AIDS Service Organizations Research Articles

Implementing Behavioral Activation and Life-Steps for Depression and HIV Medication Adherence in a Community Health Center

Antiretroviral therapy to treat HIV/AIDS has substantially improved clinical outcomes among patients living with HIV/AIDS, but only in the presence of very consistent adherence. One of the most prevalent and impactful individual-level predictors of poor adherence is depressive symptoms, even at subthreshold levels. Evidence-based cognitive behavioral interventions exist to address improvements in depressive symptoms and adherence in this population, yet these techniques have largely been designed and tested as individual treatments for delivery in mental health settings. This presents a significant challenge when transporting these techniques to medical settings where other formats for delivery may be more appropriate (i.e., groups, less frequent visits), and few hands-on resources exist to guide this process. As such, primary aims of this study were to adapt and implement evidence-based cognitive behavioral techniques for depression (behavioral activation; BA) and HIV medication adherence (Life-Steps) that have potential for dissemination in an outpatient community health center. The intervention incorporated feedback from health center staff and utilized a modular, group format that did not rely on sequential session attendance. Feasibility was examined over 8weeks (n=13). Preliminary effects on depression, health-related quality of life, and medication adherence were examined, and exit interviews were conducted with a subset of participants (n=4) to inform future modifications. Treatment descriptions and recommendations for effective clinical implementation based on patient and clinician feedback are provided along with case material of two individual patients and an example group session. Current efforts are an important next step for disseminating evidence-based techniques for depression and HIV medication adherence to community health center or AIDS service organization settings.

Motives for meaningful involvement in rural AIDS service organizations

The research described herein was a three-year exploratory descriptive study to examine how meaningful involvement (MIPA) is conceptualized and experienced in rural regions of the Maritime provinces of Canada. The focus of this paper is one aspect of the research; i.e., what motivates the clients of AIDS Service Organizations (ASOs) in rural Canada to become meaningfully involved? We interviewed 34 people who were past or current clients of ASOs in Maritime Canada and who self-reported as engaging in at-risk behaviors for HIV or living with HIV. The interviews explored participants' perspectives about their motives for becoming meaningfully involved in an ASO. Three themes regarding motives for MIPA were revealed: (1) meeting personal needs; (2) making a difference to others; and (3) recognizing a fit between their skills, goals, needs and the opportunities and experiences within the ASO and with other ASO clients. Participants generally cited more than one motive. This research study contributed to the field of knowledge about the motives for MIPA in which it reveals (1) that MIPA was conceptualized by the rural ASO clients as whatever participation provided them personal meaning (i.e., by fulfilling a personal need, by making a difference, and by recognizing a fit) and (2) the important role that ASO staff and volunteers have in fostering and sustaining MIPA. The study also highlighted a trajectory of involvements that support the need for ASOs to entertain a wide range of roles that are assumed as MIPA.

What You See Is What You Get: 30 Years of the HIV Epidemic

The John E. Fryer, MD Award, an annual award given by the American Psychiatric Association and sponsored by the Association of Gay and Lesbian Psychiatrists (AGLP), honors an individual whose work has contributed to the mental health of sexual minorities. Dr. Fryer was the psychiatrist who appeared in a Nixon mask and fright wig as “Dr. H Anonymous” at a 1972 American Psychiatric Association presentation (Scasta, 2003; Barber, 2008) to talk about how the listing of homosexuality as a mental illness affected him and other gay psychiatrists. The talk was one factor in moving the organization to take homosexuality out of psychiatry's diagnostic manual the following year (Bayer, 1981). The Fryer Award was endowed through a generous grant from the Gill Foundation, a bequest from the estate of psychiatrist and longtime AGLP member Frank Rundle, and contributions from AGLP members. The first award in 2006 was given to Barbara Gittings and Franklin Kameny in New York City; other previous recipients include Freedom to Marry's Evan Wolfson (2012) and the Right Reverend V. Gene Robinson (2012). In 2012, Marjorie J. Hill, PhD, was presented the Fryer Award at the fall American Psychiatric Association Meeting in New York City. Marjorie J. Hill, PhD is the Chief Executive Officer of the Gay Men's Health Crisis (GMHC), the nation's oldest AIDS service organization. She has been involved with GMHC since 1994 and has served as its CEO since 2006. GMHC provides a continuum of services to 11,000 men, women, and children annually and has a world renowned legacy of health care advocacy, promoting social justice and supporting lesbian, gay, bisexual, and transgender rights. Prior to her tenure at GMHC, Dr. Hill was the assistant commissioner for the Bureau of HIV AIDS at the New York City Department of Health & Mental Hygiene. Dr. Hill was responsible for all aspects of federally mandated community planning and for the development of citywide HIV/AIDS policy. Dr. Hill has been a champion for the lesbian, gay, bisexual, and transgender (LGBT) community for decades, and she has, throughout her career, contributed richly to the improvement of mental health in sexual minority communities through her activism, vision, energy, hard work, and visibility.

