Improving HIV/STD prevention in the care of persons living with HIV through a national training program.

Persons living with HIV (PLWH) are living longer, remaining sexually active, and may continue risky sexual behaviors. As such, it is crucial for providers to ask all HIV-positive patients about behaviors related to HIV transmission and STD acquisition. The "Ask, Screen, Intervene" (ASI) curriculum was developed to increase provider knowledge, skills, and motivation to incorporate risk assessment and prevention services into the care of PLWH. The ASI curriculum was delivered to 2558 HIV-care providers at 137 sites between September 30, 2007 and December 31, 2010. Immediately post-training, participants self-reported significant gains in perceived confidence to demonstrate ASI knowledge and skills (p < 0.001) and 89% agreed they would update practices as a result of the training. Three to six months post-training, 320 participants who served PLWH or supervised HIV-care providers self-reported more frequently performing ASI skills (p < 0.001), and 71% self-reported greater perceived confidence than before training to perform those skills (p < 0.001). Limitations include self-reported measures and a 30% response rate to the 3-6 month follow-up survey. Our findings suggest that a well-coordinated training program can reach a national audience of HIV-care providers, significantly increase self-reported capacity to incorporate HIV/STD prevention into the care of PLWH, and increase implementation of national recommendations.