The javascript used on this site for creative design effects is not supported by your browser. Please note that this will not affect access to the content on this web site.
Skip Navigation
H H S Department of Health and Human Services
Health Resources and Services Administration
HIV/AIDS Programs

A-Z Index  |  Questions?  |  Order Publications

  • Print this
  • Email this

Prevention with HIV-Infected Persons Seen in Primary Care Settings

About this initiative...
Background  
Grantees
Journal Articles
Initiative's Website Exit Disclaimer

SPNS publications image.
SPNS-related publications...
Listing of SPNS Products  
Download SPNS technical assistance publications (government- and grantee-produced) from the TARGET Center Library Exit Disclaimer keyword: SPNS

Background 

HIV prevention efforts to date have focused primarily on reducing the risk of infection among HIV infected individuals, concentrating on those individuals who engage in "high risk" sexual and drug using activities. Considerably less attention has been given to prevention efforts targeting individuals already infected with HIV. Recent reports suggest that HIV positive individuals continue to engage in risky activities and that their risk-taking may be becoming increasingly common, demonstrating a need for interventions targeting HIV positive individuals in clinical care.

This initiative was designed to address the need for interventions targeting HIV-positive individuals in clinical care, to prevent transmission to uninfected individuals and to prevent re-infection among people who are already infected with the virus. The Special Projects of National Significance (SPNS) program awarded grants to one evaluation center and 15 demonstration sites. The evaluation center provides leadership in the design and evaluation of interventions that will have maximum impact on the theory, practice and policy of HIV prevention in primary health care settings. The 15 clinical demonstration sites were funded to implement and evaluate prevention interventions with HIV-infected individuals seen in primary care settings. The questions to be investigated include:

  1. Are provider-driven interventions in clinical settings effective?
    What specific models are most effective with different target populations (e.g. men of color who have sex with other men, heterosexual women, rural drug users, etc.)?
  2. How can clinicians effectively assess risk and produce behavior change, given time constraints?
  3. Do clinicians have the skills needed to effectively conduct prevention interventions?
  4. What can be done to strengthen clinician skills?
  5. What tools are effective as providers conduct risk assessments and prevention interventions?
  6. What are the obstacles to conducting HIV prevention activities with HIV infected individuals in a clinical setting and how can they be overcome?
  7. Can an integrated approach that includes physician assessment and referral improve behavioral outcomes?
  8. What roles can multi-disciplinary teams play in risk assessment and producing behavior change?
  9. What types of referral links are used and how effective are they?
  10. How can integration of referral resources and clinician-delivered risk assessment and behavior change interventions be achieved?

TOP

Grantees  

Grants for this initiative were awarded to the applicants listed below. The abstract provides both contact information and a brief description of the project. 

University of San Francisco (TA/Evaluation Center)St. Luke's Roosevelt Hospital Center
DeKalb County Board of HealthUniversity of Alabama at Birmingham
Drexel UniversityUniversity of California, Davis
El Rio Santa Cruz Neighborhood Health CenterUniversity of California, San Diego
Fenway Community Health CenterUniversity of Miami
Johns Hopkins UniversityUniversity of North Carolina
Los Angeles County Department of Health ServicesUniversity of Washington
Mount Sinai HospitalWhitman-Walker Clinic

TOP


The University of San Francisco: The Ryan White Prevention Project 
Center for AIDS Prevention Studies
AIDS Research Institute
University of California, San Francisco
74 New Montgomery Street, #600
San Francisco, CA 94105

The Ryan White Prevention Project (RWPP) is a proposal to establish an Evaluation and Support Center for an Initiative on Prevention with HIV Infected persons Seen in Primary Care Settings (Center). The mission of the Center is to provide leadership in the design and evaluation of interventions that will have maximum impact on the theory, practice and policy of HIV prevention in primary health care settings. The project is being conducted by a multidisciplinary team lead by the Center for AIDS Prevention Studies (CAPS) within the AIDS Research Institute (ARI) at the University of California, San Francisco (UCSF). The specific aims of the Center are:

