This report presents data for training events and trainees reported by AETC grant recipients from July 2010 through June 2017.
Highlights of Analyses
From July 2011 through August 2015, AETCs conducted a total of 58,210 training events with 14,500 training events per year, reaching nearly 83,000 unique trainees each year (range: 79,176–85,471). From September 2015 through June 2017, AETCs conducted a total of 17,166 training events with 8,500 training events per year, and from September 2015 through June 2016, AETC events reached 50,600 trainees. As noted previously, trainee data are not available for July 2016 through June 2017 due to changes in reporting (Table 1).
Training Event Topics and Modalities
Most Frequent Training Event Topics
The most frequently presented topics in AETC training events from July 2011 through June 2016 were antiretroviral treatment (presented in 52% of training events during those years) and medication adherence (39% of events) (Table 2). Other frequently presented topics included co-morbidities (33%), clinical manifestations of HIV disease (30%), and routine HIV laboratory tests (30%). These training topics are not mutually exclusive; AETC training events typically include more than one topic. Because of modifications made to the data collection Participant Information Forms (PIFs) and Event Record (ER) tool during the July 2016–June 2017 reporting period, the proportions in the training frequencies during that period shifted.
Training topics from July 2011 through June 2016 focused on many key populations of people with HIV, including racial and ethnic minorities (29%); women (23%); and gay, lesbian, bisexual, and transgender populations (22%) (Table 2).
The training modalities or technologies used most frequently from July 2011 through June 2016 were chart and/or case reviews (41%), followed by lectures/workshops (37%) and telephone/conference calls (21%) (Table 2).
To improve the quality of healthcare provided by the HIV healthcare workforce and increase access to high-quality HIV care for vulnerable and underserved populations, AETCs concentrate on reaching professionals who have direct patient care responsibilities for people with HIV, especially those who serve racial and ethnic minority patients and those working at RWHAP- and HRSA-supported clinical health centers.
The majority of AETC trainees during the period July 2011 through June 2016 self-identified as White (55%), followed by 20% as Black and 14% as Hispanic/Latino. Nearly three-quarters of AETC trainees were female, while 26% of trainees were male and less than 1% of trainees were transgender (Table 3).
Nurses and advanced practice nurses accounted for 30% of AETC trainees from July 2011 through June 2016, while physicians accounted for 16% of AETC trainees. Other non-clinical professionals accounted for 11% of AETC trainees. Dietitians and nutritionists, health educators, mental or behavioral health professionals, social workers, substance abuse professionals, community health workers, clergy or faith-based professionals, and other public health professionals accounted for 26% of all AETC trainees. Trainees reported their primary functional roles within their organization. The most commonly reported roles were care provider/clinician (39%) and case manager (12%) (Table 3). In 2016, across all racial/ethnic groups except Asians, nurses accounted for the highest percentage of trainees; among Asians, the highest percentage of trainees were physicians (40%) (Table 4). In 2016, the highest percentages of profession by gender were as follow: Among males, 29% were physicians; among females, 27% were nurses; and among transgender individuals, 22% were other non-clinical professionals (Table 5).
Service Delivery of AETC Trainees
Regional AETC programs train and support clinicians and health care professionals who provide direct care and services to patients. During the period July 2011 through June 2016, the majority of trainees (77%) provided direct clinical services, and patient populations were mostly composed of more than 50% racial/ethnic minorities (Table 6).
Service Delivery to People with HIV
From July 2011 through June 2016, 72% of AETC trainees provided direct services to people with HIV. Most AETC trainees (42%) treated one to nine people with HIV in the month prior to their training event; 15% treated 10–19 people with HIV, 19% treated 20–49 people with HIV, and 20% treated 50 or more people with HIV (Table 7).
Approximately half of AETC trainees from July 2011 through June 2016 served people with HIV patient populations composed of at least 50% racial/ethnic minorities. For two-thirds of trainees (67%), less than 25% of their people with HIV patients had hepatitis C coinfection. Ninety-five percent of people with HIV served by the AETC trainees were on antiretroviral therapy. For more than half of trainees (53%), less than 25% of their patients were women (Table 7).
In 2016, the number of years clinicians had provided direct care to people with HIV varied slightly by race/ ethnicity of trainees. Asian trainees had the fewest number of years of experience directly treating people with HIV, with 24% having less than a year of prior experience. White trainees reported the most prior experience treating people with HIV, with 21% reporting more than 20 years of direct service provision to this population (Table 8).
Employment Setting of Trainees
From July 2011 through June 2016, the primary employment setting for most of the RWHAP AETC trainees was in a suburban/urban area (78%). Overall, approximately half of AETC trainees worked in an RWHAP-funded employment setting (Table 9).