The theme for World AIDS Day 2023, “Let Communities Lead,” recognizes that putting an end to HIV begins at home. Cizik School of Nursing at UTHealth Houston exemplifies the motto with a plethora of initiatives that engage patients, partners, and stakeholders at all levels.
“Community involvement is particularly important in Texas, which has one of the highest rates of HIV diagnoses in the nation,” said Cizik School of Nursing Dean Diane Santa Maria, DrPH, MSN, RN, FAAN. “Collaboration is key to developing successful community-based initiatives, research breakthroughs, educational enhancements, and evidence-based improvements in HIV prevention and care.”
On the interprofessional and multi-institutional level, Santa Maria continues to provide leadership as co-director of the Texas Developmental Center for AIDS Research (D-CFAR) as well as co-leading its Mentoring Program and Substance Use Scientific Working Group.
HIV Think Tank
At UTHealth Houston, Assistant Professor Veronica Brady, PhD, RN, FNP-BC, founded the HIV Think Tank, a group of researchers, clinicians, and educators who strategize, collaborate on research projects, co-author papers, and plan educational and awareness events.
Among the group’s accomplishments is supporting Robin Hardwicke, PhD, FNP-C, FAANP, in securing a $40,000 grant aimed at enhancing nurse practitioner curriculum at Cizik School of Nursing with modules on HIV care. UTHealth Houston is one of several schools nationally participating in the project funded by the Midwest AIDS Education and Training Center. Working with Hardwicke on implementation are Assistant Professor Sheryl Malone-Thomas, DNP, APRN, FNP-BC, and Associate Professor Carole Mackavey, DNP, MSN, APRN, FNP-C. Hardwicke is a professor at McGovern Medical School at UTHealth Houston and an HIV care provider with UT Physicians.
In addition, several members of the group have gained specialized certifications from the HIV/AIDS Nursing Certification Board. Santa Maria is an AIDS Certified Registered Nurse (ACRN), while Hardwicke, and Malone-Thomas are Advanced HIV/AIDS Certified Registered Nurses (AACRNs).
HOUSTON Academy 2.0 incorporates HIV research
Collaborative projects extend to students and other schools as well. For example, two undergraduate kinesiology students from Rice University are working with faculty on HIV research projects as part of the Houston-area Opportunities for Undergraduate Student Training in Obesity & Nutrition (HOUSTON) Academy 2.0. The 12-month interprofessional program is led by Associate Professor Daphne Hernandez, PhD, MSEd, FAAHB, and provides nutrition education, applied research, and community engagement opportunities led by nursing, dental, medicine, and public health scientists and professionals at UTHealth Houston.
Rice senior Andrew Kim serves as lead study coordinator for Assistant Professor Emily Barr, PhD, RN, CPNP-PC, CNM, FAAN, on a pilot study, “Lactation consultant’s knowledge, beliefs, and opinions on HIV, breastfeeding, and tele-lactation.”
Until recently, the U.S. Department of Health and Human Services (DHHS) universally advised post-partum people living with HIV to feed their infants formula – where its use is safe and available – to avoid transmission of HIV to their babies. However, studies in other countries showed HIV transmission to be less than 1% when the breastfeeding parent consistently uses antiretroviral drugs and sustains an undetectable HIV viral load.
“DHHS changed its guidance in January 2023 and now recommends supporting parents with HIV in this low-risk category whether they choose to breastfeed or formula feed,” Barr said. “This gives us the opportunity to survey lactation consultants to assess their knowledge and opinions about breastfeeding as an option for people with HIV, and about using telehealth to reach families with HIV across North America.”
Kim conducted a literature review supporting the study and helped draft survey questions, which Barr hopes to begin disseminating in the next few weeks to lactation consultants in the U.S. and Canada.
“It’s inspiring to see that science is still making breakthroughs to help this vulnerable population,” Kim said.
Co-investigators are Assistant Professor Rebecca Tsusaki, PhD, RN, WHNP-BC; Jennifer R. McKinney, MD, from Baylor College of Medicine; and Elizabeth Lowenthal, MD, from Children’s Hospital of Philadelphia.
Crystal Unegbu also got hands-on HIV research experience through HOUSTON Academy 2.0. She is a junior at Rice and works with Assistant Professor Annalynn Galvin, PhD, RN, on the pilot project, “Perceived HIV-related health information needs, behaviors, and outcomes for youth experiencing homelessness at risk for HIV: A qualitative study.”
Unegbu assisted Galvin in interviewing youth served by local shelters as well as health care and social service providers who work with this population. Their goal is to gain insight on where and how the youth access HIV-related health information and how well they understand and apply it. Although the study is still ongoing, Galvin said the need to build trust is clearly emerging as a central theme.
“The youth we interviewed often use the internet to access information about HIV because of privacy concerns,” Galvin said. “Social workers and health care providers also recognize the importance of establishing trust to ensure patients perceive the information they provide as accurate and relevant.”
Like Kim, Unegbu said participation in HOUSTON Academy 2.0 has shown her the personal side of HIV and homelessness. “We know people are experience homelessness, but sometimes we don’t think about young people like us being among them,” she said.
Barr and Santa Maria are co-investigators on Galvin’s study.
A long string of success and innovation
Barr’s and Galvin’s studies are just two recent examples of community-based initiatives at Cizik School of Nursing and UTHealth Houston that aim to prevent HIV infections and improve the lives of those with the disease.
Learn more about other innovations and achievements from the past year:
- Santa Maria secured a four-year, $2.9 million grant from the National Institute for Nursing Research for her project “Assessing the use of MY-RIDE, a Just-in-Time Adaptive Intervention, to Improve HIV Prevention and Substance Use in Youth Experiencing Homelessness.” The award came as Santa Maria’s team wraps up work on its five-year NINR-funded study “Come As You Are – Assessing the Efficacy of a Nurse Case Management HIV Prevention and Care Intervention among Homeless Youth.”
- Barr is using her second $50,000 Texas D-CFAR grant to fund the project “ePATHS: Patient Activation Through Home STI testing using electronic communication and telehealth in youth living with HIV,” which examines the acceptability and effectiveness of mailing home test kits for sexually transmitted infections to patients with an eye to improving participation in telehealth visits.
- Brady received a $12,000 All of Us Research Program Mini-Grant Researcher Award from the American Association of Colleges of Nursing in partnership with the National Institutes of Health for her project, “Treatment of Type 2 Diabetes (T2D) in the Presence of Human Immunodeficiency Virus (HIV) among All of Us Participants.”
- UTHealth Houston faculty and their colleagues were recently honored with four awards at the Association of Nurses in AIDS Care 2023 Conference.