  1. To facilitate and conduct rigorous evaluation research across multiple demonstration sites that will have maximum impact on practice and policy of HIV prevention.
  2. To provide methodological (both quantitative and qualitative) research design and evaluation consultation and support to proposed demonstration projects, technical assistance on the development of behaviorally based interventions, assist sites in design of state-of-the-art data collection and management systems, and provide a central database for measurement outcomes.
  3. To synthesize and disseminate findings from demonstration projects so that they have optimum impact on further prevention research, practices and policies.
  4. To provide the leadership to stimulate innovative projects and ensure scientific excellence, as well as the organizational capacity to ensure integrity of research and sound fiscal operations.

The Center is working with HAB's SPNS program for the next five years as part of the agency's initiative on prevention with person seen in primary care settings. The Center is also working with specific projects to be funded during years 2-5 of the initiative. During the first year, the Center has worked with the SPNS program to refine a proposed multisite evaluation design for behavioral interventions with HIV infected individuals in health care settings. In the following years, the Center will work with the SPNS to evaluate the demonstration projects and disseminate findings to other health care settings.

TOP


DeKalb County (GA) Board of Health 
445 Winn Way, PO Box 987
Decatur, GA 30031

Project Title: Prevention with HIV Positives in the Clinical Setting

Project Period: 2003-06

Target Population: Urban African-American patients living with HIV infection

Collaborating Partners: The Southeast AIDS Training and Education Center, and the AIDS Research Consortium of Atlanta

Description: This project is testing the feasibility and impact of three different models of intervention with the target population being seen at an existing early care clinic. The first model is prevention counseling and education conducted solely by existing clinical providers. All providers are trained before the project is initiated. The second model will have such counseling conducted by an HIV prevention specialist. The third model is a small group intervention. The evaluation of the project will examine and compare the impact of each model with regard to development of individualized plans for behavior change, and self-reports of behavior change sustained over time. Outcomes with regard to decreases in secondary transmission of HIV to others are also being examined.

TOP


Drexel University 
School of Public Health
1505 Race Street, 11th Floor, MS 660
Philadelphia, PA 19102

Project Title: The Protect and Respect Program for Women Living with HIV or AIDS

Project Period: 2003-06

Target Population: HIV-infected women

Collaborating Organizations: the Partnership Comprehensive Care Practice (PCCP) of the Drexel University College of Medicine; the Business College at Drexel University; and the Pennsylvania Mid-Atlantic AIDS Education and Training Center (AETC)

Description: This project is seeking to reduce high risk sexual behavior among women being seen at PCCP by adding prevention-oriented small group skill-building sessions and peer support activities to existing prevention counseling provided by clinical providers. Evaluation focuses on clinical outcomes, self report regarding behavior, reports from providers and economic analyses. Cost effectiveness analysis is being performed by faculty in the Business School. Training is being provided by the Pennsylvania Mid-Atlantic AETC.

TOP


El Rio Santa Cruz Neighborhood Health Center 
Special Immunology Associates
839 West Congress
Tuscon, AZ 85745

Project Title: Supporting Healthy Alternatives through Patient Education (SHAPE)

Project Period: 2003-06

Target Population: HIV-infected persons currently being seen in clinical primary care services, many of whom are persons of Latino descent

Collaborating Partners: Impact Consulting, and the Center for AIDS Prevention Studies at the University of California, San Francisco

Description: This project is implementing a prevention specialist educational intervention to complement prevention counseling currently provided by clinical providers in the context of ongoing HIV-oriented primary care. A specialist intervention developed by Kalichman, et.al. (2001) is being modified to be culturally and linguistically matched to the target audience. The intervention are focusing on high-risk anal and vaginal intercourse and disclosure of HIV status to sexual partners. Patients receiving the prevention specialist intervention are being compared to those receiving only the clinical provider counseling. The project evaluation is examining outcome data related to reduction HIV transmission and re-infection risks, and increasing efficacy for self-disclosure of serostatus. Process data regarding project reach and fidelity, and client satisfaction are also be examined.

