PMID- 31037543 OWN - NLM STAT- MEDLINE DCOM- 20201030 LR - 20201030 IS - 1525-1497 (Electronic) IS - 0884-8734 (Print) IS - 0884-8734 (Linking) VI - 34 IP - 7 DP - 2019 Jul TI - A Mixed Methods Evaluation of an Inclusive Sexual History Taking and HIV Prevention Curriculum for Trainees. PG - 1279-1288 LID - 10.1007/s11606-019-04958-z [doi] AB - BACKGROUND: Health disparities exist in HIV risk in the USA among the lesbian-gay-bisexual-transgender-queer (LGBTQ) community. There is also scarce literature on curricula for HIV prevention and pre-exposure prophylaxis (PrEP) for trainees. AIM: To create a curriculum to train residents to perform inclusive sexual history taking and HIV prevention care. The curriculum covers sexual history, LGBTQ health, sexually transmitted infections, and HIV risk assessment and risk reduction counseling including use of PrEP. SETTING: A dedicated PrEP Clinic was created within an Academic Medical Center Outpatient HIV Clinic. Patients were primarily LGBTQ identified, but also included HIV sero-discordant couples, cisgender individuals, heterosexual invididuals, and those with experience of homelessness, sex work, and substance abuse. PARTICIPANTS: Thirty-four internal medicine residents completed the course between November 2017 and May 2018. PROGRAM DESCRIPTION: The curriculum was delivered as Just in Time Teaching (JiTT) via online virtual patient cases followed by directly observed clinical care at a large urban PrEP clinic. PROGRAM EVALUATION AND RESULTS: The effectiveness of the curriculum was assessed through paired pre/post-self-assessment surveys (n = 19), additional post-surveys on the online modules (n = 22), and interviews (n = 9). Many respondents reported no prior training or inadequate prior training in the course content. As a result of the course, participants reported statistically significant increased confidence and comfort in all seven HIV prevention topic areas, with the greatest gains in safe sex counseling for LGBTQ patients and in discussing PrEP (mean changes of 1.21, 1.58 on 5-point Likert scale, respectively, p < 0.0001). Six of nine interviewees post-course had applied what they learned to patient care; five indicated their learning would benefit patients. DISCUSSION: An HIV prevention curriculum focused on cultural humility in care can improve trainee's skills in HIV risk reduction counseling, including PrEP, among all patients including those identifying as LGBTQ. FAU - Frasca, Katherine AU - Frasca K AD - Division of Infectious Diseases, University of Colorado, Aurora, CO, USA. katherine.frasca@ucdenver.edu. FAU - Castillo-Mancilla, Jose AU - Castillo-Mancilla J AD - Division of Infectious Diseases, University of Colorado, Aurora, CO, USA. FAU - McNulty, Monica C AU - McNulty MC AD - School of Medicine, University of Colorado, Aurora, CO, USA. FAU - Connors, Susan AU - Connors S AD - School of Education and Human Development, University of Colorado Denver, Aurora, CO, USA. FAU - Sweitzer, Elizabeth AU - Sweitzer E AD - School of Education and Human Development, University of Colorado Denver, Aurora, CO, USA. FAU - Zimmer, Shanta AU - Zimmer S AD - Division of Infectious Diseases, University of Colorado, Aurora, CO, USA. AD - School of Medicine, University of Colorado, Aurora, CO, USA. FAU - Madinger, Nancy AU - Madinger N AD - Division of Infectious Diseases, University of Colorado, Aurora, CO, USA. LA - eng PT - Journal Article DEP - 20190429 PL - United States TA - J Gen Intern Med JT - Journal of general internal medicine JID - 8605834 SB - IM MH - Adult MH - Curriculum/*standards MH - Female MH - HIV Infections/prevention & control/*psychology MH - Humans MH - Internship and Residency/methods/*standards MH - Pre-Exposure Prophylaxis/methods/standards MH - Program Evaluation/methods/*standards MH - Sexual Behavior/*psychology MH - Sexual and Gender Minorities/*psychology PMC - PMC6614307 OTO - NOTNLM OT - HIV OT - disparities OT - medical education curriculum development/evaluation OT - preventative care OT - underserved populations COIS- Nancy Madinger: NIH grant that has a for-profit company collaboration (Accelerate Diagnostics), NIH 1 R01 AI116993-01. Jose Castillo-Mancilla: NIH/NIAID K23AI104315 and R21AI124859. All remaining authors declare that they do not have a conflict of interest. EDAT- 2019/05/01 06:00 MHDA- 2020/10/31 06:00 PMCR- 2020/07/01 CRDT- 2019/05/01 06:00 PHST- 2018/06/11 00:00 [received] PHST- 2019/02/22 00:00 [accepted] PHST- 2018/11/30 00:00 [revised] PHST- 2019/05/01 06:00 [pubmed] PHST- 2020/10/31 06:00 [medline] PHST- 2019/05/01 06:00 [entrez] PHST- 2020/07/01 00:00 [pmc-release] AID - 10.1007/s11606-019-04958-z [pii] AID - 4958 [pii] AID - 10.1007/s11606-019-04958-z [doi] PST - ppublish SO - J Gen Intern Med. 2019 Jul;34(7):1279-1288. doi: 10.1007/s11606-019-04958-z. Epub 2019 Apr 29.