A National Training Program to Improve HIV/STD Prevention into the Care of Persons Living with HIV

Background:  Persons living with HIV (PLWH) are living longer, remaining sexually active, and may engage in risky sexual behaviors. As such, it is crucial for providers to ask all HIV-positive patients about behaviors related to HIV transmission and STD acquisition. The Ask, Screen, Intervene (ASI) curriculum was developed to increase provider knowledge, skills, and motivation to incorporate risk assessment and prevention services into the care of PLWH. Our objective was to determine if a national training could increase the uptake and implementation of federally recommended practice guidelines. 

Methods:  The National Network of STD/HIV Prevention Training Centers (NNPTC) recruited HIV-care providers in geographic areas with high incidence and prevalence of HIV among racial and ethnic minorities through emails, at conferences, and through direct outreach to HIV clinics. ASI participants completed post-course evaluations and were contacted three to six months post-training for further evaluation. Descriptive statistics summarized demographic, occupational, and satisfaction data. Likert scale confidence levels demonstrate ASI learning objectives; means were calculated to measure pre to post course changes and pre to 3-6 month follow-up; and paired two-tailed Student’s t-test was used to test significance

Results:  The ASI curriculum was delivered to 2,558 HIV-care providers at 137 sites between September 30, 2007 and December 31, 2010. Immediately post-training, participants self-reported significant gains in perceived confidence to demonstrate ASI knowledge and skills (p<.001), and 89% agreed they would update practices as a result of this training. Three to six months post-training, 320 participants who serve PLWH self-reported more frequently performing ASI skills (p<.001), and 71% self-reported greater perceived confidence than before training to perform those skills (p<.001). 

Conclusions: Our findings suggest that a well-coordinated training program can reach a national audience of HIV-care providers, significantly increase self-reported capacity to incorporate HIV/STD prevention into the care of PLWH, and increase implementation of federally recommended practice guidelines.