Knowing Better, Doing Better: Brandon Harrison
Brandon Harrison, PrEP Supervisor at Callen Lorde Community Health Center in New York
The results were alarming: The HIV/AIDS health-care providers at health departments and AIDS service and community-based organizations who were polled answered only 63 percent of questions correctly—essentially earning a grade of D for their knowledge of HIV science and treatment, while earning the equivalent of an F on treatment-related questions.
In part 6 of this series, we interview African American HIV University (AAHU) Science and Treatment College Fellow Brandon Harrison, who recently moved from Chicago, where he was the Trilogy prevention coordinator at Chicago House and Social Service Agency, to New York to be PrEP supervisor at Callen-Lorde Community Health Center, which has been prescribing pre-exposure prophylaxis since 2012.
Why did you move to New York?
I wanted to be a part of PrEP implementation, and Callen-Lorde is one of the few agencies in the U.S. that is actually implementing PrEP services. They currently have about 700 people on PrEP, so they're always a little ahead of the curve, and I wanted to be a part of that curve. I really think PrEP is one of the best tools we have right now to prevent HIV.
Who is your client base?
Callen-Lorde's client base is LGBT—that's their specialty—but we serve anyone who needs health care. At the Chicago House we treated patients in a behavioral health setting.
Who are the non-medical providers that patients at Callen-Lorde deal with?
Front-desk people. Our prevention team is mostly non-medical as well, but we take on PrEP, so that probably includes some medical aspects. We also have case managers, HIV testers and counselors.
Do you think the center's non-medical staff has sufficient science and treatment knowledge?
I think Callen-Lorde does a good job of educating our staff on HIV science and treatment because we have knowledgeable medical providers. If we don't know the answer, we have the resources to ask, identify and find the answer easily. But in other areas of the organization, the science and treatment isn't part of training and really integrated into staff development.
Why is it important that the non-medical workforce be literate in science and treatment?
As a non-medical provider, I should be aware of how the medications interact with each other and that an HIV diagnosis may or may not affect someone mentally. You have to have an understanding of HIV to deal with preventing it: for example, knowing the transmission routes and even knowing that PrEP exists and that we can prevent all new HIV infections by getting people on PrEP.
What is the impact when non-medical providers don't have that knowledge?
If they don't have the knowledge that they need, then they can't help their patients engage in care. For example, if a patient is not in adherence with their daily medication, they could develop resistance and go back to having to take multiple pills a day and/or change their entire regimen—their viral loads could spike, their CD4 count could go down, etc. So it's vital for non-medical providers to understand the importance of having a balance of medication when they're counseling patients.
What do non-medical providers need to know to help patients stay on treatment?
I'm going to speak about PrEP. I think they need to be able to point their patients toward PrEP. Part of my job is to go throughout New York state and give presentations on PrEP and how to access it. With Gilead's medical assistance program and New York state's PrEP-AP program, which is similar to ADAP, it makes PReP absolutely free for people who are uninsured if you apply to these programs. AAHU has helped develop my presentation skills, so I now definitely have a different level of confidence when I'm doing presentations, compared to a year ago before I was a Fellow.
You also want us to know that Callen-Lorde administers PEP?
PEP is postexposure prophylaxis, which we've been using for years, mainly in occupational-exposure situations like needle pricks. But it wasn't available for people who have sex and afterward find out that their partner is HIV positive. Within 72 hours of that sexual encounter, you have an option to go out and get postexposure prophylaxis. Currently we have at least five people a day come in for PEP, and that's probably a conservative number.
For more information about the African American HIV University, visit blackaids.org or call 213-353-3610, ext. 100.
April Eugene is a Philadelphia-based writer.