TOP


Fenway Community Health Center 
7 Haviland Street
Boston, MA 02115

Project Title: HIV Prevention in Primary Care Settings

Project Period: 2003-06

Target Population: HIV infected men who are sexually active with other men

Description: This project is conducting a randomized trial of a four-session behavioral intervention to reduce high-risk sexual practices among HIV-infected men who have sex with other men. Particular attention is being given to engaging men who are receiving HIV-oriented primary care at the Fenway Center. An individualized intervention is being given by a medical social worker, to include education, motivational and behavioral skills enhancement in addition to standard prevention case management (PCM). Control group participants will only receive PCM. Once screened, patients who have engaged in unprotected anal intercourse with anyone except a monogamous seroconcordant partner during the previous 3 months will be enrolled into the study.

TOP


Johns Hopkins University 
School of Medicine
1830 E. Monument Street, Room 445
Baltimore, MD 21287

Project Title: Improving Provider Counseling Interventions in HIV Practice

Project Period: 2003-04

Target Population: HIV-infected patients being seen in existing HIV clinics

Collaborating Partners: The Rochester (NY) Center for Health and Behavioral Training

Description: This project is evaluating the impact of a prevention counseling protocol that will be used by existing clinical providers. Participating patients are being asked to complete an audio-computer assisted self interview (ACASI) upon arrival at clinical appointments. Of these, a randomly-selected portion of those presenting high-risk profiles are given prevention counseling as part of their scheduled visit. The ACASI risk assessment with counseling by providers (according to assignment to an intervention or control group) will continue at every standard 3 month visit for the following year. All providers are being trained by a staff person from the Rochester Center for Health and Behavioral Training before the project is initiated.

The project is being evaluated by comparing changes in self-reported transmission behavior at 12-month follow-up in the intervention group compared to the control group. The project is also measuring patients' intent to change behavior as captured by the ACASI. Finally, the evaluation is measuring improvements in health service counseling during clinical encounters, and patients' perception of the intervention's impact on interactions with clinical providers.

TOP


Los Angeles County Department of Health Services 
600 S. Commonwealth Avenue, 6th Floor
Los Angeles, CA 90005

Project Title: HIV Prevention in Primary Care Settings

Project Period: 2003-05

Target Population: Sexually active HIV-infected patients being seen at HIV-oriented primary care sites

Collaborating Partners: The Keck School of Medicine at the University of Southern California, Children's Hospital of Los Angeles, AltaMed Health Services, and Northeast Valley Health Corporation

Description: From 2001-02, the awardee and its partners studied the impact of current prevention counseling offered by clinical providers in the context of ongoing clinical care, and established impact baselines. During 2003-05, the awardee and its partners will study the effect enhanced provider-based prevention services using motivational interviewing and loss-framed messages. Project goals include improving the patient-provider relationship, improving the ability of providers to iimplement prevention counseling, and reduce high-risk sexual behaviors. Project evaluation will assess the extent to which the enhanced intervention meets project goals, identify patient characteristics that are covariates of outcomes and/or that act as moderators in the intervention, and assess the extent to which high-risk sexual behaviors are related to demographic characteristics and co-occuring behaviors such as substance abuse.

TOP


Mount Sinai Hospital, Chicago 
Infectious Disease Clinic
California Avenue at 15th Street
Chicago, IL 60608

Project Title: HIV Prevention in Treatment Settings

Project Period: 2003-06

Target Population: HIV-infected low-income persons of African-American or Mexican-American ethnicity

Description: This project is evaluating the impact of a 12 month-behavioral intervention consisting of multiple individualized educational sessions with a peer advocate using computer-assisted technology. Persons who receive the intervention are being stratified by length of time from diagnosis (newly diagnosed vs. diagnosed for more than 18 months), and compared to persons who only receive prevention counseling from primary care providers according to current protocols. Evaluation of the project will examine impact of each intervention on coping ability, adherence to treatment regimens, elimination of high-risk sexual behaviors, and adoption of lower risk practices with regard to drug use (particularly injection drug use). Evaluation issues to be investigated in the peer advocate intervention include: the extent to which the intervention is effective with newly diagnosed persons vs. persons who have been infected for some time, and the extent to which participant impacts vary by HIV risk factor and demographic characteristics.

