SPNS/Fax: An Electronic Report from HRSA/HAB's SPNS Cooperative Agreements:
Volume 2, Issue 6 (March 21, 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This document has been superceded by our Online Knowledge Base on Innovative Models of HIV/AIDS Care.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.

Expanding Access to Hispanic HIV-infected Patients Through Early Intervention and Screening

In New York City, Hispanics represent 25 percent of the population, and 40 percent of all new HIV cases. Studies indicate that most Hispanics receive health care from Hispanic physicians, yet disproportionately low numbers of new cases are diagnosed by these physicians. Presumed factors preventing increased involvement of Hispanic physicians include inexperience in treating HIV infection, incomplete information about HIV risk factors, and concerns that patients always require highly specialized care.

In 1995, the Interamerican College of Physicians and Surgeons, in conjunction with Bellevue Hospital Center, developed the "Expanding Access to Hispanic HIV-infected Patients by Promoting Early Intervention, Screening and Counseling Among Hispanic Physicians" project. The program consists of a training course given to Hispanic physicians in four one-on-one sessions in their private offices. These courses are given by medical trainers who are Hispanic physicians trained in the AIDS and Dermatology Divisions of Bellevue Hospital Medical Center. These education/training sessions focus on the following topics:

  • Session 1: Statistics of the prevalence of HIV in New York City; risk assessment and pre- and post-test counseling.

  • Session 2: Complete physical examination and initial management of an HIV- seropositive patient.

  • Session 3: HIV-related opportunistic infections, prophylaxis and treatment.

  • Session 4: Clinical trials, evaluation of knowledge and attitude progress.

The primary goal of the program has been to expand access to health care services for HIV-positive or at-risk Hispanics by increasing their awareness of HIV infection. This has been accomplished by increasing awareness of HIV infection among Hispanic physicians, making them more confident and knowledgeable about risk assessment and HIV-related issues, and by improving their skills in counseling, testing and managing or referring individuals at risk for HIV infection.

Program outcomes were measured by comparing the responses from first and second year pre- and post-test questionnaires given to each physician participating in the program. The diagram to assessments the right summarizes the percentage of the 73 participating physicians offering regular risk assessments, effective counseling/testing of patients, and treatment of asymptomatic and symptomatic patients before and after the training sessions/interventions.

  • The number of physicians performing regular risk increased 61% (from 21% to 82%).

  • The number of physicians offering effective counseling and testing increased 37% (from 23% to 60%).

  • The number of physicians treating asymptomatic patients increased 42% (from 29% to 71%).

  • The number of physicians treating symptomatic patients increased 34% (from 15% to 49%).

The Expanding Access Program is currently training about 80 physicians in the New York and New Jersey metropolitan areas. Risk assessment and counseling materials have been expanded in response to physician requests. The program’s medical trainers and physicians have spoken at conferences and in personal communications to aid interested physicians in HIV management. Further information on the "Expanding Access Program" is available through the Interamerican College of Physicians and Surgeons World Wide Web page at http://www.users.interport.net/~icps/Medico/HIV1.html.

For more information, contact James Tierney, M.A., M.B.A., at the Interamerican College of Physicians and Surgeons, 915 Broadway, Suite 1105, New York, NY 10010-7108, 212.777.3642, 212.505.7984 (fax), or email at icps@interport.net.

SPNS/Fax is produced by The Measurement Group–PROTOTYPES Evaluation and Dissemination Center (EDC). Editorial comments should be made to The Measurement Group at 5811A Uplander Way, Culver City, California 90230, 310.216.1051, 310.670.7735 (fax).
 

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