Criminalization of Human Immunodeficiency Virus in the United States.

Human immunodeficiency virus (HIV) criminalization is the prosecution of people with HIV using HIV-specific state statutes, sentence enhancements, and general criminal laws wherein otherwise legal conduct becomes criminalized based on a person's HIV diagnosis. HIV criminal laws perpetuate HIV stigma and discrimination, misrepresent how HIV is transmitted, and are a barrier to HIV prevention and care. Research has found that Black Americans are more likely to be arrested for and convicted of HIV-related offenses. The harm caused by HIV laws on already marginalized communities is long-lasting and severe.

Successful Development and Implementation of a Large Virtual Interprofessional Education Activity Applying the Social Determinants of Health.

Interprofessional education (IPE) activities provide students insight into healthcare teams, shared decision-making, and social determinants of health (SDOH). Virtual IPE activities with large student populations or across multicampus have not been evaluated. The study aimed to explore the interprofessional competency growth in students, across several disciplines, following participation in a large-scale, virtual IPE activity. Students from pharmacy, medicine, social work, and physician assistant programs across Tennessee participated in an IPE patient case and SDOH in fall 2020 and fall 2021. Pre- and postsurveys included Likert ranking of 16 statements based on the 2011 Interprofessional Education Collaborative (IPEC) framework. A total of 607 students completed surveys (overall response rate, 76%). Wilcoxon signed-rank tests were performed on the pre-/postsurvey data, in aggregate and by discipline. Significant increases in all IPEC competency statements were seen, both in aggregate (100% of statements with p < 0.001) and in pharmacy (100% of statements with p < 0.001) and medicine subgroups (94% of statements with p < 0.001). Implementing large virtual IPE activities involving a complex patient case and SDOH significantly increased student IPEC competency outcomes for participating students, whether in aggregate or on a discipline-specific basis.

Using Implementation Science to Promote Integration and Sustainability of Community Health Workers in the HIV Workforce.

BACKGROUND: Community health worker (CHW) interventions are an evidence-based practice adopted by health care settings to increase retention in care and viral suppression for people living with HIV (PLWH) from racial/ethnic minority communities. However, disparate funding, unclear roles vis a vis other care team members, limited training and promotion opportunities, and a lack of standards for wages and tasks limit the ability to effectively use CHWs as part of the health care team. Guided by the Exploration, Preparation, Implementation, and Sustainment and Reach, Effectiveness, Adoption, Implementation, and Maintenance frameworks, this study describes the key determinants for CHW integration and sustainability at 3 agencies in Shelby County, TN, to improve viral suppression and reduce disparities among rural and urban people living with HIV. SETTING: Memphis Transitional Grant Area (TGA) which includes 8 rural and urban counties in west Tennessee, Arkansas, and Mississippi. METHODS: Seventeen key informants were identified using purposeful and snowball sampling techniques, including community and agency leadership staff, frontline staff, and faith leaders. RESULTS: Key determinants of CHW integration include establishing clear and standardized CHW roles within and across organizations, facilitating interorganizational networks, and leveraging funds for livable CHW wages and sustainable positions. Training strategies that strengthen the CHW workforce include content related to trauma-informed care, managing stress, and cultural humility. CONCLUSION: Several inner and outer settings and innovation and bridging factors affect CHW positions. Data collected will inform the implementation and sustainment of future policies and interventions intended to improve HIV care continuum outcomes and reduce disparities for PLWH.

Ending the HIV Epidemic: One Southern Community Speaks.

Memphis, Tennessee and its surrounding counties have been profoundly affected by the HIV epidemic. Using a participatory research approach this study identified from a community perspective: 1) the barriers and facilitators for providing support to achieve viral suppression to the most at-risk groups living with HIV in the Memphis Transitional Grant Area and 2) opportunities to strengthen the health care system through the use of community health workers (CHWs) to do outreach and engage with people living with HIV. Themes of barriers include intersectional stigma, HIV criminal laws, abstinence-only sex education, housing, transportation, and limited access to HIV case management and mental health services. Strategies to address these barriers included HIV education to youth in schools and community-wide campaigns, more testing sites, involving faith leaders, funding for housing options, innovative transportation services, rapid start of culturally appropriate HIV medical treatment, intensive case management services, and mental health counseling. Two opportunities to utilize CHWs to address the barriers identified in this geographic area are as policy advocates and as an integrated member of the HIV primary care team. The findings of this study can inform a strategy to build the CHW workforce which may have widespread implications for ending the HIV epidemic in this geographic area and across the United States.