Time, Dual Roles, and Departments of Public Health: Lessons Learned in CBPR by an AIDS Service Organization

Community-based participatory research (CBPR) is an important approach to inform the development and implementation of HIV/AIDS prevention and treatment strategies. However, there is a paucity of literature describing CBPR from the perspective of community-based organizations (CBOs), specifically AIDS service organizations (ASO). Focusing on the perspective of the executive director (ED) from the partnering ASO, we describe in this paper lessons learned during Project Counseling Others About Contacts and Exposures with HIV (COACH), a CBPR, qualitative study intended to examine perspectives and experiences of professionals and clients regarding partner notification (PN) for HIV. Specifically, we describe opportunities and challenges associated with the time investment, balancing a dual role of service provider and researcher, and partnering with the department of public health. This description of the perspective of the ED from the ASO and the associated lessons learned may inform the actions of other CBOs, including ASOs, considering partnering with academic institutions for CBPR.

Health Impact of Incarceration on HIV-Positive African American Males: A Qualitative Exploration

Previous research suggests that incarceration can have a negative effect on health. These health effects have an especially profound impact on HIV-positive individuals. As such, the current study investigates how incarceration affects the health of 12 African American HIV-positive formerly incarcerated males recruited via an AIDS Service Organization. Individuals were enrolled via purposive sampling and engaged in a series of in-depth interviews over a yearlong period (n=46). Participants ranged in age from 33 to 61 years. Most had finished high school, were not employed at time of first and last interview, and most were primarily residing at a homeless shelter. The time incarcerated ranged among participants from 3 months to 3 years. Findings suggest that health is impacted via limited and delayed access to medication, stigma, and poor quality of medical care while incarcerated. Health continues to worsen after release, largely due to incarceration's impact on individuals' social context. Macro-level policy limits opportunity to fulfill basic needs such as housing and hinders one's ability to be gainfully employed. Moreover, stigma, loss of social support, and a delay in accessing HIV-related services deleteriously impacts individuals' mental and physical health status. Implications for practice, policy and future research are also discussed.

Differences in testing, stigma, and perceived consequences of stigmatization among heterosexual men and women living with HIV in Bengaluru, India

Approximately 2.4 million people in India are living with HIV. Gender inequality affects HIV prevention, detection, and management. The purpose of this paper was to describe gender differences in the experience of living with HIV in Bengaluru, India. A subsample of n = 313 (159 men and 154 women) from a larger cohort was used for these analyses. Participants were recruited through AIDS service organizations. They completed an interviewer-administered survey assessing HIV testing experience, types of stigma, and perceived consequences of stigmatization. The majority of men (67%) reported getting HIV tested because of illness, while women were more likely to be tested after learning their spouse's HIV-positive status (42%). More men (59%) than women (45%, p<0.05) were tested in private care settings. Men reported significantly higher mean levels of internalized stigma (men: M=0.71, SD = 0.63; women: M=0.46, SD = 0.55; p<0.001), whereas the women reported significantly higher scores for enacted stigma (men: M=1.30, SD = 1.69; women: M=2.10, SD = 2.17; p<0.001). These differences remained significant after controlling for potential socio-demographic covariates. Following their diagnosis, more women reported moving out of their homes (men: 16%; women: 26%; p<0.05). More men (89%) than women (66%; p<0.001) reported to have modified their sexual behavior after being diagnosed. These findings suggest that the experience of living with HIV and HIV stigma varies by gender in this population. Suggestions for a gender-based approach to HIV prevention and stigma reduction are provided.

