The NIMH Mentored Patient-Oriented Research Career Development Award (K23) will allow me the protected time necessary to acquire skills to become a successful independent investigator in patient- oriented research. My primary goal will be to evaluate routine HIV testing in primary care patients as a method of eradicating Acquired Immunodeficiency Syndrome. This award would allow me to obtain additional experience in clinical research methodology essential for me to become an independent investigator in HIV prevention and treatment in the primary care setting. This proposal seeks to develop and pilot test an intervention that will promote routine HIV testing and evaluate its acceptance by primary care providers (PCPs), office staff and patients in community health centers that serve disadvantaged minority communities (Blacks and Latinos). Minorities are disproportionately affected by this epidemic. Most HIV tests are done in out-patient settings. The proposed research study will compare an office systems-based approach to the offering of routine HIV testing with a standard education-based intervention. The comprehensive systems-based intervention arm will be composed of an educational session, academic detailing, patient activation through posters and brochures and an HIV vitals stamp. The standard education group intervention will be composed of the education session as well as patient activation through waiting room posters and brochures. This group will not receive team building training, academic detailing or the expanded vitals sign stamp. The outcomes will be assessed by the change in the number of HIV tests offered by the primary care providers in their office setting and accepted by their young to middle aged patients. The goals for the proposed study will be accomplished through (1) mentorship from experienced researchers in Infectious Disease, Behavioral Medicine, Statistics and Primary Care Translational Research with Drs. Timothy Flanigan, Charles Eaton, Michael Goldstein, Charles Carpenter, Susan Cu-Uvin, Larry Brown, Grace Macalino and Joseph Hogan (2) available resources from Brown University, Centers for AIDS Research at Lifespan/Tufts/Brown, Centers for Primary Care and Prevention, Memorial Hospital of RI and Miriam Hospital (3) structured coursework from Brown University as well as relevant directed readings (4) additional training in HIV and AIDS and (5) conducting the proposed multi-site clinical research project. This project would be the first step in eradicating AIDS through earlier diagnosis and linkage to appropriate primary medical care by the routine offering and acceptance of HIV test in the primary care setting. ? ? ?
