Original ArticlePreparing the Future: An interprofessional approach to prepare future health and service-delivery professionals to attain an AIDS-free generation
Introduction
Over 1.2 million persons are living with HIV in the United States (US).1 The HIV epidemic is generalized in many US urban areas, disproportionately impacting racial and ethnic minorities and men who have sex with men.1
Maryland is ranked second among US states with a rate of 36.7 new HIV infections per 100,000.2 In Baltimore, Maryland 1 in 43 citizens over the age of 13 are living with HIV, among African Americans in the same geographic area, the ratio is 1 in 29.3 These alarming statistics are similar to other major urban areas of the US, representing a generalized epidemic of HIV.1 The scientific community has confirmed that there are tools, such as treatment as prevention and pre-exposure prophylaxis, to prevent, treat, and control the HIV epidemic.4, 5, 6
HIV is considered to be a health disparity, disproportionately impacting persons who live below the poverty line, those without a high school education and those who are experiencing homelessness.7 Despite advances in HIV prevention, care and treatment, HIV-related stigma and discrimination still pervade national attitudes. Evidence indicates that gaps in knowledge among practicing health and service delivery professionals hinders the potential to achieve national goals to reduce the incidence of new HIV infections, increase access to high quality HIV care and reduce HIV-related health disparities.8, 9 The United States Centers for Disease Control and Prevention (CDC) released guidelines in 2006 that encourage HIV testing as part of routine medical care.10 Despite this standard, most health care providers do not offer HIV testing to all of their patients, but to only those perceived to be at risk.11 Ending HIV in our lifetime depends on a team of professionals working together to address the HIV epidemic and provide coordinated and comprehensive prevention, diagnosis, care, treatment and supportive services.
Under the Obama White House administration, the National HIV/AIDS Strategy (NHAS) was developed in 2010.9 NHAS identified four major goals with clear benchmarks to address our national HIV epidemic which included: 1) reducing the rate of new HIV infections; 2) increasing access to high quality HIV care and supportive services for persons living with HIV; 3) reducing HIV-related health disparities; and 4) creating a coordinated national response to the HIV epidemic. These four goals were reaffirmed in an update to NHAS released in July 2015. The update places emphasis on advances in research that make the end of the epidemic achievable and on closing the gaps in the continuum of care through the engagement of all sectors of society.12
Gaps in the continuum of HIV care depict poor engagement and retention in care.13 These gaps include patients who are not tested for HIV, not linked or retained into care, and those not on or noncompliant to antiretroviral medications. To close the gaps, expertise of various disciplines are required and it is imperative that they work together to ensure the continuity of care.
Students within health and service delivery disciplines are increasingly aware of issues related to health disparities, social determinants of health, and the need for coordination and a team approach to optimize patient outcomes.14, 15 Professional schools who make interdisciplinary efforts toward health care delivery lack a definable standard for merging patient care with student education.16 Previous research has shown that Interprofessional Education (IPE) can improve confidence and knowledge in students, but such studies are inconclusive as to how involving students in IPE can improve patient care for HIV infected patients in the United States.17
The purpose of our study was to evaluate a didactic and hands-on interprofessional HIV curriculum among a group of health and service delivery professional students at a large, urban university in the United States. Our research question was, “Will students who undergo a didactic and hands-on interprofessional HIV curriculum demonstrate increased knowledge and changes in their attitudes and beliefs toward HIV?” According to the Theory of Planned Behavior, knowledge, attitudes and beliefs influence intention to perform an intended behavior.18 Therefore, positive changes in knowledge, attitudes and beliefs may lead to the development of health and service delivery professionals who are equipped to address the HIV epidemic. A pre- and post-test was used to evaluate knowledge and attitudes toward HIV prior to and after the delivery of the curriculum among participants.
Section snippets
The Preparing the Future HIV educational program
In September 2011, the JACQUES Initiative of the Institute of Human Virology at the University of Maryland School of Medicine launched the Preparing the Future (PTF) HIV Educational program at the University of Maryland Baltimore. The PTF program addresses the goals of the NHAS by engaging students from six professional disciplines (medicine, nursing, pharmacy, dentistry, law and social work) through an interprofessional, didactic, and hands-on curriculum. The curriculum was developed through a
Demographic data
The program participants included 218 students from different disciplines at the UMB. The breakdown of the majority of respondents' were as follows: 172 (78.9%) identified as female, 156 (71.6%) were between 20 and 29 years old, 127 (58.2%) students identified themselves as white, and 193 (88.5%) were of non-Hispanic ethnicity (Table 1). Based on the years of experience among respondents, including years completed in their respective academic programs, majority of the students 113 (51.8%) had
Importance of this study
Overall, the PTF program accomplished its goal of increasing knowledge and improving attitudes/beliefs about HIV among participants across all five constructs depicted by the open-ended analysis, which correspond to the questions in the quantitative portion of the analysis.
Conclusions
The Preparing the Future HIV Educational program has implications beyond Baltimore, Maryland. Other schools may use a similar approach to train students to address other relevant individual and public health epidemics. Further, this approach is successful in addressing other underlying themes in health care including health inequities, the social determinants of health and cultural competence. Robust curricular programs, like PTF, are capable of affecting local and national issues and better
Acknowledgments
The authors would like to acknowledge Marik Moen, Neha Pandit, Valli Meeks, Sara Gold, Michelle Salomon, and Angelina Battaglia for their contributions to the development and implementation of the Preparing the Future Educational Program.
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Cited by (0)
Funding source: The Preparing the Future program receives support from Gilead Sciences' FOCUS program.