Beyond the Barefoot Doctors: Using Community Health Workers to Translate HIV Research to Service
Miami-Dade leads the nation in new HIV infections, and its Black communities experience the greatest disparities in outcomes. Our prior research found that street-based HIV testing facilitated by community health workers improved access to testing and care among Black adults in a controlled trial setting. Herein, we describe our efforts translating this CHW-led intervention into a community service for diverse Blacks in Miami. From December 2016 through August 2017, CHWs educated 1672 individuals about HIV transmission, prevention methods, and risk factor modification; 529 received HIV testing and/or linkage to care services. Approximately 5% of participants (n = 26) had rapid reactive results. This efficacious and culturally-acceptable model represents a powerful change in the delivery of HIV care and demonstrates how public health leaders can foster community engagement in the transition from research to service.
KeywordsCommunity health workers HIV disparities Home-based HIV rapid testing Translational research
CHAMP was supported by the Elton John AIDS Foundation (Grant No. 5202-00-00). This program would not be possible without the dedication of our Sr. Community Health Worker, Jakisha Blackmon, and the support of Zachary Gardner, Emanuel Washington, and our growing team of Community CHAMPIONS.
- 1.Florida Department of Health. The crisis of HIV in Florida’s Black communities. Miami: Florida Department of Health. 2018. http://www.floridahealth.gov/diseases-and-conditions/aids/surveillance/_documents/fact-sheet/SID_FINAL2018.pdf. Accessed 8 Aug 2018.
- 2.Centers for Disease Control and Prevention. HIV surveillance report, 2016. 2017. http://www.cdc.gov/hiv/library/reports/hiv-surveillance.html. Accessed 8 Aug 2018.
- 3.Centers for Disease Control and Prevention. CDC Fact Sheet: Today’s HIV/AIDS epidemic. 2016. https://www.cdc.gov/nchhstp/newsroom/docs/factsheets/todaysepidemic-508.pdf. Accessed 8 Aug 2018.
- 4.Centers for Disease Control and Prevention. HIV among African Americans. 2017. https://www.cdc.gov/hiv/group/racialethnic/africanamericans/index.html. Accessed 8 Aug 2018.
- 5.Smith J, Simmons E, Mayer KH. HIV/AIDS and the Black Church: what are the barriers to prevention services? J Natl Med Assoc. 2005;97(12):1682.Google Scholar
- 6.Centers for Disease Control and Prevention. 30 years of HIV in African American communities: a timeline. 2012. https://www.cdc.gov/nchhstp/newsroom/docs/Timeline-30years-HIV-African-American-Community-508.pdf. Accessed 8 Aug 2018.
- 7.OraQuick ADVANCE Infectious Disease Testing. OraSure Technologies. 2016. https://orc.orasure.com/default.aspx?pageid=159. Accessed 8 Aug 2018.
- 10.Kenya S, Okoro I, Wallace K, Carrasquillo O, Prado G. Strategies to improve HIV testing in African Americans. JANAC. 2015;26(4):357Google Scholar
- 15.FloridaHealth - Miami-Dade. HIV/AIDS neighborhood profiles. Florida Department of Health. 2016. http://miamidade.floridahealth.gov/programs-and-services/infectious-disease-services/hiv-aids-services/neighborhood-profiles-new.html. Accessed 8 Aug 2018.
- 16.The Demographic Atlas of the US – Overview of Miami-Dade. Statistical atlas. 2014. https://statisticalatlas.com/place/Florida/Miami/Race-and-Ethnicity. Accessed 8 Aug 2018.
- 17.Why Liberty City?. I am liberty city. 2019. https://www.iamlibertycity.org/why-liberty-city/why-liberty-city. Accessed 8 Aug 2018.
- 18.HIV Prevalence in Florida. County health rankings and roadmaps. 2018. http://www.countyhealthrankings.org/app/florida/2014/measure/outcomes/61/data?sort=desc-3. Accessed 8 Aug 2018.
- 19.Lehmann U, Sanders D. Community health workers: what do we know about them. The state of the evidence on programmes, activities, costs and impact on health outcomes of using community health workers. Geneva: World Health Organization; 2007. p. 1–42.Google Scholar
- 20.HIV Testing|HIV/AIDS. Centers for disease control and prevention. 2018. https://www.cdc.gov/hiv/testing/index.html. Accessed 8 Aug 2018.
- 21.Testing and Counseling|Florida Department of Health. Florida Health. 2018. http://www.floridahealth.gov/diseases-and-conditions/aids/prevention/testing-counseling.html. Accessed 8 Aug 2018.
- 23.IBM Corp. Released 2017. IBM SPSS statistics for Macintosh, Version 24.0. Armonk, NY: IBM Corp.; 2017.Google Scholar
- 28.Anderson M. A rising share of the U.S. Black population is foreign born. Washington, DC: Pew Research Center. 2015. https://www.pewsocialtrends.org/2015/04/09/a-rising-share-of-the-u-s-black-population-is-foreign-born/. Accessed 8 Aug 2018.
- 29.Income and Poverty in Miami-Dade: 2013. Miami: Miami-Dade county department of regulatory and economic resources. 2015. http://www.miamidade.gov/business/research.asp. Accessed 8 Aug 2018.