Preparing the next generation of HIV/AIDS caregivers to end the epidemic prevention
December 16, 2024
The Midwest AIDS Training and Education Center central office staff. (Photo: Monica Kass Rogers)
For nearly four decades, physicians and scientists have fought the HIV/AIDS epidemic. Due to their efforts, what was once a fatal diagnosis is now a manageable chronic disease for millions of people worldwide.
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Since 1988, the University of Illinois Chicago has been on the front lines of this battle as home to the Midwest AIDS Training and Education Center. Based in the College of Medicine’s department of family and community medicine, the center has trained thousands of health care workers to treat people with HIV and AIDS and reduce new diagnoses.
Now, renewed funding from the federal Health Resources and Services Administration HIV/AIDS Bureau will help the center continue its critical work beyond its upcoming 40th anniversary.
The five-year, $19 million grant will help fund the center’s activities across 10 states as part of the national AIDS Education and Training Centers network. Established as part of the Ryan White HIV/AIDS program, the network supports eight regional centers that train local health care professionals and work with organizations to improve their HIV services.
The funding comes at a pivotal time for HIV/AIDS care providers, as the generation that confronted the emergence of the disease begins to retire and the care that patients need evolves.
“We’re building a new workforce of people who identify as HIV providers, who go on to become HIV medical directors or lead the opening of LGBTQ clinics,” said Amanda Wilkins, executive director of the center. “Even if they don’t go on to become HIV providers, our training helps reduce stigma and support professionals to be advocates for embedding HIV screening and prevention into their practices.”
Each center supports increased HIV testing, better prevention through education and drugs such as PrEP and connecting newly diagnosed patients to comprehensive care. By concentrating these efforts in regions and populations with high incidences of HIV, the network supports a national initiative to reduce new HIV diagnoses by 90% by 2030.
“We’re talking about ending the HIV epidemic; it’s just incredible,” said Dr. Ricardo Rivero, a clinical assistant professor of medicine at UIC who retired this fall after leading the Midwest AIDS Training and Education Center for the past decade. “That we are going to be able to help do that with 37 years of experience under our belts is such a unique opportunity.”
Expanding the HIV workforce
Dr. Maya Green, chief medical officer of Howard Brown Health, speaks on a panel at a center training event. (Photo: UIC Creative and Digital Services)
When it swept the world in the 1980s and 1990s, HIV and AIDS was largely treated by infectious disease specialists. But with the arrival of antiretroviral medications that can slow the disease or prevent infection, HIV care has expanded to other health care settings.
“Now, a lot of folks are just getting their treatment through their primary care doctors, and that’s a good thing,” said Estela Balderas, program and marketing coordinator for the Midwest AIDS Training and Education Center. “We want HIV to be normalized within the clinical setting, where if your doctor has enough knowledge and experience and confidence to treat you, then that’s fantastic.”
At UIC and partner institutions across the Midwest, the center develops training programs and resources tailored for a variety of health care disciplines. Students in medicine, nursing, pharmacy, dentistry, behavioral health, social work, public health and other fields learn how to optimize care for people with HIV, whether or not that later becomes the focus of their practice.
“People living with HIV, just like everyone else, can have complex medical needs and see specialists and people in different disciplines to receive comprehensive care,” said Dr. Andrew Trotter, an associate professor of clinical medicine at UIC who collaborates with the center. “So we need the people in those specialties to understand how to take care of people with HIV, and how to create inclusive, safe spaces.”
In person and online training sessions cover new medications and testing approaches, outreach to groups disproportionately impacted by HIV and emerging comorbid health issues as people with HIV now live longer.
The center also provides more in-depth training, such as the yearlong Clinician Scholars Program. Last year, a study found that 90% of the participants in this program continue to work in HIV care.
“Through the Clinician Scholars Program, we were able to demonstrate that participating providers increase knowledge and confidence to provide HIV services,” Rivero said. “This program also helps address stigma and helps participants develop their professional identity as an HIV care provider.”
Advancing UIC’s health equity mission
UIC nurse Norma Rolfsen, Midwest AIDS Training and Education Center program advisory committee co-chair, and Shanett Jones, program director. (Photo: UIC Creative and Digital Services)
Because the needs of patients with HIV and the health professionals who care for them change from community to community, a one-size-fits-all approach to training isn’t sufficient.
The Midwest AIDS Training and Education Center creates training modules and builds partnerships that focus on local needs and specific populations affected by HIV. Across the region, they’ve adapted training for health care and public health systems in both urban and rural areas to meet their unique challenges and goals.
In Minneapolis, they helped the Native American Community Clinic implement HIV care services and increase HIV screening in a population facing an outbreak of the disease. In Indianapolis, they helped the Eskenazi Health Infectious Disease Clinic improve cervical cancer screening for people with HIV. Partnerships in Michigan and Wisconsin helped federally qualified health centers expand testing and care for LGBTQ+ and Latino populations — communities overrepresented in the HIV epidemic.
“We go in to see where the clinic is in terms of the HIV care continuum, from identifying new infections to treating those who are infected and making sure that the patients are virally suppressed,” Rivero said. “We work with them and make sure that they use evidence-based interventions, so they learn from those who have already invested time and effort in figuring out what works best.”
These partnerships with local health centers and universities extend the center’s impact far beyond its Chicago headquarters, bringing UIC’s mission of health equity to the entire Midwest.
“The local partners are a benefit to UIC, because without them, we would not be able to provide effective services to address local needs in a 10-state region,” Wilkins said. “It’s so critical that we are there on the front lines doing the work, because that’s how we will finally end the HIV epidemic.”