TOP


St. Luke's Roosevelt Hospital Center 
Center for Comprehensive Care
1111 Amsterdam Avenue
New York, NY 10025-0000

Project Title: Positive Prevention

Project Period: 2003-06

Target Population: HIV infected persons being seen at the Center for clinical services

Description: This project is implementing an individualized, non-judgmental, and culturally competent prevention specialist intervention with current patients. Staff nurses at the Center are being trained in behavioral risk assessment and theories and techniques of behavior change. Patients are periodically assessed for risk and recruited into the intervention based upon risk profile. Motivational interviewing techniques and peer support groups are being employed. Specific behavioral outcomes that the intervention is seeking are: increased condom use during sexual activity, decreased high-risk needle use when injecting substances, decreased substance use, and improved treatment adherence. The project's evaluation will examine patient demographic variables, activity process data, the impact of the intervention on self-reported risk behaviors and service utilization, and clinical outcomes.

TOP


University of Alabama at Birmingham 
Division of Infectious Diseases, STD Program
ZRB 242, 1530 3rd Avenue, South
Birmingham, AL 35294

Project Title: HIV Prevention in the Primary Care Setting

Project Period: 2003-06

Target Population: HIV-infected men who have sex with men

Description: This project is conducting a randomized trial evaluating the effectiveness of an enhanced provider-delivered, client-centered intervention that seeks to increase motivation, facilitate positive decision-making, and increase self-efficacy for changing sexual risk behaviors. Provider-delivered messages and strategies are based on the conceptual framework of the transtheoretical model of change and matched to each patient's level of motivation to change. Computer-assisted self-interviewing technology is being used. The project will be evaluated with regard to achievement of three behavioral outcomes: increases in condom use with primary and any secondary casual partners, decreases in number of sexual partners among those reporting multiple partners, and increases in the frequency of HIV serostatus disclosure to all sexual partners. Patients receiving the intervention will be compared to those receiving only standard prevention counseling according to current clinic protocols. Incidence of sexually transmitted diseases will also be examined.

TOP


University of California, Davis 
AIDS Education and Training Center
4150 V Street, PSSB 500
Sacramento, CA 95817

Project Title: Prevention Intervention Strategies with HIV-infected Persons Seen in Four Different Primary Care Settings

Project Period: 2003-06

Target Population: HIV-infected persons seen in clinics that primarily serve low-income populations, most of who are persons of color

Collaborating Partners (if any): The Center for Health Services Research in Primary Care, and the NorCal HIV Primary Care Providers Consortium

Description: This project is training primary care providers in existing clinics, and adding the services of an HIV specialist health educator to promote behavior change among HIV-infected patients. Two intervention models are being tested. The first model is a brief intervention from a primary care provider during a regularly scheduled clinic appointment. The second model is a brief intervention by the primary care provider, immediately followed by an educational session with an HIV specialist health educator. All clinical providers are being trained in HIV prevention counseling before the project begins. Evaluation of the project will examine the extent to which the sole clinical provider counseling and the combined provider-health education specialist models are effective in reducing the prevalence of high risk behavior among patients being seen, compare the impacts of each model, assess the relative costs of each, and postulate the cost-effectiveness of each intervention.