Do Social Workers Apply "Love Thy Neighbor as Thyself" to Gay, Lesbian, Bisexual, and Transpersons in the South?

Across the United States there has been a spate of legislative bills and initiatives that blatantly stigmatize and discriminate against the lesbian, gay, bisexual, and transgender (LGBT) community. This study was a cross-sectional, exploratory survey designed to measure the attitudes, perceptions, and behaviors of Tennessee social workers and future social workers toward the LGBT population and toward proposed discriminatory legislation. A 3-way factorial ANOVA investigated the effects of political affiliation, religious affiliation, and social contact on the dependent measures. Significant main effects were found. Self-reported political affiliation was found to be the most important factor predicting LGBT acceptance and LGBT respect among this sample.

Differences in housing, health, and well-being among HIV-positive women living in poverty.

The social context of living in poverty has a direct and indirect impact on a woman's health and well-being. This cross-sectional study investigates the relationship between housing and adherence to treatment, emotional wellness, environmental safety, physical health status, and risk behaviors among HIV-positive women receiving services from an AIDS service organization in the mid-South. Significant differences were found between stably housed and unstably housed women on the dependent outcome variables. Results suggest that housing services for HIV-positive women may be an effective way to increase their health and well-being as well as prevent transmission to others.

An interprofessional educational approach to teaching spiritual assessment.

Spirituality is an essential aspect of a patient's health that can and should be integrated into routine health care. Despite recommendations of accrediting organizations such as the Association of American Medical Colleges, the National Association of Social Workers, and the Association of Professional Chaplains, there is little well defined curriculum focusing on interprofessional spiritual assessment. This article explores one program's use of an interprofessional approach in teaching spiritual assessment to students from medicine, social work, and chaplaincy. Learning objectives were adapted from the Association of American Medical Colleges Medical School Objectives Project. Workshop evaluations show that students can learn key concepts of spirituality and the basics of spiritual assessment while developing an understanding and respect for the role of chaplains, social workers, and physicians.

An interprofessional course in bioethics: training for real-world dilemmas.

Future health professionals are often educated with other students of their same discipline when, in practice, they will be working with professionals from other backgrounds to provide care for the patient. Complex issues of ethical concern are common to health professionals due to modern technology. This paper describes the evolution of an interprofessional bioethics course that had a unique combination of students and faculty. Innovative teaching methods were utilized and continuously refined based on student evaluations. Students commonly cited the interprofessional interactions as the most enjoyable part of the learning experience. Establishing a patient-centered focus and an appreciation of the contributions of other disciplines, students learned how to apply ethical decision-making to real cases. At the conclusion of the course, students reported improved attitudes toward interprofessional teamwork. This course format and teaching techniques may be applied at other universities looking for linkages to encourage consistent interprofessional collaboration across disciplines.

A rural community-based interdisciplinary curriculum: a social work perspective.

Although social workers are frequently part of interdisciplinary teams in health care and community settings, interdisciplinary training is often lacking in social work education (Berg-Weger & Schneider, 1998). This article describes a study of the effects of an interdisciplinary community-based experiential course preparing new health care professionals for work as part of interdisciplinary teams. The interdisciplinary curriculum was established for a summer course taught in 2006 by faculty from five disciplines: social work, nutrition, medicine, nursing, and public health. The course, Quality Improvement in Rural Healthcare, which focused on health literacy in people with a diagnosis of diabetes that live in northeast Tennessee, provided a model environment for learning interdisciplinary teamwork. Evaluation of this course found that social work students displayed a statistically significant increase in positive attitude toward interdisciplinary teamwork. Course strengths, weaknesses, obstacles, and opportunities for curriculum improvement are elaborated.