The Psychological Well-Being of People Living with HIV/AIDS and the Role of Religious Coping and Social Support

This study examined correlates of depressive symptoms, particularly the role of religious coping (RCOPE), among people living with HIV/AIDS (PLWHA). The study also examined social support as a possible mediator of the proposed association between religious coping and depressive symptoms and the impact of depressive symptomatology on health outcomes such as HIV medication adherence, immune function, and health-related quality of life (HRQOL) among PLWHA. A convenience sample of 292 PLWHA were recruited from an out-patient infectious disease clinic and AIDS-service organizations in the Southeastern United States. 56.7% reported depressive symptoms. PLWHA with depressive symptomatology reported significantly poorer health outcomes, including poorer HIV medication adherence, lower CD4 cell count, and poorer HRQOL. The odds of being depressed was significantly associated with birth sex (female: OR = 0.43, 95% CI = .23-.80), sexual orientation (gay/bisexual: OR = 1.95, 95% CI = 1.04-3.65), marital status (single: OR = .52, 95% CI = .27-.99), social support satisfaction (OR = 0.65, 95% CI = .49-.86), and negative RCOPE (OR = 1.22, 95% CI = 1.14-1.31). Social support partially mediated the relationship between religious coping and depressive symptoms. High rates of depressive symptoms are present in PLWHA, which negatively impact health outcomes. Religious coping, perceived stress, and social support satisfaction serve an important role in depressive symptomatology among PLWHA. These findings underscore the need for healthcare providers to regularly screen PLWHA for and adequately treat depression and collaborate with mental health providers, social workers, and pastoral care counselors to address PLWHA's mental, social, and spiritual needs and optimize their HIV-related outcomes.

Knowledge of and Opinions on HIV Preexposure Prophylaxis Among Front-Line Service Providers at Canadian AIDS Service Organizations

Oral daily tenofovir/emtricitabine (Truvada) is approved in the United States for HIV preexposure prophylaxis (PrEP) but has generated controversy in the media and within HIV-affected communities. We conducted an online survey about PrEP-related knowledge, experience, opinions, and learning needs, and received 160 responses from service providers at Canadian AIDS Service Organizations. Respondents were cautiously optimistic about PrEP and 48.8% believed that PrEP warranted Health Canada approval. In multivariable logistic regression, support for PrEP approval was associated with more years working in HIV (odds ratio=1.89 per decade, 95% CI=1.10, 3.25), low baseline familiarity with PrEP (OR=3.24, 95% CI=1.01, 14.41), and knowing someone who had used PrEP (OR=4.39, 95% CI=1.28,15.08). Participants major concerns about PrEP were similar to those highlighted in other publications, and some issues specific to certain target populations were raised. Several participants (26.2%) had been asked about PrEP in the past year and 10.6% knew of one or more Canadian who had used PrEP. Despite clients' interest, most participants thought that they (60.6%) or their organization (63.1%) did not have enough current knowledge about PrEP, highlighting the need for further education on this novel HIV prevention strategy.

Challenges to the involvement of people living with HIV in community-based HIV/AIDS organizations in Ontario, Canada

The Greater Involvement of People Living with HIV/AIDS Principle (GIPA) has been a core commitment for many people involved in the community-based HIV/AIDS movement. GIPA refers to the inclusion of people living with HIV/AIDS in service delivery and decision-making processes that affect their lives. Despite its central importance to the movement, it has received little attention in the academic literature. Drawing on focus group discussions among staff members and volunteers of AIDS service organizations, activists, and community members, we explore challenges to the implementation of the GIPA principle in community-based HIV/AIDS organizations in Ontario, Canada. Our findings reveal ways in which implementing GIPA has become more complicated over recent years. Challenges relating to health, stigma and disclosure, evolving HIV/AIDS organizations, and GIPA-related tensions are identified. This paper considers our findings in light of previous research, and suggests some implications for practice.

PEPFAR's Antiprostitution “Loyalty Oath”: Politicizing Public Health

AbstractCan Congress require AIDS service organizations to pledge fidelity to the government's view opposing prostitution as a condition of receiving funding? This term, the Supreme Court will decide whether the First Amendment permits such censorship in USAID v. Alliance for Open Society International (AOSI).The 2008 legislation reauthorizing the President's Emergency Plan for AIDS Relief (PEPFAR) requires host countries to support “activities promoting abstinence, delay of sexual début, monogamy, and fidelity.” PEPFAR's “conscience clause” allows organizations with a moral or religious objection to opt out of providing services to patients with a sexual orientation of which they disapprove. In addition, the law requires grantees to adopt “a policy explicitly opposing prostitution” and to refrain from any speech or activities the government deems “inconsistent” with that policy. The antiprostitution pledge extends not only to what a recipient says or does with PEPFAR funds, but even to what it says or does with its own private funds. The government, however, has not enforced the pledge against U.S.‐based nongovernmental organizations partly because of a preliminary injunction granted by the lower courts. That injunction is now at risk if the Supreme Court upholds the loyalty oath.

