3. Promoting HIV Testing in Diverse Populations

Suggested Activities

Module 1, U.S. HIV Epidemiology:

1. View “Understanding HIV/AIDS Surveillance Data” (insert link) and identify at least two ways this understanding can inform your practice. If possible, discuss with colleagues.
2. View HIV epidemiological data for your area at www.statehealthfacts.org and consider what this information means for your patients and how you can serve them.
3. How do you encourage your patients to honestly discuss risky behaviors such as substance use and unprotected sex? What are two strategies you can use to make this more comfortable for patients? Why do you think these will be effective?
4. Review at least one resource designed to support serving one of your key patient demographics. Examples include BESAFE cultural competency guides (insert link). Based on the information you find, what are culturally competent ways you can encourage your patients to become more aware of their partners’ risk factors?
5. List at least three ways you can communicate the serious consequences of HIV to your patients?

Module 2, Recommendations for routine HIV testing:

1. Review the CDC guidelines for rapid HIV testing and discuss the implications for your practice with colleagues and administrators:
2. Review HIV testing resources distributed by the National Institute on Drug Abuse and the Substance Abuse and Mental Health Services Administration and determine whether some may help your practice to implement CDC guidelines for HIV testing. Discuss promising products with administrators and colleagues.
3. Visit the EXPLORE web site (www.hptn.org) and review the intervention protocol. How can you support patients in participating in similar interventions? How can you help to make this type of intervention available in your community?
4. Does your practice follow current CDC and USPSTF guidelines for HIV testing? Discuss with colleagues and administrators how you can implement these as standards for your practice.
5. Find out how prevalent HIV is in your community. Discuss with colleagues what this means for serving your patients. If possible, discuss with colleagues in another discipline (e.g., if you are a physician, confer with dentists or pharmacists) and/or another practice to share a broad perspective on serving the community.

Module 3, Benefits of early testing and risks of delayed testing:

1. Discuss with colleagues and administrators the benefits of routine testing and how it can become the standard for your practice.
2. This module presents potential community benefits of routine early HIV testing.  Discuss with colleagues and administrators how you can inform your community of these benefits, and how you can elicit community support. Consider which key organizations, including other clinical practices, you could collaborate with. Consider how you and could develop culturally appropriate messages and how to deliver these messages.
3. Discuss: How do you assess whether a patient is “willing and able” to commit to lifelong treatment? How do you respond when a patient appears unwilling?  How do you respond when a patient appears unable? If possible, discuss with colleagues from different disciplines and consider how you can support each other in helping patients to overcome barriers.
4. Review at least one cultural competence tool for serving a key patient demographic group to identify potential cultural barriers to HIV testing and ways you can help to address at least one of these barriers.
5. How would you explain potential benefits of early testing to your patients? How would you assess whether a patient understood your explanation?

Module 4, Barriers to Testing and Strategies to Improve Rates of Routine HIV Testing

1. Implement at least one of the recommendations listed on the first page with at least one patient. How did the patient respond?  How can you integrate this into your everyday general practice?
2. List at least 3 ways you could attempt to overcome a patient’s resistance to HIV testing. 
3. Consider how you would approach a low-risk established patient to suggest HIV testing.  Discuss with colleagues.
4. Discuss with colleagues: How can professionals such as case managers, clinical social workers, and psychological counselors help clinical care providers to overcome barriers to testing? How can you and your practice encourage collaboration among professionals to overcome these barriers?
5. Work with administrators to solicit information about key patient communities’ cultural beliefs that may present barriers to HIV testing and develop communication approaches to address these barriers. This may include reviewing a few articles on members of cultures your practice serves, a brief in-service from a clinical case worker, or a discussion group with community leaders.

Module 5: HIV Testing Technologies

1. Does your practice have a protocol for informing a patient who was hesitant to be tested for HIV that s/he is HIV-positive? If not, discuss with colleagues and administrators how such a protocol should be developed and implemented.
2. Review at least one of the Key Resources listed and consider how it can inform and improve your practice. Consider sharing the resource with colleagues or presenting important information at staff meetings.
3. List two to three criteria that would be useful for determining the HIV testing recommendation protocol that would be best for your practice.  If your practice has not developed a protocol based on the most recent technologies, recommend a discussion.
4. Case study: George has been your patient for five years. He is due for routine blood testing. When you advise him that this now includes HIV testing, he opts out. You are concerned because George has indicated in conversation that he has had multiple sexual partners over that last couple of years. He has requested tests for STIs on two previous occasions and tested negative. He has avoided saying whether he follows your recommendations for safer sex practices. Consider and discuss how you would respond when George opts out of HIV testing.
5. Case study: Norah came in for a pregnancy test. After confirming her pregnancy, you recommend HIV testing. She appears offended, saying she trusts her husband and cannot have AIDS. Consider and discuss how you would respond to Norah.

 

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