Teaching and Training
When the AIDS epidemic began, it brought manifestations and symptoms that most clinicians had never seen, opportunistic infections rarely encountered, and death rates among young people never witnessed in the industrial age except in war.
And so AIDS brought with it the need to learn . . . and that need continues
today. The Ryan White HIV/AIDS Program responds to this need through the
AIDS Education and Training Centers (AETCs), a series of regional and national
centers that provide training to clinicians across the United States and
beyond. (To learn more, see The HIV/AIDS Program: AIDS Education adn Training Centers
and AIDS Education and Training Centers National Resource Center. 
)
The magic of the AETCs isn’t really magic at all. It is simply another manifestation of what we know about connecting people—in the case of the AETCs, connecting those who know about HIV/AIDS care with those who want to know. It is about interaction among people who are traveling a path of service, although they may be at difference places along that path. It is about the connections that occur among people united in a common cause.
AETC Provider Training Network
AETCs are a network of 11 regional centers and serve all U.S. States and territories. The AETCs and the connections built through them reach into small towns, suburban neighborhoods, and large cities to train clinicians who serve those most in need—minority populations, the homeless, rural communities, and people who are incarcerated. AETCs arm clinicians everywhere with the knowledge they need to educate, counsel, diagnose, treat, and medically manage people living with HIV disease.
During the 2006–2007 grant year, more than 128,000 participants attended
AETC training events. Clinicians trained by AETCs have been shown to be more
competent with regard to HIV issues and more willing than other primary care
providers to treat people living with HIV disease. This knowledge has added
enormously to our national capacity to screen for, help prevent, and treat
HIV/AIDS.
Worldwide, women account for about one-half of the 30.8 million HIV cases among adults.16 The feminization of HIV/AIDS is linked to poverty and other factors that can cause women to be more susceptible to HIV. The Health Resources and Services Administration (HRSA) has been at the forefront of delivering specialized, primary health care to women and educating clinicians about the needs of this population. HRSA’s Guide to the Clinical Care of Women With HIV/AIDS has become the primary textbook on the subject worldwide. HRSA continues its knowledge-sharing role through the Global HIV/AIDS Program.
Helen
Helen Miramontes is one of the world’s first trainers of clinicians serving people living with HIV/AIDS. A nurse and mother of six, Helen lived and worked in Northern California when the “strange new disease” emerged. She worked in a hospital and, having two gay sons, stayed in tune with this issue affecting gay men.
“The outbreak of PCP (pneumocystis carinii pneumonia) among gay men in San Francisco was a baffling, scientific aberration,” says Helen. “So I went to that first AIDS-related meeting in San Francisco in 1982. The big focus was PCP,” she explains. “I remember driving to the airport Hilton where the meeting was convened wondering if many people would show up,” she says. “Well, the meeting was packed,” she remembers with excitement in her voice. “People were leaning against walls, or finding a place wherever they could.
“I knew then that God had led me to nursing because of this disease. I had
an overwhelming mission: This is what I was meant to do.”
Beyond Clinical Training
The quest for knowledge found at that conference in 1982 continues, not just for scientific understanding but for programmatic and technical know-how, too. In addition to clinical training through the AETCs, comprehensive technical assistance support—encompassing program design, implementation, and evaluation—is available to Ryan White–funded grantees, planning bodies, providers, affected communities, and people living with HIV/AIDS. To find out more about these services, see the Technical Assistance Resources, Guidance, Education, and Training (TARGET) Center Web site. The TARGET Center reflects the Federal commitment to strengthening local organizations and—through doing so—building better lives for people living with HIV/AIDS.
Experience at Home Helps Give Hope Abroad
Opportunities for learning and building capacity are rich in the United States, but in much of the world, resources are tragically limited and people too often die from entirely preventable conditions like malnutrition, malaria and of course, AIDS.
The United States has a long history of international development and, for decade upon decade, has been the world’s leading donor Nation, providing assistance in various fields ranging from agriculture and animal husbandry to water management and energy development. Today, the United States is providing support to help countries address the HIV/AIDS epidemic.
