In keeping with the National Medical Association’s (NMA) mission to eliminate health disparities, the purpose of its HIV Prevention project is to have 2,000 black primary care physicians incorporate HIV testing as part of routine care to all patients and to encourage the same providers to include prevention messages to individuals who are HIV positive.
The project will take place in 6 cities--Baton Rouge, LA, East St. Louis, IL, Jackson, MS, Memphis, TN, Oakland, CA, and Raleigh/Durham, NC. These areas were chosen because they are among cities with the highest prevalence of HIV cases and also because they have an NMA affiliate society nearby.
Program Objectives/Activities Include:
An assessment of the knowledge, attitudes, perceptions, and practices of NMA primary care physicians regarding HIV prevention as part of routine medical care for all patients, including HIV testing.
Development of HIV/AIDS practice standards for physicians treating blacks. We plan to tailor the HHS federal clinical guidelines to meet the needs of African Americans and make it available as an informational sheet for distribution to physicians.
Development of training materials such as curricula, administrative tools, and policy manuals for physician trainings. The CDC’s Prevention Is Care toolkit will be edited to make it more relevant to African Americans, and tools will be added to provide information on sexual and drug-related behaviors to help physicians become more comfortable discussing prevention with patients.
Training of 2,000 NMA physicians to routinely a) offer rapid HIV testing to all patients in all settings, b) deliver ongoing, effective HIV prevention messages, and c) counsel patients (especially HIV positive persons) about safe sex and drug use behaviors. Training will be conducted by physician training groups.
Creation or adaptation of culturally appropriate consumer literature or other educational tools, followed by distribution among NMA members and their collaborators and to patients and their partners. Topics include HIV prevention, including safe sex, monogamy in relationships, and safe drug use practices for drug users; transmission of HIV to women from men; the connections between STDs and HIV; and perinatal HIV transmission.
Promotion among NMA physicians of project protocols such as HIV testing of pregnant women, incorporating HIV prevention into the medical care of persons living with HIV, and providing HIV/STD services to high-risk individuals.
Networking with other African American medical organizations to increase awareness of the HIV epidemic and to promote effective prevention strategies within clinical settings.
Piloting for acceptability CDC’s provider tool kits. ”Take Charge. Take the Test” is an HIV testing social marketing campaign for African American women, and “Prevention Is Care” is designed to help clinicians incorporate prevention services into their care of persons living with HIV. “The Take the Test” pilot project will encourage physicians to have all female patients undergo rapid testing for HIV.
Project materials such as physician curriculum and consumer literature will be developed initially by the NMA HIV Committee, made up of HIV physician experts in a variety of practice areas. Coalition workgroups headed by local NMA leaders and made up of stakeholders (Boards of Health, national HIV service organizations, etc.), and community-based organizations, will then review the materials and tailor them for regional needs. Coalitions will ensure that these educational materials are appropriate, and they will also help develop a regional plan and a support system for HIV issues that will be sustainable on a long-term basis.
Dr. Wilbert C. Jordan, M.D., M.P.H., is a Co-Principal Investigator of the NMA CDC HIV program. He is the medical director of the OASIS Clinic of King/Drew Medical Center. A Harvard graduate, Dr. Jordan has been involved with the AIDS epidemic from its recognition, and in 1983 he reported the first heterosexual case of HIV in Los Angeles County. He has treated over 3,000 patients. In 2000, he received the Surgeon General’s Award for his work with HIV, which had included his involvement with the NIH-sponsored DATRI Study on low-dose oral alpha interferon, his chairing of the Los Angeles County Commission on HIV & AIDS, 1993-1995, and his service on the Los Angeles County HIV Planning Council and the Prevention and Planning Committee since their inceptions.
Dr. Virginia Caine, Co-Principal Investigator with Dr. Jordan, is the Director of the Marion County Health Department, where she set up the first countywide HIV/AIDS integrated health care delivery system involving major hospitals, community health centers, social services agencies, and the HIV dental clinic. She is also the Chair of NMA’s Internal Medicine Section, an Associate Professor of Medicine at Indiana University School of Medicine, Infectious Disease Division, and Past President of the American Public Health Association. During the early 1990’s, Dr. Caine was instrumental in developing the first CDC-funded nationwide NMA HIV/AIDS educational provider training in 10 major cities across the U.S.
The NMA has significant experience in addressing HIV/AIDS testing. It has developed and disseminated of provider educational and training materials to promote prevention services; initiated a national education and technical assistance program (Leadership Development in HIV/AIDS) to better inform African American physicians about HIV/AIDS prevention and treatment and to promote their participation in HIV/AIDS control activities with their patients; published numerous articles on HIV in NMA peer-reviewed journals; encouraged NMA physician participation in the BET HIV/AIDS Wrap It Up Tour that provides HIV/AIDS education across the U.S.; and developed and implemented a national HIV Vaccine Communication campaign to engage minority physicians and high-risk communities of color in HIV vaccine clinical trials.