Disparities in HIV knowledge and attitudes toward biomedical interventions among the non-medical HIV workforce in the United States

Abstract

Non-medical, community-based workers play a critical role in supporting people living with (or at risk of acquiring) HIV along the care continuum. The biomedical nature of promising advances in HIV prevention, such as pre-exposure prophylaxis and treatment-as-prevention, requires frontline workers to be knowledgeable about HIV science and treatment. This study was developed to: measure knowledge of HIV science and treatment within the HIV non-medical workforce, evaluate workers' familiarity with and attitudes toward recent biomedical interventions, and identify factors that may affect HIV knowledge and attitudes. A 62-question, web-based survey was completed in English or Spanish between 2012 and 2014 by 3663 US-based employees, contractors, and volunteers working in AIDS service organizations, state/local health departments, and other community-based organizations in a non-medical capacity. Survey items captured the following: respondent demographics, HIV science and treatment knowledge, and familiarity with and attitudes toward biomedical interventions. An average of 61% of HIV knowledge questions were answered correctly. Higher knowledge scores were associated with higher education levels, work at organizations that serve people living with HIV/AIDS or who are at a high risk of acquiring HIV, and longer tenure in the field. Lower knowledge scores were associated with non-Hispanic Black or Black race/ethnicity and taking the survey in Spanish. Similarly, subgroup analyses showed that respondents who were non-Hispanic Black or Hispanic (versus non-Hispanic white), as well as those located in the South (versus other regions) scored significantly lower. These subpopulations were also less familiar with and had less positive attitudes toward newer biomedical prevention interventions. Respondents who took the survey in Spanish (versus English) had lower knowledge scores and higher familiarity with, but generally less positive attitudes toward, biomedical interventions. In summary, low knowledge scores suggest the need for additional capacity-building efforts and training for non-medical HIV workers, particularly those who provide services in the communities most affected by HIV.

Changing Knowledge and Attitudes Towards HIV Treatment-as-Prevention and “Undetectable = Untransmittable”: A Systematic Review

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Next-Wave HIV Pre-Exposure Prophylaxis Implementation for Gay and Bisexual Men

“…85 Another product of the Heath Department-HART collaboration was a 1-day Best Practices in PrEP Education and Counseling training for PrEP navigators and counselors. This training was developed to build the capacity of front-line staff in both clinical and nonclinical settings alike to support access to PrEP, 86 recognizing that inconsistent and/or insufficient messaging about PrEP to those who might benefit poses a barrier. In this training, after an introductory section providing a primer about PrEP (e.g., efficacy, mechanism, and side effects), staff were taught to normalize PrEP as part of sexual health, and to focus on agency and empowerment using a strengths-based approach.…”

Protective Factors That Foster Resilience to HIV/AIDS: Insights and Lived Experiences of Older Gay, Bisexual, and Other Men Who Have Sex with Men

“…Recent empirical studies have been conducted to help identify and explore unique opportunities to foster resilience to HIV/AIDS by building strong "villages" (i.e., social networks), reducing structural inequities, and enhancing HIV treatment and care systems in collaboration with community stakeholders [17], including opportunities that were sustained with the support of different AIDS service organizations (ASOs) and other community-based agencies [18][19][20][21][22]. ASOs have been actively involved in studies investigating broad multisectoral interventions that address income, housing, substance use, and mental health issues [18]; underscore the crucial role of non-medical, community-based workers in providing services to gbMSM in the HIV care continuum [20]; and highlight the peer support, community leadership, advocacy, and active participation of gbMSM, which have all been central to the HIV response since the epidemic began [19,22].…”