TOP


University of California, San Diego 
The Owen Clinic of the UCSD Medical Center
200 W. Arbor Drive, MC 8681
San Diego, CA 92103-8681

Project Title: Primary Prevention for Positives

Project Period: 2003-06

Target Population: HIV-infected persons currently being seen in primary care services

Description: This project is introducing an enhanced intervention using individualized prevention specialist counseling sessions with a portion of the target population identified as at high risk for transmitting infection to others. Those identified as at high risk are being referred into the enhance intervention consisting of a minimum of six hour-long sessions. Audio-computer assisted self-interviewing (ACASI) is being used to assess risk and progress toward change. The patient, primary care provider, and prevention specialist are periodically reviewing data provided by the ACASI system with regard to patient knowledge, skills, motivation , resources, and support, and identify opportunities for further change. The overall goal is to reduce the risk of HIV transmission from patients to sexual and/or needle sharing partners. The project evaluation will examine the following data: percent change in reported high risk sexual and/or drug using behaviors; intervention effects on estimates of potentially transmitting HIV to others; percent change in STD rates as measured by laboratory screening tests and client self-report; costs of implementing the intervention; and potential for reproducing the intervention.

TOP


University of Miami 
School of Medicine, Department of Psychiatry and Behavioral Sciences
1695 NW 9th Avenue
Miami, FL 33136

Project Title: Project Road Map

Project Period: 2003-06

Target Population: HIV-infected individuals 50 years of age and older

Collaborating Partner: The Adult Special Immunology Clinic at the Univsersity of Miami's Jackson Memorial Hospital

Description: This project is adapting an intervention model developed in the NIMH Multi-site Prevention Trial, Project LIGHT, to include issues related to secondary prevention of HIV infection, disclosure of HIV status to others, and addressing unique life needs of older adults. Participants are being recruited via referrals from primary care providers, and randomly assigned to an intervention group or a control group. The intervention group is receiving four 90 - 120 minute small group intervention addressing prevention and risk reduction issues. Specific groups are being formed based upon language (Spanish vs. English) and gender. The impact of each intervention will be evaluated with regard to HIV knowledge, risk reduction problem solving, and self-reported lower risk sexual behaviors.

TOP


University of North Carolina, Chapel Hill 
Infectious Disease Clinic
130 Mason Farm Road CB# 7030
Chapel Hill 27599

Project Title: UNC HIV Prevention Demonstration Project

Project Period: 2003-06

Target Population: HIV-infected persons living in non-urban areas

Description: This project is introducing enhanced prevention services into an existing Title III Early Intervention program for HIV care. Enhanced services consists of the following: patient risk assessment using a web-based risk screening tool, counseling by primary care providers based upon screening results, patient education via an educational tool linked to the web-based screening tool, and motivational interviewing by a health behavior specialist. Primary care providers are being trained before the enhanced intervention is initiated. Project evaluation will examine behavioral and health outcomes to include self-reported risk behaviors, disclosure of HIV status to others, and incidence of sexually transmitted infections. Intervention (frequency and duration) dose and cost data will also be examined.

TOP


University of Washington 
HIV/AIDS Research Program
901 Boren Avenue, Suite 900
Seattle, WA 98104

Project Title: Prevention for Positives

Project Period: 2003-06

Target Population: HIV-infected patients currently being seen at the Madison Clinic

Collaborating Partners: The Madison Clinic of the Harborview Medical Center, Seattle, WA

Description: This project is implementing an enhanced prevention specialist intervention into an existing HIV primary care clinic. Working closely with primary care providers and case managers, a trained nurse specialist is conducting risk-assessments with patients using a audio-enhanced, computer-assisted self interview. Persons with high risk profiles are being recruited into a 12-month individualized intervention by the nurse specialist. Motivational interviewing and small group peer interventions are being employed. Evaluation of the project will examine changes in patient behaviors at 12 and 24 month intervals. Intervention patients will be compared to patients referred to the intervention but who choose not to enroll or who delay enrollment. Provider behavior change will also be assessed through reviews of medical records.

