HIV care. Chart abstraction is useful to assess clinical practice, facilitate conversations about quality improvement, and evaluate the effectiveness of clinical training.

A dynamic model of client recruitment and retention in community-based HIV prevention programs.

The study used system dynamics modeling computer simulations to gain a better understanding of the process of delivering small-group, evidence-based HIV prevention programs in the community and to explore implications for public health practice. A model was developed to explain provider-reported challenges associated with recruiting, retaining, and graduating people from small-group workshop programs. The model simulations revealed the difficulty in sustaining high rates of recruitment and retention in small-group programs over time. The model simulations provided insight into what processes may lead to suboptimal numbers of people being recruited and positively influenced by these programs.

Care of HIV-infected Latinos in the United States: a description of calls to the National HIV/AIDS Clinicians' Consultation Center.

HIV disproportionately affects the Latino population in the United States. Little is known about clinicians who provide HIV care to the Latino community or the types of issues they face. This report presents descriptive analyses of calls made by clinicians who care for HIV-infected Latinos to two lines of the National HIV/AIDS Clinicians' Consultation Center, the National HIV Telephone Consultation Service (Warmline) and the National Perinatal HIV Consultation and Referral Service (Perinatal HIV Hotline). Separate analyses of data from Latino clinicians are also presented. The majority of Warmline calls about Latino patients (81.0%) concerned antiretroviral treatment strategies or HIV-related conditions. More than half (54.3%) of perinatal-specific calls concerned HIV management during pregnancy and the care of HIV-exposed infants. Latino clinicians most frequently called about minority patients. This descriptive study adds to the growing literature about the care of the Latino HIV-infected patient. The Warmline and Perinatal HIV Hotline are resources for HIV care providers in the nursing and medical care of Latinos.