CCCoP Knowledge Center
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The resource materials in the Knowledge Center are organized by the following categories:
- Case Studies
- HIV-HCV CCCoP Webinar Series
- HIV Clinical Practice Guidelines
- HCV Clinical Practice Guidelines
- Cultural Competency
- Stigma and Discrimination
- Links to HIV/HCV Care-Related Case Studies
A unique feature of the HU-CCCoP Program is the inclusion of case-based studies in every webinar to enhance the learning experience of clinicians. Each case study is carefully designed to incorporate the social, cultural and clinical realities that are relevant to the Caribbean context.
Case studies actively engage webinar participants in problem solving and clinical decision making; and help them to apply the knowledge gained through discussion in their own clinical practice.
HIV-HCV CCCoP Webinar Series
- Prescribing Pre-Exposure Prophylaxis (PrEP) for HIV Prevention: A Guide for Clinicians in the Caribbean : Pre-exposure prophylaxis (PrEP) is an effective HIV prevention strategy that expands options for persons at greatest risk for contracting HIV through sex or injection drug use. This webinar discusses PrEP initiation and adherence protocols, barriers to initiation, risk reduction counseling, stigma and other factors clinicians should consider when prescribing PrEP to their patients and supporting adherence.
- HIV, HBV, HCV and TB Co-Infection in the Caribbean: People living with HIV are at a higher risk of developing other infections such as hepatitis B (HCB), hepatitis C (HCV) and tuberculosis (TB). These co-infections which commonly occur alongside HIV can make disease management difficult. This webinar discusses the epidemiology of HIV, HBV, HCV, and TB coinfection, screening, treatment and drug-drug interactions.
- HIV and Metabolic Complications: Cardiovascular Diseases and Diabetes: Chronic diseases, a major cause of death in the Caribbean, are often comorbidities for persons living with HIV. This webinar describes cardiovascular and common metabolic diseases occurring in persons living with HIV and discuss recommended treatment modalities. Clinicians are encouraged to envision future models of care for the management of patients with HIV comorbidities.
- Strategies to Reduce HIV/HVC Among Sexual and Gender Minorities in the Caribbean: Sexual and gender minorities in the Caribbean are disproportionately affected by HIV. High levels of stigma and discrimination continue to be barriers to prevention, treatment and care. This webinar provides a social and cultural framework for reducing HIV/HCV among sexual and gender minorities and discusses biomedical advances and evidence-based risk reduction interventions for prevention.
- Understanding the Associations between Mental Health and HIV: Living with HIV places a person at higher risk for mental health conditions. Attention to the psycho-social needs of persons living with HIV must be an integral part of HIV care. This webinar discusses mental health risk factors and consequences of HIV, identify tools for assessing mental health disorders in patients and share mental health treatment approaches for supporting persons living with HIV.
- Intimate Partner Violence and HIV: Identifying the Link: One in three women in the Caribbean will experience Intimate Partner Violence (IPV) in their lifetime. Clinicians play a critical role in screening, identifying, treating and referring patients to support services. This webinar describes the incidence and prevalence of IPV in the region and examine the link between IPV and HIV. Sexual violence legislation in effect in the Caribbean is also addressed.
- HIV and Substance Use in the Caribbean: An Overview: With the prevalence of substance use disorders being higher among people living with HIV than the general population, it is critical to understand the epidemiology, treatment and strategies for HIV prevention among substance users.. This webinar describes the link between substance use and HIV, the impact of substance use on HIV and ART, considerations for selecting ART, and drug-drug interactions.
- Strategies for Improving Adherence to Lifelong Antiretroviral Treatment: Adherence to ART is essential to ensure viral suppression in people living with HIV. While there are multiple barriers, a multidisciplinary approach toward adherence is needed. This webinar describes the complexity of adherence and the results of poor adherence to ART. Strategies to improve adherence, including but not limited to, counseling, provider follow up and family support are examined.
- HIV and Neurocognitive Disorders Management: People living with HIV may develop a spectrum of cognitive, motor, and/or mood problems known as HIV-Associated Neurocognitive Disorders (HAND). Approximately 1 out of every 4 people living with HIV will suffer from HAND. This webinar discusses the prevalence, risk factors and treatment options associated with HAND.
- HIV Update: Clinical Trials in HIV Prevention: Significant reductions in HIV transmission have occurred through the early initiation of ART as prevention. This webinar describes the results of clinical trials conducted to assess the concept of Treatment as Prevention. The efficacy of drugs used for PrEP and the challenges to retention and adherence to PrEP are also discussed.
- HIV and Aging: As individuals living with HIV grow older, it is increasingly important to identify and manage the frequently diagnosed aging-related comorbidities such as cardiovascular disease, kidney disease, osteoporosis and bone fractures. This webinar addresses the impact of these aging-related comorbidities in persons living with HIV and how to best manage them.
