How POP was developed

After more than seven years working to integrate routine HIV screening into general medical settings, PHIMC recognized health professionals face personal barriers to fully implementing this standard of care. From 2014-2015, PHIMC partnered with the Illinois Department of Public Health and a cross-sector team to address these issues and reduce homophobia and transphobia in clinics. The team included healthcare, public health, community-based, communications, and creative professionals. PHIMC used the following methods to better understand how healthcare clinics were implementing routine HIV screening and serving Lesbian, Gay, Bisexual, Transgender, Queer, and Questioning (LGBTQ+) individuals:

• Surveyed existing literature and campaigns
• Engaged healthcare teams and health professionals through focus groups, conversations, and interviews
• Collected stories from African-American and Latino/a/e LGBTQ+ individuals about their experiences in healthcare settings

PHIMC synthesized the information collected using a combination of storytelling, training, peer support, visual art, and communications strategies to mobilize support among care professionals. As our work on POP has continued, we have included community-based care in the design of POP to ensure equity, which is reflected in our language shift from “healthcare” to “care.”

What is happening in care settings

In developing POP, PHIMC conducted focus groups that included 70 physicians, nurses, medical assistants, lab technicians, front desk clerks, and medical residents from seven different healthcare sites throughout Illinois. Participants spoke about the limited information they received about HIV/AIDS in their education and training programs, their current hesitations about HIV and providing affirming care, and the opportunities that exist for integration of these topics into various components of their professional education. The results of this research were distilled into the following six major findings and five barriers that led to the identification of POP’s two primary initiatives.

Major findings:

• Care teams accept routine HIV screening as part of general care but remain hesitant to implement.
• Care teams are open to LGBTQ+ inclusive strategies but do not see the need for them.
• Care teams that feel ill-equipped or uninformed are likely to avoid the topics and practices out of discomfort.
• Care teams are concerned that people in their care and the general population will reject screening due to lack of information and understanding.
• Care teams respond well to testimonies, scripting, role-playing, and informational tools for themselves and the people in their care.
• Ongoing training materials that can be used in diverse settings will reach more providers.

Major barriers:

• Discomfort with sexual behaviors, particularly when delivering care and giving a positive diagnosis as well as treating patients who are acquaintances and minors with their parents.
• Confusion about why routine HIV screening needs to be integrated, what their role is in the screening process, and how to manage competing priorities.
• Inexperience dealing with HIV/AIDS, understanding current epidemiological trends, offering an HIV screening, identifying sufficient resources for people in care, and providing LGBTQ+-competent care.
• Disbelief that older people, married individuals, and folks in their area are at risk for HIV.
• Blaming individuals living with HIV for behaviors that led to their acquisition.