We propose a five-year project (Integrating HIV/STI Prevention/Treatment in China) entitled """"""""Ai Shi Zi"""""""" (pronounced """"""""aces""""""""), which in Mandarin simultaneously means """"""""AIDS Plus"""""""" and also high-quality medical professional services for HIV infection. The goal is to teach physicians how to enhance and integrate prevention and care for HIV and STIs. HIV and STIs are intimately linked, and HIV and STI prevention requires both state-of-the-art treatment and changes in sexual behavior. A total of 60 counties have been recruited for the study and they will be randomized to the intervention and delayed-intervention control conditions. We hypothesize that patients of county-level physicians trained by us (primary training level) will have lower annual incidence of chlamydia and gonorrhea than patients of wait-list control physicians. For the primary level training (Aims 1 and 2), a total of 4 county-level hospital physicians from each county will be recruited to participate in the study (240 physicians in all). All physicians will be administered the baseline questionnaire. Physicians in intervention counties (n =120) will be provided with the experimental training, while physicians in the delayed-intervention control counties (n = 120) will receive the intervention following the final 12-month assessment. All intervention and delayed-intervention control physicians will be assessed post-training, and at 6 and 12 months following baseline (Aim 1). To assess these physicians' impact on patient care and behavior, 4 HIV- or STI- infected patients from each of the intervention and delayed-intervention control physicians (960 patients in all) will be assessed immediately following physician training and at 6 and 12 months following baseline (Aim 2). County-level physicians will each provide training to four township level physicians (secondary training) in a train-the-trainer model. For the secondary level training (Aims 3 and 4), township level physicians in the delayed-intervention control condition will be assessed at the same time points as the township-level intervention physicians-at baseline and 6 and 12 months following baseline (Aim 3). A total of 4 HIV or STI-infected patients for each township-level physician (3,840 patients total) will be assessed at baseline and at 6 and 12 months following baseline (Aim 4). We hypothesize that patients of township level physicians will have lower annual incidence of gonorrhea and Chlamydia than patients of waitlist control physicians. Public health impact: This project has the potential to provide a replicable and widespread training program to teach physicians to integrate HIV and STI prevention and care. If efficacious, it can be adopted by the Chinese government, and adapted for use in other countries.
| Operario, Don; Wang, Debin; Zaller, Nickolas D et al. (2016) Effect of a knowledge-based and skills-based programme for physicians on risk of sexually transmitted reinfections among high-risk patients in China: a cluster randomised trial. Lancet Glob Health 4:e29-36 |
| Wang, Debin; Operario, Don; Hong, Qian et al. (2009) Intervention to train physicians in rural China on HIV/STI knowledge and risk reduction counseling: preliminary findings. AIDS Care 21:468-72 |