The Micro Dynamics of Support Seeking

Previous literature suggests that AIDS Service Organizations (ASOs) play an important support role in the lives of impoverished women living with HIV. Less is known about the dynamics of institutional support for middle-class women living with HIV/AIDS, who are assumed to possess a broader base of resources to address their diagnosis. Using qualitative data collected from a racially and economically diverse group of HIV-positive women in Chicago, this article compares how low-income and middle-class women utilize ASOs and reveals how the women’s divergent approaches to availing themselves of institutional resources have important implications for their social and economic coping. For example, associating with ASOs can be status-improving for impoverished women and status-diminishing for middle-class women. As a result, middle-class women report a less robust network of social service providers and people living with HIV/AIDS on whom they rely for HIV-related information and social support, making them vulnerable to HIV-specific social isolation. In sum, the ways that HIV-positive women deploy institutional ties to negotiate their HIV/AIDS status differs markedly depending on socioeconomic status, suggesting that the role of class in gathering social support may be more complex than previously understood.

HIV risk perception and distribution of HIV risk among African, Caribbean and other Black people in a Canadian city: mixed methods results from the BLACCH study

BackgroundAfrican, Caribbean and other Black (ACB) people are a priority group for HIV prevention in Canada, but little is known about the epidemiology of HIV risk in this population. This paper helps fill the knowledge gap by: presenting service providers’ and ACB people’s perceptions about HIV risk in ACB populations; describing the distribution of HIV risk behaviours among ACB people according to markers of social status and position; and comparing results from these two analyses.MethodsThe Black, African and Caribbean Canadian Health (BLACCH) Study is a mixed methods study that used semi-structured interviews and a cross-sectional quantitative questionnaire to collect information about HIV and health from 188 ACB people in London, Ontario, Canada. Qualitative content analysis was used to identify interview themes, and weighted bivariate statistical analyses were performed on the quantitative data. Behaviours related to HIV risk were stratified by sex, poverty status, immigration experience and employment status.ResultsCommunity members perceived that they were at low risk for HIV and mainly focused on sexual risks. They called for more information about HIV in Canada and culturally appropriate HIV services. Service providers cited marital infidelity and cultural and religious attitudes about condoms as barriers to women protecting themselves. They mentioned cultural norms, beliefs about masculinity and underrepresentation of heterosexual ACB men at AIDS service organizations as barriers to men protecting themselves. There were few statistically significant differences in risk behaviours reported by men and women. Those living in poverty were more likely to abstain from sex (p = 0.006) and use condoms (p = 0.027) in the past year. Those living in Canada longer reported higher prevalences of forced sex (p < 0.001), mixing alcohol or drugs with sex (p = 0.001) and past STI diagnoses (p = 0.032). Stable employment was associated with higher prevalences of not using condoms in the past year (p = 0.005) and past STI diagnoses (p = 0.018).ConclusionsThe results show that perceptions about ACB people’s HIV risk differ from actual risk, and those with higher social standing might be at greater risk. Furthermore, the social determinants of health are important factors in the epidemiology of HIV among ACB people.

HIV Symptom Distress and Smoking Outcome Expectancies Among HIV+ Smokers: A Pilot Test

Smoking occurs at high rates among people with HIV/AIDS, but little attention has been paid to understanding the nature of tobacco use among HIV+ smokers, especially the role that HIV symptoms may play in cognitive smoking processes. Accordingly, the present investigation examined the relation between HIV symptom distress (i.e., the degree to which HIV symptoms are bothersome) and smoking outcome expectancies. Fifty-seven HIV+ adult smokers (82.50% male; M(age)=47.18; 45.6% White, 28.1% Black, 17.5% Hispanic) were recruited from AIDS service organizations and hospital-based clinics. On average, participants reported knowing their HIV+ status for 16 years and the majority of participants reported that they acquired HIV through unprotected sex (66.6%). Participants completed measures pertaining to HIV symptoms, smoking behavior, and smoking outcome expectancies. HIV symptom distress was positively related to negative reinforcement, negative consequences, and positive reinforcement smoking outcome expectancies after accounting for relevant covariates. The present research suggests that HIV symptom distress may play an important role in understanding smoking outcome expectancies for smokers with HIV/AIDS. Clinical implications for HIV+ smokers are discussed, including the importance of developing effective smoking cessation treatments that meet the unique needs of this group of smokers.

