A Community-Based, Multidisciplinary Training Program to Improve HIV Services for US-Based African Immigrants: Lessons Learned over 5 Years of Implementation

TL;DR

A 5-year training program improved HIV care for African immigrants in the U.S. by engaging healthcare providers in culturally responsive training.

Contribution

The program combined community-based models to iteratively train providers in culturally responsive HIV care for African immigrants.

Findings

100+ providers enrolled, with 58 completing the program, showing strong engagement.

Participants who implemented their Commitment to Change plans reported improved culturally responsive care.

Iterative adaptations to the program enhanced provider engagement and retention.

Abstract

African immigrants in the U.S. face disproportionately high rates of HIV, yet existing services often lack alignment with their cultural and linguistic needs. Healthcare providers are rarely trained to address these gaps, contributing to persistent disparities in HIV prevention and care. Traditional in-house trainings for providers often have limited applicability. Collaborative, community-engaged approaches offer an opportunity to build culturally responsive, coordinated care. African Immigrant (AI) Health was a 5-year initiative integrating the Extension for Community Healthcare Outcomes model, Community of Practice model, and Commitment to Change (CtC) evaluation framework. We used an iterative process to improve the AI Health program based on participant feedback. Data were collected through pre/post-CtC questionnaires, case presentations, and discussion groups. CtCs were analyzed thematically and organized using the socioecological model. Over five years, 100+ providers enrolled, with 58 completing the program. Participants represented diverse healthcare roles, with a majority identifying as Black/African American (62%), female (81%), and residing in the Northeast region (57%). A total of 390 CtCs were developed, with the most common themes at the individual level. Most (54.5%) participants partially implemented their CtCs. Participants who implemented their CtCs reported improvements in culturally responsive care. Iterative adaptations enhanced engagement and retention. AI Health effectively supported providers in enhancing HIV care for African immigrants through culturally responsive training. Findings highlight the need for sustainable, longitudinal training models that integrate community expertise and call for policy and structural reforms to address systemic barriers to equitable HIV care.

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