Skip to main content

Advertisement

SpringerLink
Log in

Beyond the Barefoot Doctors: Using Community Health Workers to Translate HIV Research to Service

  • Original Paper
  • Published:
AIDS and Behavior Aims and scope Submit manuscript

Abstract

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  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.

    PubMed  PubMed Central  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.

  8. Kenya S, Chida N, Symes S, Shor-Posner G. Can community health workers improve adherence to highly active antiretroviral therapy in the USA? a review of the literature. HIV Medicine. 2011;12(9):525.

    Article  CAS  PubMed  Google Scholar 

  9. Kenya S, Jones J, Arheart K, Kobetz E, Chida N, Baer S, Powell A, Symes S, Hunte T, Monroe A, Carrasquillo O. Using community health workers to improve clinical outcomes among people living with HIV: a randomized controlled trial. AIDS Behavior. 2013;17(9):2927.

    Article  PubMed  Google Scholar 

  10. Kenya S, Okoro I, Wallace K, Carrasquillo O, Prado G. Strategies to improve HIV testing in African Americans. JANAC. 2015;26(4):357

    PubMed  Google Scholar 

  11. Kenya S, Okoro IS, Wallace K, Ricciardi M, Carrasquillo O, Prado G. Can home-based HIV rapid testing reduce HIV disparities among African Americans in Miami? Health Promot Pract. 2016;17(5):722

    Article  PubMed  Google Scholar 

  12. Busza J, Dauya E, Bandason T, et al. The role of community health workers in improving HIV treatment outcomes in children: lessons learned from the ZENITH trial in Zimbabwe. Health Policy Plan. 2018;33(3):328–34.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Breimaier HE, Heckemann B, Halfens RJ, Lohrmann C. The consolidated framework for implementation research (CFIR): a useful theoretical framework for guiding and evaluating a guideline implementation process in a hospital-based nursing practice. BMC Nurs. 2015;14(1):43.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Twycross A, Shorten A. Service evaluation, audit and research: what is the difference? Evid Based Nurs. 2014;17(3):65–6.

    Article  PubMed  Google 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.

  22. LaChausse R. Evaluation of the positive prevention HIV/STD curriculum. Am J Health Educ. 2006;37(4):203–9.

    Article  Google Scholar 

  23. IBM Corp. Released 2017. IBM SPSS statistics for Macintosh, Version 24.0. Armonk, NY: IBM Corp.; 2017.

    Google Scholar 

  24. Krishnaratne S, Hensen B, Cordes J, Enstone J, Hargreaves J. Interventions to strengthen the HIV prevention cascade: a systematic review of reviews. Lancet HIV. 2016;3(7):307–17.

    Article  Google Scholar 

  25. McNairy M, El-Sadr W. A paradigm shift: focus on the HIV prevention continuum. Clin Infect Dis. 2014;59(Suppl 1):S12–5.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Jenness SM, Myers JE, Neaigus A, Lulek J, Navejas M, Raj-Singh S. Delayed entry into HIV medical care after HIV diagnosis: risk factors and research methods. AIDS Care. 2012;24(10):1240–8.

    Article  PubMed  Google Scholar 

  27. Kim K, Choi JS, Choi E, Nieman CL, Joo JH, Lin FR, Gitlin LN, Han HR. Effects of community-based health worker interventions to improve chronic disease management and care among vulnerable populations: a systematic review. Am J Public Health. 2016;106(4):e3–28.

    Article  PubMed  PubMed Central  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.

  30. Keenan JM, Hill T, Gumber A. Climate gentrification: from theory to empiricism in Miami-Dade County, Florida. Environ Res Lett. 2018;13(5):054001.

    Article  Google Scholar 

  31. Barría P, Mauricio R. The gap remains: the challenge of translating research into policies for the health care of people and communities. Invest Educ Enferm. 2017;35(2):129–30.

    Article  Google Scholar 

Download references

Acknowledgements

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.

Author information

Authors and Affiliations

  1. Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA

    BreAnne Young, Amanda Rosenthal, Simran Shah, Olveen Carrasquillo & Sonjia Kenya

  2. Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA

    BreAnne Young & Sebastian Escarfuller

  3. Don Soffer Clinical Research Center, University of Miami Miller School of Medicine, 1120 NW 14th Street, Suite 960, Miami, FL, 33136, USA

    BreAnne Young

Authors
  1. BreAnne Young
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Amanda Rosenthal
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sebastian Escarfuller
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Simran Shah
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Olveen Carrasquillo
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Sonjia Kenya
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to BreAnne Young.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Young, B., Rosenthal, A., Escarfuller, S. et al. Beyond the Barefoot Doctors: Using Community Health Workers to Translate HIV Research to Service. AIDS Behav 23, 2879–2888 (2019). https://doi.org/10.1007/s10461-019-02636-z

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10461-019-02636-z

Keywords

Search

Navigation