Making It Real Through Transformative Scholarship, Service-Learning, and a Community-Based Partnership for HIV Education in Alabama

HIV/AIDS is increasingly common in the U.S. South, especially among young people. This article describes a sociology course on HIV/AIDS for college students at the University of Alabama that sought to increase HIV knowledge through instruction, service-learning activities, and community- based research. In the first half of the course, the students partnered with an AIDS service organization (ASO) for HIV outreach. In the second half of the course, the students conducted surveys on HIV- related knowledge and attitudes in the community. Three main conclusions emerged from teaching the course: (1) service-learning with community-based research on HIV/AIDS is feasible, (2) service-learning modules require careful planning, and (3) student engagement for HIV prevention is beneficial for advancing the principles of public sociology.

Planning to Succeed: A Case Study of the Implementation of the Strategic Prevention Framework

This study is an evaluation of the use of the Strategic Prevention Framework (SPF) by a community-based AIDS service organization in Dallas, Texas. The program is sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA). The study examined how well the SPF was used by the program in its first year. The evaluation was conducted through a qualitative method of use of program documents, guided conversations with staff members, and the use of an open-ended survey. Findings show that the program has achieved notable milestones in the process of undertaking a comprehensive needs assessment, developing a strategic plan, and preparing for implementing evidence-based programs aimed at 3 groups that are in need of enhanced services: veterans, college-aged youths, and the reentry population. Lessons learned are described in this article.

Problems with sex among gay and bisexual men with diagnosed HIV in the United Kingdom

BackgroundA significant research literature exists that details the sexual health and sexual behaviour of gay and bisexual men who have diagnosed HIV. However, much of this research has focussed on HIV transmission risk behaviours among this group, rather than seeking to understand their sexual health and sexual well-being more broadly. There have been growing calls for interventions to support people with diagnosed HIV to achieve health and well-being, including sexual health and well-being. A detailed understanding of the problems people in this group face, and how they might be overcome, is required to facilitate such interventions.MethodsOne thousand two hundred and seventeen gay and bisexual men with diagnosed HIV were recruited by convenience sampling through charitable AIDS service organisations, genitourinary medicine clinics and local authority agencies to complete a survey of their health and social care needs. Respondents were asked to report any problems they had with regards to sex during the 12 months prior to survey completion. They were also asked to describe what support might help them to overcome any problems they experienced.ResultsOverall, 70.5% of the gay and bisexual men with diagnosed HIV completing the survey reported one or more problems with sex within the previous 12 months. Most commonly reported problems include loss of libido (44.0%, n=540), poor self-image or low self confidence (43.9%, n=534), worries about passing HIV to potential sexual partners (37.3%, n=454), and fears of rejection from sexual partners (34.7%, n=422). Responses varied according to age, time since diagnosis, and whether or not the respondent was currently taking anti-retroviral therapy. Qualitative analysis of data relating to what support might help men overcome problems with sex indicate a need for therapeutic support to increase self esteem and confidence, clarity on criminalisation of HIV transmission, the tackling of HIV related stigma and help to achieve a higher quality (as opposed to quantity) of sex.ConclusionsThe findings indicate a need for the maintenance and expansion of services to meet the significant needs of people with diagnosed HIV, especially as these intersect with their ability to negotiate sex that is satisfying.

Chronic illness burden and quality of life in an aging HIV population

The population of persons living with HIV (PLWH) is growing older and more prone to developing other chronic health conditions. Disease progression has been shown to be related to quality of life (QoL). However, descriptions of chronic comorbid illnesses and the unique QoL challenges of older adults living with HIV are not well understood and have not been examined in multiple geographic locations. About 452 PLWH aged 50 years or older were recruited from AIDS Service Organizations in nine states. Participants completed a telephone survey that included measures of other chronic health conditions, perceived stress, depression, and health-related quality of life. As much as 94% of the sample reported a chronic health condition in addition to HIV (mode = 2). The highest reported conditions were hypertension, chronic pain, hepatitis, and arthritis. Despite relatively high rates of depression, overall QoL was moderately high for the sample. Physical functioning was most impacted by the addition of other chronic health problems. Social functioning, mental health functioning, stress, and depression were also strongly associated with chronic disease burden. Additional chronic health problems are the norm for PLWH aged 50 years and older. QoL is significantly related to the addition of chronic health problems. As increasing numbers of PLWH reach older age, this raises challenges for providing comprehensive healthcare to older PLWH with multiple chronic conditions.

