Overview

The AIDS Education and Training Centers (AETCs) Program of the Ryan White CARE Act supports 14 regional centers with more than 70 local performance sites that conduct targeted, multi-disciplinary education and training programs for health care providers treating persons with HIV/AIDS.

The AETCs Program strives to increase the number of health care providers who are effectively educated and motivated to counsel, diagnose, treat, and medically manage individuals with HIV infections. The AETCs serve all 50 States, the District of Columbia, the U.S. Virgin Islands, Puerto Rico, and the six U.S. Pacific Jurisdictions.

The National Resource AETC supports the training needs of the regional AETCs through coordination of HIV/AIDS training materials, rapid dissemination of new treatment advances and changes in treatment guidelines as well as critical review of available patient education materials.

The National Evaluation AETC is responsible for program evaluation activities, including assessing the effectiveness of the AETCs’ education, training, and consultation activities. The National Evaluation Center also tracks the training activities conducted by the AETCs.

Provider Training

Providers serving minority populations, the homeless, rural communities, incarcerated persons, and Ryan White CARE Act-funded sites are preferentially targeted for training by AETCs Programs. AETCs focus on training primary health care clinicians such as physicians, physician assistants, nurses, dentists and pharmacists.

Training activities are developed based on assessments of local needs. Emphasis is placed on providing clinicians with current, up-to-date treatment information that addresses the complex issues related to providing care and managing patients with HIV/AIDS.

Program Training

The National Evaluation Center along with the regional AETCs and the local performance sites utilize common data collections forms to monitor training activities at the participant and event level.

The Program Report (PR) provides information on the training activity or event. The number of enrolled participants, hours of training and collaboration of Ryan White CARE Act programs in sponsoring the training as well as the level of training provided are reported for each event.

Regional AETCs assign each sponsored educational event to one more training levels. Definitions for each level of training follow.

Level I: Didactic Presentation

• Method of Training
  Didactic knowledge transfer
  Journal club
  
• Training Objective
  Change in knowledge
  Limited attitudinal change
  
• Role of Learner
  Passive
  
• Duration
  Minimum, 1 hour

Level II: Skill Building Workshop

• Method of Training
  Small group interactive sessions
  Workshops
  Role play
  Instructor generated (hypothetical) case discussion
  Use of standardized simulated patient care
  
• Training Objective
  Change in attitudes and skills
  
• Role of Learner
  Interactive with instructor and other participants in skills building activities
  
• Duration
  Minimum, 1 hour
  Typical, 2-4 hours

Level III: Clinical Training

• Method of Training
  Clinical observation of patient care (Level IIIa)
  Interaction with patients in care setting (Level IIIb)
  Mini-residency
  Preceptorship
  Telemedicine
  
• Training Objective
  Change in knowledge, attitude and clinical skills
  Comfort and confidence to make appropriate/sound clinical decisions
  
• Role of Learner
  Interactive with patient and facility within clinical setting
  
• Duration
  Minimum, 1 day
  Typical, 2-5 days

Program Record (PR) Data

The data presented here is a summary of training events conducted by the 14 regional AETCs and the National Minority AETC during the grant year ending June 30, 2001.

During the reporting period July 1, 2000 through June 30, 2001, 4,438 training events were reported. Forty-one percent of these events were Level 1 trainings, 32 percent were Level II, and 27 percent were Level III training activities.

A total of 106,460 trainees participated in AETCs events during the reporting period. Fifty-four percent of the participants enrolled in Level I trainings, 40 percent participated in Level II events and 6 percent enrolled in Level III programs.

Number of Events by Training Level

Data shown in pie chart above:
Level I - 1,853
Level II - 1,404
Level III - 1,181

Number of Participants Attending AETCs Events

Data shown in pie chart above:
Level I - 57,244
Level II - 43,183
Level III - 6,033

Participant Information Form (PIF) Data

In addition to completing the PR data for each training event, AETC programs also have training participants complete a one page Participant Information Form (PIF). The PIF provides data that characterize training participants as well as the clients served by participants.

During the reporting period July 1, 2000 through June 30, 2001, 79,603 PIFs were received from the 14 Regional AETCs submitting data and the National Minority AETC. The data presented here exclude 312 PIFs (less than 1% of all PIFs submitted) due to missing information on training level.

Professional Discipline and Employment Setting

Overall, 17 percent of all training participants during the period July 1, 2000 through June 30, 2001 were physicians. Twenty-eight percent of training enrollees were nurses and an additional 9 percent of trainees were nurse practitioners, other advanced practice nurses or physician assistants. Dentists and dental hygienist comprised 6 percent of those receiving training.

A Community/Primary Care facility was reported as the primary employment setting by 36 percent of training participants. Hospital/Long Term Care facilities were reported by 29% of participants, 10% reported Private Practice/HMOs, and 11% reported Other Health Care settings as participant primary employment settings.

Discipline of Participants by Training Level

Data shown in Bar Chart above:

AIDS Education and Training Centers (AETCs)  TOP

Primary Employment Setting of Participants by Training Level

Data Source: PIF
Notes: This table excludes 19,791 training participants who were not working or had missing information on primary employment setting.

Work Role of Training Participants

Forty-one percent of those participating in AETC sponsored training events during the period July 1, 2000 through June 30, 2001 were care providers. Residents and students represented 12 percent of trainees and 11 percent of participants were case managers. Eleven percent of training participants were persons working in administrative roles.

Work Role by Training Level

Data Source: PIF
Notes: This table excludes 3,126 training participants who had missing information on work role

Race/Ethnicity of Training Participants

Sixty-four percent of all training participants during the July1, 2000 through June 30, 2001 reporting period were White. African Americans comprised 24% of the trainees and 14% were Hispanic. Examination of racial/ethnic characteristics by level of training revealed that 60 percent of those attending Level I trainings were White, 18 percent were African American, and 9 percent were Hispanic.

Race/Ethnicity of All Training Participants

Data shown in pie chart above:
African American 21%
White - 55%
Hispanic - 13%
Asian/Pacific Islander - 6%
American Indian/Alaska Native - 1%
Multiple Race/Ethnicity - 3%

Race/Ethnicity of All Training Participants by Training Level

Data Source: PIF
Notes: This table excludes 3,654 training participants who had missing information on race/ethnicity.

HIV+ Caseload and Patient Characteristics

Twelve percent of the trainees with direct patient care responsibilities reported HIV+ caseloads of 51 or more patients. Eleven percent of participants with patient responsibilities served 21 to 50 HIV+ patients, 10 percent reported providing care to 1 to 20 HIV-infected patients and 36% reported providing care to 1 to 10 HIV-infected patients . Thirty-one percent of the trainees with direct patient care responsibilities reported having no HIV-infected patients.

Seventy-one percent of the training participants with patient care responsibilities reported that 25 percent or more of their patients were racial/ethnic minorities.

Number of HIV+ Patients per Training Participant with Direct Patient Care Responsibilities

Data Source: PIF
Notes: This table excludes 25,320 participants who were not working, do not have direct care responsibilities or had missing information on HIV+ patient caseload. Direct patient care providers include case managers and care providers.

Number of HAART Patients per Training Participant with Direct Patient Care Responsibilities

Percentage of Special Populations in Caseload for Trainees with Direct Patient Care Responsibilities

Data Source: PIF
Notes: The final two tables exclude 25,407participants who were not working, do not have direct care responsibilities or had missing information on percent of minority patients in caseload. Direct patient care providers include case managers and care providers.