PEPFAR
In 2003, President George W. Bush announced the President’s Emergency Plan for AIDS Relief (PEPFAR), a 5-year, $15 billion U.S. Government initiative (see U.S. President's Emergency Plan for AIDS Relief). PEPFAR aims to provide treatment to at least 2 million people infected with HIV; prevent 7 million new HIV infections; and provide care and support to 10 million people living with and affected by HIV/AIDS, including orphans and vulnerable children. The annual funding for PEPFAR’s efforts has steadily increased since its inception and rose to an all-time high of $6 billion in FY 2008.
Today, more than 1.3 million men, women, and children in 15 focus countries in sub-Saharan Africa, Asia, and the Caribbean are getting lifesaving antiretroviral medications thanks to PEPFAR. This marks a dramatic increase from the rates of HIV treatment that existed prior to PEPFAR funding. In sub-Saharan Africa, for example, it was estimated that only 50,000 people were receiving treatment for HIV/AIDS when PEPFAR began its work in the region.
The Global HIV/AIDS Program of HRSA’s HIV/AIDS Bureau (HAB) is taking the reins in implementing PEPFAR’s international services, serving as the third-largest provider of PEPFAR funds to organizations in FY 2007. One of these organizations is the AIDSRelief Consortium, which provides HIV care and treatment at sites across nine countries in sub-Saharan Africa and the Caribbean, including Haiti.
mission. This is what I was meant to do.”
Edna and Adam
Fifteen years ago, Edna and Adam Adnor were among the first people diagnosed with HIV in Fond-des-Negres, Haiti, a mountainous community. The news was nearly a death sentence for the parents of four children. Edna contracted tuberculosis. Adam, a carpenter, battled bouts of a skin disease that kept him out of work for months. “There were times we didn’t think we would survive,” Adam says.
Now Edna and Adam, as well as 2,559 other people living with HIV/AIDS, receive free, lifesaving antiretroviral medications thanks to the AIDSRelief Consortium, which is funded by PEPFAR and supported by the Global HIV/AIDS Program. People living with HIV/AIDS travel up to 75 miles to be seen at the Salvation Army Bethel Clinic in Fond-des-Negres, one of eight AIDSRelief clinical partners that provide voluntary testing and counseling, full medical care, medication, and support services in Haiti. In 2008, an estimated 200,000 people with HIV/AIDS were living in Haiti.
“It was difficult at first,” says Edna of the medication and side effects
that made her ill. The AIDSRelief staff helped her cope with the medicines.
A Bethel Clinic counselor made house calls to help her through that difficult
period, providing support and advice for ways to deal with the illness. They
also connected the Adnor family to monthly nutritional support from Catholic
Relief Services’s Multi-Year Assistance Program.
It has been 4 years since Edna and Adam began receiving medications. Today, their family is thriving. All four children are in school. Their small, concrete house is filled with shiny pine furniture made by Adam. Edna is selling corn again at the local market. And last year the couple did something they’ve always wanted to do: They got married. “I had the white dress and the decorations and everything,” says Edna, pointing to the brass-framed wedding photo on her dining room hutch. “I know that I’m going to die one day,” she says, smiling. “But I know it’s not going to be HIV that kills me.”
The high quality of care that the Adnors experienced at AIDSRelief is no accident. The Global HIV/AIDS Program provides its grantees with an arsenal of technical assistance and support, and HRSA HAB staff regularly assist grantees with policy, funding, human resources, and outreach activities. This support ensures that the reach of PEPFAR and HAB extends beyond the sharing of financial resources to include the coveted resource of experience—experience gained from almost 2 decades of administering HIV services through the Ryan White HIV/AIDS Program. In this manner, the hard-won knowledge that comes from years of fighting the HIV epidemic on American soil can benefit a new, global audience. Because when it comes to fighting this deadly disease, we are all part of the same movement.
Notes
- United National Joint Programme on HIV/AIDS (UNAIDS). 07
AIDS epidemic update. 2007. Available at: http://data.unaids.org/pub/EPISlides/2007/2007_epiupdate_en.pdf.
Accessed
June 3, 2008.