# Presentation: 776901

## Preparing the Next Generation of HIV Medical Providers

- HIV Medicine Association
- Andrea Weddle
- Jennifer Rainey
- Presidential Advisory Council on HIV/AIDS
- February 27, 2007

## HIVMA represents more than 3,500 clinicians and researchers devoted to HIV medicine across the U.S. We...

**Advocate:**
- Improve access to health care through Medicaid, Medicare, Ryan White
- Increase federal funding to support HIV research, prevention and treatment
- Promote evidence-based public policies
- Support Ryan White Title III Medical Provider Coalition
**Ensure adequate and qualified HIV medical workforce**

**Educate:**
- Develop clinic practice guidelines,
- Lead HIV track at IDSA Annual Meeting
- Publish annual HIV compendium
- Created Minority Fellowship Awards

## What’s Happening to the HIV Workforce

- Rapid evolution of HIV care and treatment
- Medical residents no longer exposed to HIV/AIDS during medical training
- Complex care and treatment, yet lack of defined training track
- First generation aging and retiring
- Demanding job, poor reimbursement
- State and federal funding streams frozen

## What We Know:  Experience and Training Make a Difference

- Experienced HIV Medical Provider
**=**
- Better Health Outcomes
- More Cost Effective Care
- Selected Cites:
- Bozzette SA, Joyce G, McCaffrey DF, et al. Expenditures for the care of HIV-infected patients in the era of highly active antiretroviral therapy. N Engl J Med. 2001;344(1):817-823.
- Kitahata MM, Van Rompaey SE, Dillingham PD, et al. Primary care delivery is associated with greater physician experience and improved survival among persons with AIDS. J Gen Intern Med. 2003;18:95-103.
- Kitahata MM, Van Rompaey SE, Shields AW. Physician experience in the care of HIV-infected persons is associated with earlier adoption of new antiretroviral therapy. J Acquir Immune Defic Syndr. 2000;24(2):106-114.

## What’s Needed: Supporting HIV Clinicians 

- Independent study by HHS (or authorized by Congress) to evaluate the capacity of the HIV workforce to meet current and future patient health care needs on a regional basis
- Federal support for training incentives – loan forgiveness, tuition support

## What’s Needed:  Strengthening the Care System

- Adequate funding for Ryan White CARE Act programs
- Protection and expansion of state and federal safety-net programs, i.e., Medicaid, Early Treatment for HIV Act, Medicare Part D (protect access to ARVs and other drugs)

## Where the HIV Medical Providers and the Patients Are in the U.S.

- Source:  Centers for Disease Control and Prevention (CDC) . HIV/AIDS Surveillance Report, 2003 (Vol.15). Atlanta: US Department of Health and Human Services, CDC; 2004: 20.

## A More Diverse Medical Workforce is Needed Across Specialties

- Source:  Association of American Medical Colleges. Diversity in the Physician Workforce: Facts & Figures 2006:15.  Online at _[www.aamc.org](http://www.aamc.org/)_.
- *Other combines Asian, Native American, and International Medical Graduates.

## Persons Living with AIDS in the U.S. – 2003 

- Source:  Centers for Disease Control and Prevention (CDC). HIV/AIDS Surveillance Report, 2003 (Vol.15). Atlanta: US Department of Health and Human Services, CDC; 2004: 20. Also available at: _[http://www.cdc.gov/hiv/topics/surveillance/_x000b_resources/reports/index.htm](http://www.cdc.gov/hiv/topics/surveillance/%0Bresources/reports/index.htm)__. _
***API/AI=Asian/Pacific Islanders and American Indians**

## HIVMA Minority Clinical Fellowship Program 

- Created in 2006 to help address workforce issue
- Specifically targets African-American and Latino physicians
- Currently provides funding for two fellows

## HIVMA Minority Clinical Fellowship Program

**Fellows will receive:**
- $60,000 plus fringe benefits for one year through the sponsoring institutions
- One year membership to HIVMA
- Free registration and travel support for the IDSA Annual Meeting, where winners will be recognized
**Sponsors will receive:**
- $10,000 to defray cost of administering fellowship

## Applicant Requirements

- 		**Eligibility**
- African American or Latino descent
- MD or DO
- Demonstrated interest in and commitment to practicing HIV medicine
- Legal resident of the United States
- 		**Criteria**
- Fellows may elect to spend up to two months of their fellowship at a community based clinic
- Candidates will identify a mentor and an HIV clinical program with a linkage to an academic institution where the majority of their time is spent engaged in HIV clinical care.

## Sponsor Requirements

- Mentors must be HIVMA members.
- Candidates must have the opportunity to continuously manage at least 30 HIV patients in both inpatient and outpatient settings.
- Clinical settings with large minority patient populations are required.

## Results

- 28 total applicants
- 12 female
- 16 male
- 16 african-american
- 12 latino

## Slide 15

## Minority Fellowship CommitteeHIV Medicine Association2007

**Arlene Bardeguez, MD, MPH**
**Committee Chair**
- OB/GYN
- Professor/Dir HIV Services
- UMDNJ-New Jersey Med School

**Richard Elion, MD **
- Family MedicineWashington, DC

**Joseph Gathe, Jr, MD **
- Private Practitioner
- Houston, TX

**Kimberly Smith, MD, MPH**
- Infectious Diseases
- Rush University Medical Center

## Funding Support

## Consider HIVMA a Resource

**HIV Medicine Association**
**www.hivma.org**
**Phone:  (703) 299-1215**
**Email: hivma@idsociety.org**
**	****	****      ****aweddle@idsociety.org**
**	****	****    ****jrainey@idsociety.org**