- HIV and Cardiovascular Diseases (French): Chronic diseases, a major cause of death in the Caribbean, are often comorbidities for persons living with HIV. This webinar describes cardiovascular and common metabolic diseases occurring in persons living with HIV and discuss recommended treatment modalities. Clinicians are encouraged to envision future models of care for the management of patients with HIV comorbidities.
HIV Clinical Practice Guidelines
- Consolidated Guidelines on the Use of Antiretroviral Drugs for Treating and Preventing HIV Infection, Recommendations for a Public Health Approach, Second Edition 2016
- Clinical Management Guidelines for HIV/AIDS National TB, & Other STIs, Ministry of Health Belize July 2012
This guideline was created in 2003, the Ministry of Health initiated the implementation of care and treatment for persons with HIV. This initiative, has from the onset, included the free provision of antiretrovirals for everyone who meets the medical criteria. Care and treatment for pediatric patients is mostly provided by the Karl Heusner Memorial Hospital, via its Pediatric Department, and Hand in Hand Ministries located in Belize City. There are currently, thirteen sites providing antiretroviral therapy for both adults and adolescents in the country. However, because The National Clinical Management guidelines have not been revised since their development in 2003, the clinical management has been largely guided by the Caribbean Guidelines for the Care and Treatment of Persons with HIV Infection (2007).
- Guide for HIV/AIDS Clinical Care, U.S. Department of Health and Human Services Health Resources and Services Administration HIV/AIDS Bureau, April 2014
This guide discusses how HIV/AIDS clinical care has improved over the decades, given the availability of new medications and a better understanding of how best to use antiretrovirals and deliver primary care to persons living with HIV/AIDS.
- Guidelines and Recommendations, U.S. Centers for Disease Control and Prevention
A wide-ranging collection of HIV clinical guidelines
This website offers information on HIV/AIDS Clinical Guidelines on Treatment, Prevention and Research.
These federally approved medical practice guidelines for HIV/AIDS are developed by experts in HIV care.
HCV Clinical Practice Guidelines
- Considerations for Antiretroviral Use in Patients with Coinfections, December 2019
These guidelines were developed by the Department of Health and Human Services Panel on Antiretroviral Guidelines for Adults and Adolescents (a working group of the Office of AIDS Research Advisory Council).
- Guidelines for the Care and Treatment of Persons Diagnosed with Chronic Hepatitis C Virus Infection, July 2018, World Health Organization
These guidelines provide evidence-based recommendations on the care and treatment of persons diagnosed with chronic HCV infection
- Update on the Management and Treatment of Hepatitis C Virus Infection: Recommendations from the Department of Veterans Affairs Hepatitis C Resource Center Program and the National Hepatitis C Program Office, 2012
This article provides recommendations for optimally managing hepatitis C and associated comorbidities. It emphasizes the importance of multidisciplinary teams that can provide HCV-specific care and treatment to patients.
- Webinar: Building Providers’ Capacity to Provide Culturally Appropriate Care: African, African-American, and Caribbean Women, Southeast AETC, Georgia AIDS Education and Training Center, August, 2016
Presentation is on providing culturally competent services to, African-American, and Caribbean women through effective communication, health services using a holistic harm reduction approach, and identifying resources for culturally competent care .
- Webinar: Culturally Competent Care for Haitian Americans Living with HIV/AIDS, March, 2018
Presentation is on cultural competence and understanding the impact of the epidemic among Haitian Americans
- Toolkit: Providing Inclusive Care for LGBTQ Patients, 2015
This resource toolkit is designed for clinical settings to assist healthcare workers to meet the needs of LGBTQ patients.
- The Caribbean/West Indies Cultural Competency Program for Florida Nurses Implications for HIV/AIDS Prevention and Treatment The Journal of Multicultural Nursing & Health 11:1 Winter 2005
This article discussed the training program to educate nurses about working with diverse client populations from the various islands of the Caribbean and West Indies in order to improve delivery of culturally and linguistically competent care.
- Cultural Tailoring for an Afro-Caribbean Community: A Naturalistic Approach, Journal of Cultural Diversity, 2011
The paper explored the purpose of the study was to discover ways to tailor health care interventions to fit the cultural identity of a minority group of people in order to reduce health disparity.
- Issues of Clinical and Cultural Competence in Caribbean Migrants. Transcult Psychiatry. 2012
The paper discussed issues of clinical and cultural competence relevant to assessing, diagnosing, and treating Caribbean migrants with a focus on three areas: cultural influences on illness phenomenology; the role of language differences in clinical misunderstandings; and the complexities of culture and migration.
