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Implementation of CDC HIV Testing Recommendations: The AETC Perspective. Donna E. Sweet, MD, MACP Professor of Medicine The University of Kansas School of Medicine - Wichita. AETC Activity Snapshot July 2006-June 2007. 64,500 unduplicated learners 32% RN, ARNP, NP 24%MD, PA 28% Other. - PowerPoint PPT Presentation
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Implementation of CDC HIV Implementation of CDC HIV Testing Recommendations: Testing Recommendations:
The AETC PerspectiveThe AETC Perspective
Donna E. Sweet, MD, MACPDonna E. Sweet, MD, MACPProfessor of MedicineProfessor of Medicine
The University of Kansas School of Medicine The University of Kansas School of Medicine - Wichita- Wichita
AETC Activity Snapshot AETC Activity Snapshot July 2006-June 2007July 2006-June 2007
64,500 unduplicated learners 64,500 unduplicated learners 32% 32% RN, ARNP, NPRN, ARNP, NP24%24% MD, PAMD, PA28% 28% OtherOther
AETC Activity Snapshot AETC Activity Snapshot July 2006-June 2007July 2006-June 2007
Top Five Training Topics:Top Five Training Topics:antiretroviral therapyantiretroviral therapydiagnostic tests and disease diagnostic tests and disease
progressionprogressionadherenceadherenceclinical manifestations of HIVclinical manifestations of HIVcomorbiditiescomorbidities
CHEYENNE RAW LINS DECATUR NORTON
SHERMAN THOMAS SHERIDAN GRAHAM ROOKS
WALLACE
GREELEY
HAMIILTON KEARNEY FINNEY
PHILLIPS
LOGAN GOVE TREGO ELLIS
RUSHNESSLANESCOTTWICHITA
HODGEMAN
PAWNEE
STANTON GRANT HASKELL
STEVENS SEWARD
MEADE CLARK
GRAY
FORD
KIOW A
COMANCHE
BARBERHARPER
KINGMAN
PRATT
MORTON
RENO
EDW ARDS
STAF-FORD
RICE
ELLSW ORTH
LINCOLN
MCPHERSON
HARVEY
SEDGWICK
SUMNER
MARION
DICKINSON
CLAY
WASHINGTONREPUBLICJEWELL
MITCHELL
CLOUD
OSBORNE
RUSSELL
BARTON
OTTAW A
SALINE
SMITH MARSHALL NEMAHA BROWN
RILEY
MORRIS
CHASE
BUTLER GREENWOOD
LYON
OSAGE
WABAUNSEE
DOUGLAS
SHAW NEE
GEARY
POTTAWA-TOMIE
JACKSONATCHISON
JEFF-ERSON
JOHNSON
MIAMIFRANKLIN
LEAVEN-WORTH
WYAN-DOTTE
COFFEYANDERSON LINN
WOODSON ALLEN BOURBON
COW LEY
ELK
CHAUTAUQUA
WILSON NEOSHO
CRAWFORD
LABETTECHEROKEE
MONT-GOMERY
DONIPHAN
Kansas Community Planning Regions
89
clinic
clinic
clinic
““I don’t take I don’t take care of those care of those kind of people.”kind of people.”
“We Don’t Have AIDS In My Community!”
The BrochureThe Brochure AETC Mission StatementAETC Mission Statement Project Sponsorship Project Sponsorship Brief program explanationBrief program explanation Program incentivesProgram incentives
Continuing education Continuing education possibilitiespossibilities
MealMeal Resource MaterialsResource Materials ALL FREE!!ALL FREE!!
Reply sectionReply section
Educational MaterialsEducational Materials
Results of the 6 month follow up Results of the 6 month follow up surveysurvey
As a result of/since the KAETC HIV education programAs a result of/since the KAETC HIV education program
attended:attended:
52%52% Providers had seen HIV-infected Providers had seen HIV-infected patientspatients
41%41% Had conducted at least informal risk Had conducted at least informal risk
assessmentsassessments
34%34% Had conducted at least informal sexual Had conducted at least informal sexual
history assessmentshistory assessments
3%3% Had conducted Rapid HIV tests Had conducted Rapid HIV tests
31%31% Had conducted Standard HIV tests Had conducted Standard HIV tests
9%9% Had given Referrals for HIV testing Had given Referrals for HIV testing
Medical Professionals:Medical Professionals: 96%96% would offer routine HIV testing to would offer routine HIV testing to ALLALL the following: the following:
-an apparently healthy but sexually -an apparently healthy but sexually active female active female-a patient presenting with an STD-a patient presenting with an STD-an apparently healthy but sexually -an apparently healthy but sexually active male active male-an apparently healthy pregnant -an apparently healthy pregnant
womanwoman-an apparently healthy patient with a -an apparently healthy patient with a history of recent substance history of recent substance
abuseabuse
Results of the 6 month follow up Results of the 6 month follow up surveysurveyProfession specific questionsProfession specific questions (to check for info retention):(to check for info retention):
San Francisco Area AIDS Education and San Francisco Area AIDS Education and Training Center, University of California, San Training Center, University of California, San FranciscoFranciscoat San Francisco General Hospital at San Francisco General Hospital Curriculum with slides and HandoutCurriculum with slides and Handout
http://www.ucsf.edu/sfaetc/CURRICULA/HIVTESTING.html
HIV Screening and TestingHIV Screening and TestingSan Francisco Area
AIDS Education and Training Center
University of California, San Francisco
at San Francisco General Hospital
New England AETC
Doing a lot of training activities, especially in Mass. and Conn. – L&D, ED, primary care settings
Blending testing with other training topics such as MRSA; utilizing well known/respected presenters
Have had to “sell” the program, but with good response; concerns about informed consent and funding
New York / New Jersey AETC
Doing a mix of large collaborative conferences, TA, monographs, and clinical support tools
Prior provider relationships have helped create a demand for training; very positive response
Complications: NY/NJ laws don’t follow Recommendations; concern about funding for test kits and program sustainability
Pennsylvania / Mid Atlantic AETC
Level 1 and 2 presentations and TA done in all states; tools created on how to reconcile state laws and Recommendations
HIV Testing is #1 needs assessment request; over 2000 requests
Mixed response: Perceived burden shift from reconciling laws and Recommendations to financial/logistics/time, absence of linkages for, and increased cost of new positives; 50/50 split on informed consent issue (consumers vs. providers)
Southeast AETC
On-site training workshops for EDs, FQHCs, and state health department testing funds grantees; Testing Toolkit
Marketing to identified newly funded state testing contracts; spontaneous requests; incorporating info into training updates
Finding that staff buy-in more important than leadership/
administration enthusiasm for successful training; linkage to care and false positive policies needed for new testing sites
Florida / Caribbean AETC
Trainings for Corrections RNs; producing training materials for EDs; more focus on Why? and Laws than “How To”
Having to sell the program; materials requested by state health department
Positive response via follow up surveys
Midwest ATEC
Collaborative programming, TA, material/product development
Marketing program; development of materials requested by state health department
Acceptance of Recommendations spreading, especially in EDs; funding for test kits is a strong concern
Pacific AETC
Development of resource manuals for testing implementation in L&D hospitals and primary care CHCs
Integrating pieces into all training and TA
Mostly positive response to curriculum in both product and approach; some resistance
Common Threads
• Recommendations integrated into existing programming
• Multi-faceted implementation strategies: direct training, materials development, TA
• About 50/50 “selling” program vs. spontaneous request
• Mostly positive response, but some resistance
• Common Concerns :
• State laws vs. Recommendations
• Funding for test kits and increased case loads
• False positive rates in low incidence areas