SPNS/Fax: An Electronic Report from HRSA/HAB's SPNS Cooperative Agreements:
Volume 2, Issue 15 (July 25, 1997)

This document has been superceded by our Online Knowledge Base on Innovative Models of HIV/AIDS Care. Click here to access the Knowledge Base. Click here to access descriptions of 27 Innovative Models of HIV/AIDS Care and the lessons learned from these projects. SPNS/Fax was written, published, and distributed by fax by The Measurement Group between 1995 and 1998.

Information dissemination from 27 Innovative Models of HIV Care projects funded as Special Projects of National Significance by the HIV/AIDS Bureau (HAB) of the Health Resources and Services Administration (HRSA).

Introduction

Welcome to SPNS/Fax: An Electronic Report from HRSA/HAB's SPNS Cooperative Agreements. In each issue of SPNS/Fax, we will highlight findings from the HRSA Special Projects of National Significance Program Cooperative Agreements. The projects have been funded to develop innovative models of HIV/AIDS care. SPNS/Fax reports are distributed every two weeks by fax machine to all subscribers. All issues of SPNS/Fax are also available at this Web site. Due to slight differences in the media, issues distributed by fax machine may appear slightly different from those posted on this Web site, but the content is identical.

Emory University Provides HIV Training for Georgia’s Correctional Health Providers

Georgia ranked sixth in AIDS cases in 1996, and eighth in cumulative AIDS cases reported to the Centers for Disease Control and Prevention since 1981, compared with its ranking of eleventh in population size. Medical chart review study results have revealed the urgent need for HIV/AIDS training of correctional facility providers on the medical manifestations and management of this disease, and new therapies and medications available. Consequently, Emory University’s HIV Training for Georgia’s Correctional Health Providers project provides training and education that will increase the capacity of correctional health care providers to deliver comprehensive and appropriate care to inmates living with HIV.

The Southeast AIDS Training and Education Center of Emory University designed two training models to improve the ability of Georgia’s correctional health providers to manage the medical and psychosocial care of inmates with HIV: Model A is a series of regional, centralized training workshops and Model B incorporates the training workshops utilized in Model A plus intensive, onsite preceptored clinical training. The models target doctors, nurses, nurse practitioners, and physicians assistants employed in Georgia correctional institutions.

By comparing the impact and outcome of the two training models, the project will be able to evaluate the effectiveness and replicability of different HIV training and education models for service providers in correctional facilities. Model A offers regularly scheduled high priority HIV/AIDS training workshops. This model is designed to increase providers’ knowledge, self-confidence and care skills, and to improve attitudes. Model B provides intensive, preceptored HIV training to participants working in eight "experimental" correctional institutions. This model, which is interactive, is designed similarly to Model A; however, Model B is specific to the particular correctional institution of the provider, and adds opportunities for feedback, questions, and clarification.

Centralized Workshops (Model A)

Phase I (1995)

  • Epidemiology & Natural History of HIV Disease
  • Client - centered Post Test Counseling
  • Initial Patient Assessment & Medical Management Across the HIV Spectrum
  • Dermatological Manifestations of HIV

Phase II (March-June 1996)

  • Counseling Issues Across the Spectrum of HIV
  • Initiating, Switching, and Combining Antiretroviral Therapy
  • HIV and Tuberculosis
  • Diagnosis and Management of Opportunistic Infections
  • Terminal Care Issues in HIV Disease
  • HIV Neoplastic Disease
  • Neuropsychiatric Aspects of HIV Disease

Phase III (October 1996-May 1997)

  • Initiating, Switching, and Combining Antiretroviral Therapy
  • Medical Management and Early Intervention
  • Dermatological Manifestations of HIV
  • Pre and Post Test Counseling
  • Late Stage Disease

Preceptor Model (Model B)

Phase I

  • Introduction to administrative and healthcare personnel
  • Team building, trust, and support
  • Begin journalizing of descriptive data, demographics, climate of AIDS care, particular characteristics of each site

Phase II

  • Development of individualized teaching and consultation plan
  • Identify site-specific training needs and develop plan
  • Goal to meet the needs of each site and develop a plan to complement core content
  • Visits include chart review and one-on-one interaction in clinic site with providers, nurses and patients, identification of caseloads of HIV/AIDS patients and how care is organized

Phase III

  • Intervention and teaching phase
  • Concentration on interactive training
  • HIV/AIDS Training topics: Epidemiology and Natural History; Medical Management Across the HIV spectrum; Initial Treatment Plan and Chronic Care Visits; Antiretroviral Therapy; Opportunistic Infections; Late-stage Disease Management

The desired outcome of this project is to improve the HIV/AIDS care provided by training recipients at correctional facilities. Pre and post training intervention and medical chart audits of HIV-positive inmates conducted to assess the degree to which the care provided was appropriate, and whether it changed as a result of exposure to training. Project services being provided include: baseline and follow-up chart review; regional training workshops on HIV; intensive, targeted HIV training at the correctional worksites; curriculum development; and evaluation.

The Project Coordinator is Jacqueline Zalumas, Ph.D. For more information contact Ira K. Schwartz, M.D., Director, Southeast AIDS Training & Education Center, 735 Gatewood Road, Atlanta, GA 30322, Phone 404.727.2927, Fax 404.727.4562, URL www.cc.emory.edu/SEATEC/.

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