- HIV in Communities of Color: The Compendium of Culturally Competent Promising Practices – The Role of Traditional Healing in HIV Clinical Management, 2011
This symposium compendium includes articles that provided an understanding of the role of complementary and alternative medicine among minority patients living with HIV. Among the topics addressed are: Neighborhood Botanicos, HIV and Santeria, Haitian Vodou, and Acupuncture and HIV Management.
Stigma and Discrimination
- Patient-Trainers are Key to Providing High-Quality Care to MSM, Sex Worker, and Transgender Communities in the Caribbean, January 2017
This article discusses the discrimination key populations in the Caribbean experience when accessing HIV care and treatment services. It describes a novel preceptorship program aimed at building clinicians’ capacity to provide nonjudgmental, high-quality, comprehensive HIV care to most-at-risk communities.
- Stigma and Discrimination in Caribbean Health Care, Health Policy Project, 2011
This article discussed that interventions need to be delivered in a mutually reinforcing package through programs formulated to respond to local realities that are usually in health facilities by trained health professionals. Also, people at risk for HIV will not benefit from these life-saving prevention services if they are denied access to them, are afraid to seek them, or experience stigma or discrimination when trying to access them.
- AIDS Stigma in Health Services in the Eastern Caribbean, Sociology of Health & Illness Vol. 31 No. 1 2009
This article examines AIDS stigma posing a barrier for HIV/AIDS prevention and care.
- Ending Stigma and Discrimination is Critical to Expanding HIV Services in Jamaica, UNAIDS,
December 4 2019
Jamaica’s Minister of Health talked about HIV-related stigma and discrimination and how it is still a big challenge in the community and the work that needs to be done.
- Jamaica Tackling HIV-Related Stigma and Discrimination, November 19, 2019
This video presentation focuses on people who have experienced prejudice in the health-care, education and employment sectors and how to report it to the proper authorities. Clients are often referred through a community facilitator in their health region, other civil society organizations or the Ministry of Health’s client complaint mechanism.
- Shifting the HIV Paradigm from Care to Cure: Proceedings from the Caribbean Expert Summit in Barbados, AIDS Research and Human Retroviruses, August 2017
This conference summary examined the emphasis was placed on reexamining stigma and discrimination through a critical appraisal of whether public health messaging and advocacy had kept pace with the advances in medicine. Persistent fear of HIV driving discriminatory behavior was widely reported in different regions and sectors, including the healthcare profession itself
- Baseline Assessment - Jamaica Scaling up Programs to Reduce Human Rights Related Barriers to HIV Services, Global Fund September 2019 Geneva, Switzerland
This paper is a baseline assessment of support to Jamaica and is intended to provide the country with the data and analysis necessary to identify, apply for, and implement comprehensive programs to remove barriers to HIV services. This assessment: (a) establishes a baseline of human rights-related barriers to HIV services and existing programs to remove them.
- Cultural Humility & Reducing Stigma and Discrimination Provider Handbook Updated Draft
April 6, 2018, Southeast AETC
This handbook defines Cultural humility and the ongoing commitment to self-reflection and cultivation of beneficial, non-paternalistic relationships.
Links to HIV Care-Related Case Studies
The following links will lead you to case studies from previous projects implemented by the Howard University TeleHealth Training Center. They may be used as teaching and training resources for clinicians involved in HIV prevention, treatment, care and support.
Addressing HIV Care of Adolescents: Case studies of provider to patient encounters with adolescents cover health literacy, trust and other socio-ethnic barriers. Cases also cover intra-ethnic variations involving adolescents and the need to avoid stereotyping in one's approach to care and treatment.
Addressing HIV Care of Incarcerated People Living with HIV: Case studies of provider to patient encounters covering cultural gaps in gender, age, health literacy, trust and other socio-ethnic barriers. Cases also cover intra-ethnic variations among incarcerated people living with HIV/AIDS and the need to avoid stereotyping in one's approach to care and treatment.
Addressing HIV Care of LGBTQ Persons: Case studies cover the many cultural, socioeconomic and environmental factors that have impact on the LGBT patient population. These scenarios cover issues of appropriate response and more effective patient encounters.
Addressing HIV Care and Alternative Medicine: Case studies of provider to patient encounters covering cultural gaps in gender, age, health literacy, trust and other socio-ethnic barriers. Cases also cover intra-ethnic variations among patients and the need to avoid stereotyping in one's approach to care and treatment.
Addressing HIV Care and Substance Use: Case studies that deal with substance use and/or abuse show cultural gaps in gender, age, health literacy, trust and other socio-ethnic barriers. Cases also cover intra-ethnic variations among those using or abusing substances and the need to avoid stereotyping in one's approach to care and treatment.
Addressing HIV Care of Women:
Case studies of provider to patient encounters covering cultural gaps in gender, age, health literacy, trust and other socio-ethnic barriers. Cases also cover intra-ethnic variations among women and the need to avoid stereotyping in one's approach to care and treatment