Training centers gear up to teach new standards

Satellite conferences planned this fall

With so much at stake on whether new therapies eradicate HIV or fail under the pressures of resistance, public health officials are doing their best to give primary care providers access to new HIV treatment guidelines, and adequate training in how to apply the guidelines in their practices.

Unlike previous HIV treatment recommendations, the new federal guidelines underscore the complexity of treating AIDS in an era of combination therapy and viral-load testing. The guidelines suggest that primary care physicians who have little contact with AIDS patients seek referral or consultation with providers who have expertise in HIV. But even experienced HIV providers will require updated training in how to put the recommendations into practice, they say.

By the time the federal guidelines become final, the Health Resources and Services Administration will have a plan for saturating its training programs with programs and activities on the new standard of care, says Bruce Martell, acting chief of HRSA’s AIDS Education and Training Centers (AETC), a network of 15 regional centers established 10 years ago to provide multidisciplinary HIV education and training for health care providers, including social workers. The programs will help providers interpret the guidelines and give them tools for making treatment decisions.

"At lot of it now is much more patient contact, more counseling and education of the patient, and then a joint decision by both the provider and patient on the best course of treatment," he says. "We have been working for years trying to get physicians to do a better job of taking a sexual history, drug history, doing prevention counseling, and now this is an added-on responsibility to try to get them to work more closely with patients."

In September, AETC will sponsor a clinical conference call on the new guidelines. It also is planning a November satellite broadcast in conjunction with the Centers for Disease Control and Prevention on what the new guidelines’ implications are for providers.

Martell also points out that AETC has provided an HIV consultation "warm line" for providers for six years now. The line is connected to HIV experts at San Francisco General Hospital. The toll-free line (800-933-3413) has been active in the past year because of the advent of protease inhibitors, and will become busier now that the guidelines are published. Callers are not only given expert advice, but are referred to local training centers for more education. (See chart listing training centers, p. 89.)