Health survey yields shocking results about HIV workforce

Anthony Galloway of AIDS Foundation of Chicago, introduces a video from the “Step Up Get Tested” project, a video series geared towards youth that encourages HIV testing. He was one of seven AIDS workers who spoke at an event hosted by the Black AIDS Institute. (Dawnn Anderson/MEDILL)

By Dawnn Anderson

A recent health survey revealed a significant number of the HIV workforce is ill-informed about the virus. Of the 135 AIDS workers in Chicago who participated in the HIV Workforce Study, they scored 63 percent, equivalent to a “D” average.

More than 3,600 people participated in the study nationwide and scored 61 percent. Officials at the Black AIDS Institute say it is too early to determine whether one’s lack of knowledge will directly affect clinical practice regarding prevention and treatment.

“Before, it wasn’t incumbent of the HIV workforce to know about science and treatment, because medical doctors were initially charged with the task of informing the public,” said Anthony Guitierrez, BAI’s mobilization manager.

BAI designed a three-year study, from 2012 to 2014, to assess HIV science and treatment literacy among non-medical workers, ranging from top health officials and case managers to outreach workers. Responses were graded based on three main categories: basic knowledge and terminology, treatment and interventions–both clinical and biomedical.

The survey was administered at the local, state and national levels, in both English and Spanish, to people age 18 and older. Survey participants contributed to a diverse demographic profile regarding gender identification, sexual orientation, HIV status, education and ethnicity.

The organization expressed its optimism about establishing a nationwide certification program and making it a requirement for workers to further their education on HIV science and treatment issues.

“Today we have all of the tools and biomedical breakthroughs in intervention so that there should be no new [HIV/AIDS] infections,” Guitierez said. He added the motivation behind the study was anecdotal evidence of interactions between uninformed HIV workers and HIV positive individuals.

As the results were released on Feb. 11., BAI discussed Highly Active Antiretroviral Therapy and pre-exposure prophylaxis, two major scientific developments. In addition to viral suppression, officials say these developments will only be effective if the workforce is able to skillfully articulate them with proper knowledge and understanding.

HAART refers to a concoction of antiretroviral medicines used to slow the rate at which HIV multiplies in the body. According to Guitierrez, it is a prevention method that “we have had in our toolkit since the ’90s.” PrEP is a pill given to people who are at a substantial risk of contracting the virus. According to the CDC, PrEP can reduce the risk of HIV infection up to 92 percent when used consistently.

Survey results showed many workers have yet to be trained or educated about the major scientific developments of recent years that have dramatically changed the prevention and management of HIV/AIDS. According to Guitierrez, it is imperative that the workforce is educated, now that treatment is considered a form of prevention.

In terms of academic experience, participants with a postgraduate degree comprised 42 percent while those with a bachelor’s degree made up 25 percent. Participants with an associate’s degree or less made up 33 percent. African-Americans made up the largest ethnic group among Chicagoans at 47 percent with whites trailing behind at 38 percent and Latinos at 10 percent.

“This data shows that as health advocates we are not meeting the expectations of the community, there is a major disconnect,” said Alan D. Johnson, program manager of Project Elevate and Community Partnerships at AIDS Foundation of Chicago.

Johnson said the survey is beneficial because it speaks to the need of building capacity in the workforce, specifically among African-Americans who are disproportionately affected by HIV.

“From informing them about proper science and treatment to the importance of having condom negotiations with a partner, even talking about getting tested together, we all have to really think strategically about making changes in our community,” Johnson said.

AIDS service organizations had the largest presence in the survey followed by community-based organizations. Employees accounted for 79 percent in comparison to volunteers and consultants who together made up about 21 percent. In terms of outreach, the majority of the participants who took the survey were in prevention services followed by education.

“The HIV workforce is not given proper training or financial support because it is not institutionalized,” Raniyah Copeland, BAI’s program director, said, adding that the lack of knowledge was shocking but not surprising given that performance was so widespread.

Representatives of BAI and AIDS Foundation of Chicago said they rely heavily on elected officials to help fund outreach and education initiatives.

“In terms of local government, we have a duty and obligation to be involved in matters of health that impact the general public, whether it is healthcare cost or catering to people who are uninsured,” said Lavonte Stewart Sr., 13th district liaison for Sen. Kwame Raoul. Stewart, who referred to HIV/AIDS as a “costly disease and very debilitating process” said early education and prevention initiatives are key.

To counteract poor performance of the HIV workforce, BAI has developed a national initiative titled, “When We know Better We Do Better” to establish a set of core competencies as workers interact with clinical providers and patients on a routine basis.

Lastly, the organization encourages more diversity in training, specifically employing service workers who have HIV/AIDS, based on the assumption that individuals who are HIV positive will be more cognizant of the virus within vulnerable communities.

Photo at top: At the Black AIDS Institute survey release event, Anthony Galloway, HIV prevention program manager of AIDS Foundation of Chicago, introduces a video from the “Step Up Get Tested” project, a video series geared towards youth that encourages HIV testing. (Dawnn Anderson/Medill)