The development of a health information exchange to enhance care and improve patient outcomes among HIV+ individuals in rural North Carolina

BackgroundThe Regional Health Information Integration Project (RHIIP) has developed the Carolina HIV Information Cooperative regional health information organization (CHIC RHIO). The CHIC RHIO was implemented to improve patient care and health outcomes by enhancing communication among geographically disconnected networks of HIV care providers in rural North Carolina. CHIC RHIO comprises one medical clinic and five AIDS Service Organizations (ASOs) serving clients in eight rural counties. MethodsCommunication among the CHIC RHIO members is facilitated by CAREWare software. The RHIIP team assessed organizational readiness to change, facilitated relationship-building for CHIC RHIO, created the CHIC RHIO and used both qualitative and quantitative approaches to evaluate the process-related effects of implementing a data-sharing intervention. ResultsWe found the CHIC RHIO member organizations were ready to engage in the IT intervention prior to its implementation, which most likely contributed to its successful adoption. The qualitative findings indicate that CHIC RHIO members personally benefited – and perceived their clients benefited – from participation in the information exchange. The quantitative results echoed the qualitative findings; following the CHIC RHIO intervention, quality improvements were noted in the ASO and medical clinic relationships, information exchange, and perceived level of patient care. Furthermore, hopes for what data sharing would accomplish were overly high at the beginning of the project, thus requiring a recalibration of expectations as the project came to a close. ConclusionsInnovative strategies for health information exchange can be implemented in rural communities to increase communication among providers. With this increased communication comes the potential for improved health outcomes and, in turn, healthier communities.

Testing a service integration model: Results from the HIV/AIDS initiative, ConnectHIV

Staff of 20 AIDS Service Organizations (ASOs), grantees of the initiative ConnectHIV in the United States, developed a theoretical model of five categories of factors – external, community, organizational, staff, and client – that lead to effective service integration (SI) and took part in a self-assessment related to the model. The model was tested empirically using GEE analysis to assess the effect of ASO SI scores on client outcomes from participation in HIV/AIDS interventions involving case management with persons living with HIV/AIDS. Results showed that clients served by ASOs with more effective SI were more knowledgeable of HIV disease, healthier (higher CD4, lower viral load) and perceived themselves as healthier than clients in ASOs with less effective SI. In addition, clients at ASOs with more effective SI more often showed stronger gains in CD4 count over their time in the HIV/AIDS intervention than those at ASOs with less effective SI. Further research is needed on models and measurement of SI in order to effectively investigate the impact of HIV SI on client health outcomes.

Development, implementation, and evaluation of a student-initiated undergraduate medical education elective in HIV care

Background: The literature indicates that medical students require more comprehensive HIV training.Aim: Medical students at the University of Toronto developed and implemented the preclerkship HIV elective (PHE) with the aim to increase trainee HIV knowledge, address important issues in HIV care, and prepare students to serve affected populations.Methods: Developed in partnership with the Ontario HIV Treatment Network and in consultation with local AIDS service organizations and the University of Toronto Faculty of Medicine, the PHE was inaugurated in November 2008 as an elective supplement to medical curriculum content. Eighteen second-year medical students participated in the PHE, consisting of lectures, small group sessions, clinical observerships, community placements, reading assignments, and an HIV counseling and testing workshop. Participants completed a self-assessment of HIV knowledge prior to starting and after PHE completion.Results: Self-assessment scores of HIV knowledge among PHE participants significantly increased from 78.1% (pre-PHE) to 90.2% (post-PHE) (p = 0.0016). Common themes from feedback on participant satisfaction included enthusiasm for small group sessions, clinical observerships, community agency placements, and the diversity of topics covered.Conclusions: Student-run initiatives can supplement medical curriculum content and program feedback may be used to advocate for curriculum changes. Factors influencing success include student leadership and interest, community partnerships, and faculty mentorship.