TOP


Whitman-Walker Clinic 
1407 S Street, NW
Washington, DC 20009

Project Title: Prevention with HIV-infected Persons Seen in Primary Care

Project Period: 2003-06

Target Population: HIV-infected men who are seen in HIV-oriented primary care facilities

Collaborating Partners: Georgetown University School of Nursing and Health Studies, and Boston University School of Public Health

Description: This project is evaluating the impact of an intervention that combines primary care provider counseling with focused behavioral interventions by health educators. Outcome measures are being examined include awareness of sexual risk, openness and trust with primary care providers regarding high risk behaviors, and self-reports of engagement in high-risk behaviors. A quasi-experimental design with a longitudinal time dimension is being used. Duration and intensity of the intervention, patient demographics, and risk assessment scores are also being compared.

TOP

Journal Articles 

Marseille E, Shade SB, Myers J, & Morin S. The cost-effectiveness of HIV prevention interventions for HIV-infected patients seen in clinical settings.  Journal of Acquired Immune Deficiency Syndromes, 2011 March; 56 (3): e87-e94. http://www.ncbi.nlm.nih.gov/pubmed/21317579

Myers JJ, Shade SB, Rose CD, Koester K, Maiorana A, Malitz FE, Bie J, Kang-Dufour MS, & Morin SF (2010). Interventions Delivered in Clinical Settings are Effective in Reducing Risk of HIV Transmission Among People Living with HIV: Results from the Health Resources and Services Administration (HRSA)'s
Special Projects of National Significance Initiative. Aids and Behavior, E-published ahead of print March 13, 2010.

Estes LJ, Lloyd LE, Teti M, Raja S, Bowleg L, Allgood KL, & Glick N. (2010) Perceptions of Audio Computer-Assisted Self-Interviewing (ACASI) among Women in an HIV Positive Prevention Program. PLoS ONE 5(2): e-published February 10, 2010. Exit Disclaimer

Iverson EF, Balasuriya D, García GP, Sheng M, Richardson JL, Stoyanoff S, & King JB (2008) The Challenges of Assessing Fidelity to Physician-Driven HIV Prevention Interventions: Lessons Learned Implementing Partnership for Health in a Los Angeles HIV Clinic. AIDS and Behavior, 12 (6): 978-988.

Grodensky CA, Golin CE, Boland MS, Patel SN, Quinlivan EB, & Price M. (2008) Translating concern into action: HIV care providers' views on counseling patients about HIV prevention in the clinical setting. AIDS and Behavior, 12 (3): 404-411.

Malitz FE, & Eldred L. (2007) Evolution of the special projects of national significance prevention with HIV-infected persons seen in primary care settings initiative.AIDS and Behavior, 11 (5 Supplement): S1-S5.

Morin SF, Myers JJ, Shade SB, Koester K, Maiorana A, & Rose CD. (2007) Predicting HIV transmission risk among HIV-infected patients seen in clinical settings. AIDS and Behavior, 11 (5 Supplement): S6-16.

Koester KA, Maiorana A, Vernon K, Myers J, Rose CD, & Morin S. (2007) Implementation of HIV prevention interventions with people living with HIV/AIDS in clinical settings: challenges and lessons learned. AIDS and Behavior, 11 (5 Supplement): S17-S29.

Myers JJ, Rose CD, Shade SB, Koester KA, Maiorana A, Malitz F, Steward WT, & Morin SF. (2007) Sex, risk and responsibility: provider attitudes and beliefs predict HIV transmission risk prevention counseling in clinical care settings. AIDS and Behavior, 11 (5 Supplement): S30-S38.

Grimley DM, Bachmann LH, Jenckes MW, & Erbelding EJ. (2007) Provider-delivered, theory-based, individualized prevention interventions for HIV positive adults receiving HIV comprehensive care. AIDS and Behavior, 11 (5 Supplement): S39-S47.

Callahan EJ, Flynn NM, Kuenneth CA, & Enders SR. (2007) Strategies to reduce HIV risk behavior in HIV primary care clinics: brief provider messages and specialist intervention. AIDS and Behavior, 11 (5 Supplement): S48-S57.

