2281. Building Comprehensive HIV Prevention, Testing, and Care Capacity in Rural Communities
Session: Poster Abstract Session: Teaching the Future: Education in Infectious Diseases
Saturday, October 29, 2016
Room: Poster Hall
  • LarsonHIVRural.pdf (181.9 kB)
  • Background: Indiana’s unprecedented HIV outbreak, due to prescription opioid injection misuse, portends additional possible outbreaks in other rural communities where prescription opioid misuse and/or HCV infections are prevalent. Shortly after the public health emergency response to the outbreak concluded, Med-IQ, in collaboration with the Indiana University School of Medicine Office of CME and the National Rural Health Association (NRHA), implemented a comprehensive educational initiative designed to close practice gaps in HIV screening, prevention, and management approaches in rural healthcare settings wrestling with epidemics of prescription opioid misuse.

    Interventions targeting HIV, HCV, and opioid use disorder in rural areas must consider unique socioeconomic characteristics, including high poverty rates and limited healthcare access. Local solutions engaging a variety of clinicians, designed in collaboration with regional infectious disease experts familiar with rural communities’ culture and health infrastructure, are essential to develop and strengthen HIV prevention efforts in resource-limited settings.

    Methods: The CME/CE-certified education was delivered in a series of 4 live workshops in rural cities in Indiana and Kentucky, and 2 Webinars for a national audience of rural healthcare providers, hospital staff, and public health officials provided live through NRHA and endured online by Med-IQ. Learning gains were measured by pre/post surveys.

    Results: Outcomes data suggest the workshops elevated awareness of screening PWID for HIV, indicated by an increase of 36% in the self-reported intention to implement testing into routine care. Learners demonstrated knowledge and competence gains on HIV testing specifics, the timing of ART initiation after HIV diagnosis, and first-line ART selection for uncomplicated patient cases. Additionally, 35% more learners reported they were moderately or extremely confident in counseling PWID on HIV risk-reduction strategies immediately after the workshops.

    Conclusion: Despite these knowledge gains, gaps in care remain in the approach to patients with newly diagnosed HIV and opioid use disorders and will require a continued comprehensive approach to prevent future epidemics. Future directions will focus on assessment of enduring components’ outcomes.

    Stephanie Larson, PhD1, Allison Gardner, PhD1, Matthew Miles, MD2, Mitchell Goldman, MD3, Kurt Snyder, JD4 and Diane M. Janowicz, MD3, (1)Med-IQ, Baltimore, MD, (2)Indiana University School of Medicine, Indianapolis, IN, (3)Infectious Diseases, Indiana University School of Medicine, Indianapolis, IN, (4)Division of Continuing Medical Education, Indiana University School of Medicine, Indianapolis, IN


    S. Larson, None

    A. Gardner, None

    M. Miles, None

    M. Goldman, None

    K. Snyder, None

    D. M. Janowicz, None

    Findings in the abstracts are embargoed until 12:01 a.m. CDT, Wednesday Oct. 26th with the exception of research findings presented at the IDWeek press conferences.