HIV & LGBTQ Health Disparities Track

Purpose: The HIV & LGBTQ Health Disparities Track endeavors to provide additional emphasis training in preparing professional psychologists to provide services in interdisciplinary environments for 1) individuals and families affected by HIV/AIDS and 2) LGBTQ patients and family members in primary care settings.

Settings: Augusta University-Medical College of Georgia Outpatient Psychiatry, Augusta University Medical Center Adult Infectious Diseases and Reproductive Endocrinology (Transgender Care) Clinics, Children’s Hospital of Georgia Pediatric Infectious Disease Clinic, AU Health Services-Equality Clinic of Augusta, Augusta.

Faculty:

• Lara Stepleman, PhD, Track Director
• Christopher Drescher, PhD
• Amy House, PhD
• Graham Theisen, MD
• David Haburchack, MD
• Cheryl Newman, MD
• Jonell Poe, PA

Goals/Objectives of the HIV & LGBTQ Health Disparities Track:

1. To develop proficiency in the theory, research, and practice of LGBTQ health and HIV/AIDS psychology, and more generally, in health psychology, chronic illness management, and integrated primary health care delivery.
2. To train Interns to function effectively in interdisciplinary medical settings.
3. To train Interns in consultation assessment strategies in HIV/AIDS medical settings using a biopsychosocial approach.
4. To train Interns in consultation assessment strategies in LGBTQ primary care settings and hormone/surgery readiness evaluations for transgender individuals in outpatient psychiatry.
5. To develop a working knowledge of HIV transmission, disease course, medications, common co-morbid psychiatric and substance abuse diagnoses, and related psychosocial issues.
6. To develop a working knowledge of LGBTQ health disparities, related psychosocial issues, and delivery of appropriate medical and mental health care.
7. To train Interns to become proficient in the assessment of a broad range of disadvantaged patient populations (e.g., rural, low SES, racial, sexual, and gender minorities) with emphasis on assessment in primary care settings.
8. To train Interns to become proficient in the implementation of evidenced based interventions with a broad range of patient populations in psychiatric, primary care, and social service settings. Emphasis will be placed on individual therapy, group therapy, behavioral medicine, motivational interviewing, and psychoeducation.
9. To train Interns to provide HIV/AIDS and LGBTQ mental health education to consumers and medical and mental health care providers, particularly in areas of critical need such as in rural and African American communities.
10. To develop a working knowledge of how culture, race, religion, sexual orientation, gender identity, and economic status intersect with HIV/AIDS mental health issues and other health considerations.

Measurable Outcomes HIV & LGBTQ Health Disparities Track:

1. Interns will work comfortably across a broad array of HIV/AIDS and LGBTQ treatment environments including medical and mental health settings that work largely with medically underserved patient populations.
2. Interns will demonstrate proficiency in consultation assessment strategies by completing a minimum of 45 brief consultations across Infectious Disease HIV Clinics, Equality Clinic, and Reproductive Endocrinology (Transgender Care) Clinic. The quality of the consultations will be judged by the responsible clinical supervisor on the basis of the accuracy of the consultation documentation and the effectiveness of communication with the consultee.
3. Interns will demonstrate knowledge of common psychiatric and medical illnesses associated with HIV/AIDS and related psychosocial issues as determined by the quality of their assessments, consultations, and associated treatment recommendations in ID settings.
4. Interns will demonstrate knowledge of common health disparities affecting sexual and gender minorities, and related psychosocial issues as determined by the quality of their assessments, consultations, and associated treatment recommendations in LGBTQ primary care settings.
5. Interns must complete a minimum of one integrated assessment reports of an HIV/AIDS case and/or one medical or surgical gender transitioning evaluation of a transgender patient in which the Intern provides pertinent data for the purpose of a clear formulation of the case, demonstrates a thorough conceptualization of the case consistent with the theoretical model used, provides a treatment plan that effectively follows from the conceptualization of the case, and includes evidence of empirical support for the treatment plan devised (if applicable).
6. Interns will demonstrate proficiency in at least two evidenced based interventions (DBT, CPT, CBT, Seeking Safety, etc). The responsible supervisor will judge the quality of these interventions.
7. Interns will successfully participate in at least one HIV/AIDS and/or LGBTQ mental health educational program that may include consumer/community presentations, lectures to medical students, and medical/mental health provider continuing education.

Educational Implementation: Interns will spend one four-month rotation plus one full day per week throughout the year in The HIV & LGBTQ Health Disparities track. The track makes use of the following training environments in an effort to achieve the identified Goals/Objectives of this emphasis track: 

1. The MCG/AU Adult and Pediatric Infectious Disease Clinics treats close to over 1400 HIV+ individuals and is the recipient of Ryan White funding that provides primary and ancillary medical services to indigent HIV-positive patients. The intern functions as part of a large multidisciplinary primary care team, training and practicing alongside physicians, physician assistants, nurses, treatment navigators, peer educators, fellows, medical students, and social workers. In this setting the intern will gain skills in consultation to physicians and patients, rapid assessment, crisis intervention, motivational interviewing and behavioral interventions.
2. MCG/AU Outpatient Psychiatry Clinic provides diagnostic evaluation, individual, family, and group psychotherapy for transgender/genderqueer individuals and individuals infected with or affected by HIV/AIDS. In this setting the intern will gain skills in assessment, evaluation, and brief and long term evidence-based psychotherapeutic interventions.
3. AU Health’s Equality Clinic of Augusta is an all-volunteer clinic that provides integrated primary care services to uninsured/under-insured LGBTQ individuals from the CSRA and surrounding regions. The intern functions as part of a large multidisciplinary primary care team, training and practicing alongside physicians, fellows, medical students, dental students, and occupational therapy students. In this setting the intern will gain skills in consultation to physicians and patients, rapid assessment, crisis intervention, motivational interviewing and behavioral interventions.
4. MCG/AU Reproductive Endocrinology (Transgender Care) Clinic provides specialty care in hormone therapy and related healthcare services to transgender individuals with eligible insurance. The intern functions as part of a multidisciplinary care team, training and practicing alongside physicians, nurses, and fellows. In this setting, the intern will gain skills in consultation to physicians and patients, rapid assessment, crisis intervention, motivational interviewing and behavioral interventions.
5. Interns will chose from other MCG/AU and VA clinic options to augment their track experience including substance abuse, trauma, psychology of women, palliative care, and other chronic illness populations.
6. Interns will participate in at least one HIV/AIDS and/or LGBTQ mental health educational program that may include consumer/community presentations, lectures to medical students, and medical/mental health provider continuing education.
7. The intern will participate 4 hours per week in activities that fulfill the research requirement for the internship. This may involve a data-based research project, analysis of an existing data base, writing a critical review, conducting a program evaluation project, or a policy evaluation project. The intern’s research project will be relevant to LGBTQ health, people living with HIV/AIDS, and/or HIV risk behavior.