Zúñiga ML, Baldwin H, Uhler D, Brennan J, Olshefsky AM, Oliver E, & Mathews WC. (2007) Supporting Positive Living and Sexual Health (SPLASH): a clinician and behavioral counselor risk-reduction intervention in a university-based HIV clinic. AIDS and Behavior, 11 (5 Supplement): S58-S71.

Golin CE, Patel S, Tiller K, Quinlivan EB, Grodensky CA, & Boland M. (2007) Start Talking About Risks: development of a Motivational Interviewing-based safer sex program for people living with HIV. AIDS and Behavior, 11 (5 Supplement): S72-S83.

Nollen C, Drainoni ML & Sharp V. (2007) Designing and delivering a prevention project within an HIV treatment setting: lessons learned from a specialist model. AIDS and Behavior, 11 (5 Supplement): S84-S94.

Estrada BD, Trujillo S, & Estrada AL. (2007) Supporting Healthy Alternatives through Patient Education: a theoretically driven HIV prevention intervention for persons living with HIV/AIDS. AIDS and Behavior, 11 (5 Supplement): S95-S105.

Teti M, Rubinstein S, Lloyd L, Aaron E, Merron-Brainerd J, Spencer S, Ricksecker A, & Gold M. (2007) The Protect and Respect program: a sexual risk reduction intervention for women living with HIV/AIDS. AIDS and Behavior, 11 (5 Supplement): S106-S116.

Knauz Rom Safren SA, O’Cleirigh C, Capistrant BD, Driskell JR, Aguilar D, Salomon L, Hobson J, & Mayer KH (2007) Developing an HIV-Prevention Intervention for HIV-Infected Men Who Have Sex with Men in HIV Care: Project Enhance. AIDS and Behavior, 11 (5 Supplement): S117-S126.

Raja S, McKirnan D, & Glick N. (2007) The Treatment Advocacy Program--Sinai: a peer-based HIV prevention intervention for working with African American HIV-infected persons. AIDS and Behavior, 11 (5 Supplement): S127-S137.

Steward WT, Koester KA, Myers JJ, & Morin SF. (2006) Provider fatalism reduces the likelihood of HIV-prevention counseling in primary care settings. AIDS and Behavior, 11 (1): 3-12.

Myers JJ, Steward WT, Charlebois E, Koester KA, Maiorana A, & Morin SF (2004) Written clinic procedures enhance delivery of HIV "prevention with positives" counseling in primary health care settings.Journal of Acquired Immune Deficiency Syndromes, 37 (Supplement 2): S95-S100.

Morin SF, Koester KA, Steward WT, Maiorana A, McLaughlin M, Myers JJ, Vernon K, & Chesney MA. (2004) Missed opportunities: prevention with HIV-infected patients in clinical care settings. Journal of Acquired Immune Deficiency Syndromes, 36 (4): 960–966.

TOP

Part F - SPNS Resources

A Living History: Get the Back Story Image.

The SPNS program began with some of the first Federal grants to target adolescents and women living with HIV, and over the years, initiatives have been developed to reflect the evolution of the epidemic and the health care arena.



Part F - SPNS Products and Publications

iHiP Exit Disclaimer

Products from SPNS Initiatives

Technical Assistance TARGET Center Library Exit Disclaimer

SPNS Staff

Adan Cajina
Branch Chief
acajina at hrsa.gov
301-443-3180

Pamela Belton
Public Health Analyst
pbelton at hrsa.gov
301-443-4461

Renetta Boyd
Public Health Analyst
rboyd at hrsa.gov
301-443-4549

Chau Nguyen
Public Health Analyst
cnguyen1 at hrsa.gov
301-443-5785

Natalie Solomon
Public Health Analyst
nsolomon at hrsa.gov
301-443-7753

Melinda Tinsley
Public Health Analyst
mtinsley1 at hrsa.gov
301-443-3496

Jessica Xavier
Public Health Analyst
jxavier at hrsa.gov
301-443-0833