HIV, STIs, Viral Hepatitis and LTBI Routine Screening Toolkit: Education and post-test counseling

Step 5: Education & post-test counseling

Educating and engaging patients in their care is a critical consideration for how to implement an effective routine screening program. However, lack of care team training or knowledge on infectious disease control contributes to the uneven division of labor, reducing the likelihood of routine screening and causing missteps in follow up and linkage to care.

Some clinicians who lack counseling skills may be intimidated by sharing positive results and thus may skip routine screening all together. Empowering every member of the care team with education and equipping the care team with health coach training can help overcome these concerns. Additionally, having patient friendly education materials can help improve discharge communications.

Critical considerations at this stage

Knowledge gaps exist across members of the care team who may not know the steps to take or the latest HIV or STI treatments
Access to patient-centric material to distribute is needed
Patients do not understand the behaviors associated with HIV, STIs, viral hepatitis or LTBI, especially if they do not identify with the stereotypical population disproportionately affected
Additional training on how to provide sensitive counseling of post-test results is needed
Time for clinicians and staff members to effectively communicate results and counsel with respect to the patient’s privacy needs to be allocated

Strategies you can implement

Empower every member of the care team with education
1. Providing in-depth, disease-specific education sessions for every member of the care team on the need for routine screening and how to conduct it, engenders greater empathy for the patient and boosts confidence to answer questions rather than deferring to the lead clinician.
2. Related resources
3. Training and education for the care team on HIV, STIs, viral hepatitis and LTBI essentials: The following links are a compilation of education and training resources from the CDC targeted to health care professionals. These training materials can be leveraged to equip your care team members with the latest information to help boost the confidence of any member of the care team in answering patient questions.
1. County-level Syphilis Rates to Direct Screening Efforts: Health care professionals can use this county-level map from the CDC that visualizes primary & secondary syphilis rates as they consider their syphilis screening efforts.
2. Compendium of Evidence-Based Interventions and Best Practices for HIV Prevention: This webpage from the CDC outlines a collection of HIV interventions in the form of evidence-based and evidence-informed info sheets.
3. Preventing new HIV Infections: This webpage from the CDC includes both the latest Clinical Practice Guidelines and Clinical Providers’ Supplement for using PrEP for the prevention of HIV infection.
4. National HIV PrEP Curriculum: This free resource was developed at the University of Washington for health care professionals who want to learn about HIV PrEP.
5. Learn About PrEP: This CDC webpage provides an overview of clinical practice and prescribing guidelines for PrEP for clinicians.
6. Health Department directories: This resource from the CDC outlines who is working to protect the public’s health in your area, including senior health officials, state, local, and territorial health departments, and tribes and Indian organizations. Clinical staff may need to develop relationships with staff in various sections of health departments in order to facilitate reporting, linkage to care or prevention and other critical services.
Have patient education materials available at visit completion
1. Having patient friendly education materials at discharge is important piece of patient care. Patients should be provided with information about the communicable nature of these infections and consider options for notifying others that were potentially exposed.
2. Related resources
  Patient Education Materials from the CDC: These links compile downloadable patient education materials from the CDC with resources targeted to different patient demographics and available in multiple languages.
- HIV Consumer Info Sheets
- Viral hepatitis Patient Education Materials
- STI Patient Education Resources from the CDC
- LTBI and TB disease resources
  - Find TB Resources: TB Education & Training from the CDC
  - Tuberculosis Patient & General Public Materials
1. JAMA Network™ Patient Pages: JAMA Patient Pages are free patient resources designed to distill high-quality evidence and updated guidance from USPSTF into a more accessible patient friendly format to help guide patient decisions. These resources can also be helpful to reference as your clinic or institution develops their own patient-friendly educational resources.
2. HIV
1. Viral hepatitis
1. STIs
1. LTBI: Screening for Latent Tuberculosis
Equip staff with skills to communicate more effectively with patients
1. In the absence of patient navigators, investing in training and training for the care team on counseling and cultural safety or structural competence can help staff develop skills to communicate more effectively with patients, leading to increased comfort with counseling patients on results.
2. Related resources
- AMA STEPS Forward®: Health Coaching: This learning module from AMA STEPS Forward® outlines steps to help you develop and implement a health coaching model in your practice.
- Talking with Your Patients about Latent Tuberculosis (TB) Infection (PDF): A conversation guide for healthcare providers about how to talk to patients about latent TB infection.
- Target HIV Cultural Competency Resources: This webpage includes a collection of guidance, tools and trainings that clinicians can use to identify and address bias to improve communication with diverse patients.
- Cultural Competence in Health and Human Services: This resource from the National Prevention Information Network defines what cultural competence is and how it applies to HIV, viral hepatitis, STI and TB prevention.

Next steps

The HIV, STIs, Viral Hepatitis and LTBI Routine Screening Toolkit is organized across the screening continuum and offers helpful resources and best practices for the care team.