Evidence of Success - New England AETC Service Area: Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, Vermont

New England AETC

Service Area: Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, Vermont

In the New England region, a large proportion of HIV care is provided in the community health center setting. The majority of the Title III funded sites are also community health centers. Each year when Title III funding is awarded to sites in New England, the central office of the New England AETC is notified and a team is identified to work with the newly funded site. Individualized training on-site in the health center has been the most successful strategy utilized by the New England AETC. As part of this strategy, an initial meeting with the site is conducted in order to identify education needs for the year as well as to determine the appropriate time and format for the trainings. Usually, a team of two, including a clinical program specialist, meets with the Title III director and any staff hired as part of the program. Generally, a plan is proposed to meet quarterly for education and/or clinical consultation and then tailored to meet the needs of current and planned staff. AETC staff members outline state-of-the-art topics and match the appropriate topics with the HIV-infected patient population.

Illustration: Progression from Training to Policy Changes: Post-Exposure Prophylaxis

In the fall of 2002, the New England AETC identified a newly funded Title III clinic serving a low income Latino community south of Boston. An AETC clinical program specialist in substance use was assigned to the site to identify needs and develop a series of HIV education programs for the staff. After several months of meetings, the first program took place. The topic was Post-Exposure Prophylaxis (PEP): Occupational and Non-occupational. A series of education sessions and clinical consultations was planned. Two months later, the center's HIV nurse called the AETC hotline. One of the center's employees had a needle stick injury. The nurse realized that the center did not have a PEP policy or procedure in place and said she felt it would "be safe" to call the hotline to get advice. After consulting with the New England AETC, the exposed employee was appropriately triaged and treated. The New England AETC also provided two weeks of intensive technical assistance to help develop a clinic-focused PEP policy and procedure.

Outcomes

Immediate/Short-term

	Increased knowledge of post-exposure prophylaxis in providers.
	Identified New England AETC as a resource for the newly-funded Title III clinic.
	Provided appropriate advice regarding treatment for an occupational exposure.

Mid-term/Long-term:

	Established a policy for post-exposure prophylaxis.
	Met immediate needs and reinforced access to expert assistance.