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.

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.

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.