Beyond the Barefoot Doctors: Using Community Health Workers to Translate HIV Research to Service

Untold Risk: HIV Transmission Behaviors in Miami’s Historically Black Communities

“…Our work, and that of others, shows that tailoring HIV programs to align with the cultural norms of minority communities is one approach that can increase the uptake of HIV prevention services [11,12]. Accomplishing this requires a rich understanding of the unique risk factors and context of HIV transmission among men and women within distinct communities [12,13].…”

“…CHAMP's service-delivery methods were developed from a prior randomized controlled trial study examining the feasibility of home-based rapid HIV testing [16]. Since then, the program has evolved into a public health service supported by the Florida Department of Health [11].…”

“…A comprehensive description of the CHAMP protocol has been previously published [11]. To summarize, CHAMP services are led by community health workers (CHWs) who are trained to provide culturally tailored HIV outreach and street-based screening and linkage to care in the heart of Miami's Black neighborhoods, which have been identified by ZIP code as priority areas of focus in the County's Jurisdictional Strategy for Ending the HIV Epidemic [17].…”

“…The HIV disparities observed in these neighborhoods are rooted in a long history of racial discrimination, poverty, and stigma that are further compounded by a person's gender, race, class, and sexual identity. Functioning as a "clinic without walls," CHAMP supports the individuals in these communities at any stage of the HIV Care Continuum by providing street-based testing, access to same-day treatment services, and home-based support for people living with HIV [11].…”

Using Implementation Science to Promote Integration and Sustainability of Community Health Workers in the HIV Workforce

“…Using the EPIS and RE-AIM frameworks, this project is gathering key evidence for building the CHW workforce in priority jurisdictions where health disparities are prevalent. [44][45][46][47][48][49] The findings highlight the key determinants and strategies influencing CHW integration, including addressing stigma and supporting disclosure, aspects of a supportive organizational culture, opportunities for CHW leadership, resource and referral systems, a comprehensive training program, and interorganizational CHW networks. These factors affect the ability of CHWs to function effectively within the care team.…”