Disparities in HIV knowledge and attitudes toward biomedical interventions among the non-medical HIV workforce in the United States

ABSTRACT

Non-medical, community-based workers play a critical role in supporting people living with (or at risk of acquiring) HIV along the care continuum. The biomedical nature of promising advances in HIV prevention, such as pre-exposure prophylaxis and treatment-as-prevention, requires frontline workers to be knowledgeable about HIV science and treatment. This study was developed to: measure knowledge of HIV science and treatment within the HIV non-medical workforce, evaluate workers’ familiarity with and attitudes toward recent biomedical interventions, and identify factors that may affect HIV knowledge and attitudes. A 62-question, web-based survey was completed in English or Spanish between 2012 and 2014 by 3663 US-based employees, contractors, and volunteers working in AIDS service organizations, state/local health departments, and other community-based organizations in a non-medical capacity. Survey items captured the following: respondent demographics, HIV science and treatment knowledge, and familiarity with and attitudes toward biomedical interventions. An average of 61% of HIV knowledge questions were answered correctly. Higher knowledge scores were associated with higher education levels, work at organizations that serve people living with HIV/AIDS or who are at a high risk of acquiring HIV, and longer tenure in the field. Lower knowledge scores were associated with non-Hispanic Black or Black race/ethnicity and taking the survey in Spanish. Similarly, subgroup analyses showed that respondents who were non-Hispanic Black or Hispanic (versus non-Hispanic white), as well as those located in the South (versus other regions) scored significantly lower. These subpopulations were also less familiar with and had less positive attitudes toward newer biomedical prevention interventions. Respondents who took the survey in Spanish (versus English) had lower knowledge scores and higher familiarity with, but generally less positive attitudes toward, biomedical interventions. In summary, low knowledge scores suggest the need for additional capacity-building efforts and training for non-medical HIV workers, particularly those who provide services in the communities most affected by HIV.

KEYWORDS:

• HIV/AIDS
• survey
• workforce
• knowledge
• biomedical interventions
• attitudes

Acknowledgments

We thank all of the HIV workers who participated in this survey; staff members from the Black AIDS Institute, the Latino Commission on AIDS, and the National Alliance of State & Territorial AIDS Directors for supporting the work of this manuscript; and Alisha Bermudez (Added Value) for statistical support. Medical writing support for this manuscript was provided by Courtney St. Amour, PhD, of MedErgy, and was funded by Janssen Scientific Affairs, LLC.

Disclosure statement

In accordance with Taylor & Francis policy and the authors’ obligations as researchers, the authors report that Janssen Scientific Affairs, LLC, and the Black AIDS Institute provided funding for this survey-based study. R. M. Copeland and P. Wilson are employed by the Black AIDS Institute, which provides training and capacity building to the HIV workforce, including through its flagship training programs, the African American HIV University (AAHU) and the Black Treatment Advocates Network (BTAN); the Black AIDS Institute has received funding from Merck, Bristol-Myers Squibb, ViiV, and Gilead to support its HIV training programs. M. Penner is employed by the National Alliance of State & Territorial AIDS Directors, which receives funding from Janssen Therapeutics. E. Y. Wong and L. D. Parisi are employees and shareholders of Janssen Scientific Affairs, LLC. G. Betancourt, D. Garcia, and R. Abravanel report no potential conflict of interest. Medical writing support for this manuscript was provided by Courtney St. Amour, PhD, of MedErgy, and was funded by Janssen Scientific Affairs, LLC. These interests have been disclosed fully to Taylor & Francis, and an approval plan is in place for managing any potential conflicts arising from the stated interests.

Additional information

Funding

This study was funded by Janssen Scientific Affairs, LLC, and the Black AIDS Institute.