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Vital Signs

A Model Approach to Culturally Competent AIDS Care

Because the AIDS epidemic in America so disproportionately affects minority populations--especially African Americans and Latinos--culturally competent approaches to HIV/AIDS treatment and prevention are absolutely essential to eliminating the disparities. Health care providers who work with these communities must be sensitive to a wide range of cultural factors that can dramatically impact treatment outcomes--from language barriers, ethnic stereotypes and lack of health insurance to minority AIDS patients’ beliefs about health, illness, family, spirituality and the health care system.

Fortunately, the National Minority AIDS Education and Training Center (NMAETC), a federally funded HIV/AIDS training and technical resource headquartered at Howard University, has developed two excellent tools to help clinicians provide more effective, culturally relevant care to HIV/AIDS-infected patients of color: BE SAFE: A Cultural Competency Model for African Americans and BE SAFE: A Cultural Competency Model for Latinos.

These publications are comprehensive workbooks created by teams of minority health and transcultural health experts from the fields of medicine, nursing, public health, social work and more. Several of the contributors are minority nurses, including Josepha Campinha-Bacote, PhD, RN, CS, CNS, CTN, FAAN, founder of Transcultural C.A.R.E. Associates; Geraldine Brown, PhD, RN, of Howard University; and Antonio Duran, BS, LVN, of The University of Texas Health Science Center at San Antonio.

BE SAFE is the acronym for a cultural competency model developed by NMAETC based on Campinha-Bacote’s 1998 model “The Process of Cultural Competence in the Delivery of Healthcare Services.” Its six core elements are:

• Barriers to care (real or perceived gaps to receiving or providing quality care)

• Ethics (morality, belief systems, “right” vs. “wrong” behavior)

• Sensitivity of the provider (cultural awareness and self-examination of one’s own biases and prejudices)

• Assessment (ability to collect data in the context of the patient’s culture)

• Facts (understanding of physiology, behavior, health disparities, patients’ cultural beliefs and perceptions of their illness, etc.)

• Encounters (communicating effectively with minority AIDS patients in clinical situations).

Using this six-part framework, the models provide clinicians with a wealth of HIV/AIDS-specific information designed to help them better understand and respond to the unique cultural needs of African American and Latino patients. Each workbook is filled with practical tools, such as step-by-step guides to conducting cultural assessments, evaluating one’s own cultural sensitivity, developing culturally based treatment plans and conducting clinical interviews. The Latino workbook, produced in collaboration with the National Council of La Raza, includes a glossary of relevant Spanish-language terms, from confianza and fatalismo to SIDA and células T.

The BE SAFE: A Cultural Competency Model workbooks can be downloaded free of charge from the NMAETC Web site at www.nmaetc.org/resources.html.