On October 4, 2011, the Office of National AIDS Policy (ONAP) hosted the second in a series of five Implementation Dialogues in Seattle Washington at Swedish Medical Center. The theme for this meeting was “Building Capacity Within the HIV Workforce so that it Delivers What We Need Today and Tomorrow”. The meeting was an opportunity to focus attention on the multi-faceted challenges we face with the HIV workforce, spark conversations around this issue, and encourage action and collaboration at the State and local levels. The meeting began with a Federal update, followed by a presentation on HIV workforce issues, a panel discussion, and a discussion between the panel and the audience, which included policy makers, academic experts, clinicians, providers, community advocates, patients, and other health professionals.
ONAP Director Jeffrey S. Crowley opened the meeting with remarks about the challenges we face with the HIV workforce and opportunities made available in the Affordable Care Act to bolster the workforce of clinicians and other health care providers. Dr. Todd Strumwasser, Vice President of Medical Affairs at Swedish Medical Center, provided opening remarks and emphasized that this meeting was a way to reaffirm our collective commitment to focus more attention on the domestic epidemic in our communities and around the country. Dr. David Spach, the Principal Investigator for the Northwest AIDS Education and Training Center at the University of Washington, gave an informative presentation on the key factors contributing to HIV workforce shortages in the nation. Dr. Spach focused on several key issues regarding the workforce supply, including the lack of exposure to an HIV curriculum during a medical student’s academic or residency training; the complexity of providing HIV care; the financial disincentives faced by medical students and medical residents; the competition between global HIV health work and domestic HIV health work; and the reluctance of some individuals to work with people living with HIV. Dr. Spach’s provided several recommendations that could be adopted to expand the HIV workforce, including the importance of active recruiting during a clinician’s medical school training or during their residency; increasing the amount of pilot programs for recruitment; supporting mentorships and building relationships between current HIV clinicians and future clinicians; providing innovative financial incentives for clinicians; and developing more programs that increase provider diversity.
Dr. Kathleen Clanon, the Medical Director of HIV Access in Alameda County, California, moderated a lively panel of federal, state, community, and academic participants. The panelists included: Mr. Richard Aleshire, Washington State Department of Health; Dr. Maggie Czarnogorski, U.S. Department of Veterans Affairs; Dr. Mari Kitahata, University of Washington, Center for AIDS Research; Ms. Angela Powell, Health Services and Resources Administration; Mr. Randall Russell, Lifelong AIDS Alliance; and Dr. Adele Webb, Association of Nurses in AIDS Care.
The meeting touched on several key topics, including the role of the Ryan White HIV/AIDS program in supporting the HIV workforce, the importance of the Ryan White medical home model and how it supports a continuum of care. There was also a discussion about the opportunities that exist to attract new talent to provide HIV care and what actions need to be taken to engage non-HIV providers (i.e., those not experienced in providing HIV care and treatment) into HIV. Finally, there was a discussion about how we can engage private sector and philanthropic resources to generate local solutions. Some of the recommendations from the audience included the need of mentorship programs for new and future clinicians to cultivate a pipeline of experts in the field of HIV care. There was also a recommendation to acknowledge the significant role of other health professionals, such as social workers and public health workers and expand mentorship and other activities to support their continuing professional development as critical HIV providers. Other recommendations were made on how to better address the care and needs of people with HIV in jail and prison settings and how to engage physician assistants and HIV-specialty pharmacists into the care of people living with HIV.
Many ideas and recommendations were put forward during the meeting. In the coming weeks, ONAP will be developing a synthesis report of this and other meetings that will be made available on the ONAP website. In addition, all of the Implementation Dialogues will be videocast on the website.
If you have additional thoughts that you would like to share about this meeting or any of the Implementation Dialogues, please send them to AIDSPolicy@who.eop.gov.
Chantelle Britton is a Policy Advisor in the Office of National AIDS Policy