Advancing Excellence in Transgender Health: An International Professional Development Conference on Affirming Care for Transgender and Gender Diverse People.

OBJECTIVE: Increasing workforce capacity to provide knowledgeable, skilled, and affirming care for transgender and gender diverse people is critical to reduce health inequities; however, few clinicians receive sufficient training on this topic. This article describes Advancing Excellence in Transgender Health (AETH), an annual international conference that offers continuing professional development on evidence-based medical and behavioral healthcare for transgender and gender diverse people across the lifespan. METHODS: Registration data and post-conference evaluation data were descriptively analyzed to assess conference reach, participant satisfaction, and participant intentions to change practice. RESULTS: Between 2015 and 2022, AETH trained 2677 participants from all US states and 24 countries. Based on post-conference evaluations, 2017-2022, participant satisfaction was high (mean ≥4.4 on a 5-point scale) on all measures, including meeting learning objectives, quality of presentations, and relevance to practice. Participants reported intentions to: implement new information or skills (86.7%); create or revise protocols, policies, and/or procedures (63.2%); and seek additional information (64.2%). To increase equity, the conference waives fees for transgender and gender diverse participants and offers free online sessions. The conference also holds sessions specifically for transgender and gender diverse participants to promote opportunities for community-building, self-care, and professional networking. CONCLUSION: The broad reach of AETH demonstrates a large demand for more continuing professional development on transgender and gender diverse healthcare. This conference has expanded the availability of training designed to increase and enhance clinical workforce capacity to meet the health needs of transgender and gender diverse communities in the US and across the world.

PrEP Echo: A National Interdisciplinary Telementoring Program for HIV Prevention Through Practice Transformation.

HIV pre-exposure prophylaxis (PrEP) is highly effective, but PrEP use has been suboptimal. We describe a telementoring program for clinics in high-HIV burden areas, focusing on systems-level practice transformation and care for populations disproportionately affected by HIV. We developed and delivered a telementoring program for U.S. health centers. We analyzed participants' baseline and post-session surveys to ascertain experiences providing PrEP and caring for people disproportionately affected by HIV, comparing responses between medical and behavioral health clinicians. Forty-eight people from 16 health centers participated. Medical clinicians were more likely than behavioral health clinicians to care for people taking PrEP, but the groups did not differ in self-rated capacity to counsel about PrEP or care for populations disproportionately affected by HIV. Virtual training on practice transformation for PrEP, involving medical and behavioral health clinicians, is feasible and acceptable. PrEP training and delivery efforts should include behavioral health clinicians.

TransECHO: A National Tele-Education Program for Expanding Transgender and Gender Diverse Health Care.

Purpose: Few clinicians have received training to provide comprehensive primary care for transgender and gender diverse (TGD) people. This article describes the program design and evaluation outcomes of TransECHO, a national professional development program for training primary care teams on the provision of affirming integrated medical and behavioral health care for TGD people. TransECHO is based on Project ECHO (Extension for Community Healthcare Outcomes), a tele-education model that aims to reduce health disparities and increase access to specialty care in underserved areas. Methods: Between 2016 and 2020, TransECHO conducted 7 year-long cycles of monthly training sessions facilitated by expert faculty through videoconference technology. Primary care teams of medical and behavioral health providers from federally qualified health centers (HCs) and other community HCs across the United States engaged in didactic, case-based, and peer-to-peer learning. Participants completed monthly postsession satisfaction surveys and pre-post TransECHO surveys. Results: TransECHO trained 464 providers from 129 HCs in 35 U.S. states, Washington DC, and Puerto Rico. On satisfaction surveys, participants provided high scores for all items, including those related to enhanced knowledge, effectiveness of teaching methods, and intentions to apply knowledge and change practice. Compared with pre-ECHO survey responses, post-ECHO responses averaged higher self-efficacy and lower perceived barriers to providing TGD care. Conclusions: As the first Project ECHO on TGD care for U.S. HCs, TransECHO has helped to fill the gap in training on comprehensive primary care for TGD people.

Readiness of US Federally Qualified Health Centers to Provide HIV Pre-exposure Prophylaxis.

We report the results of a survey on HIV pre-exposure prophylaxis (PrEP) perceptions, capacity, and barriers at federally qualified health centers (FQHCs) in high-HIV burden jurisdictions in the United States. Health care workers at FQHCs identified multiple barriers to, and strategies for, improving PrEP implementation.