Public Health, Spring 1997

Supporting Player The growth of an AIDS training center brings both good and bad news. While it demonstrates the community's commitment to serve people living with AIDS, it unfortunately reflects the size of the ep
idemic in our society.




The SEATEC team (l to r): Director of Training Felicia Guest, Director Ira Schwartz, and Assistant Director Debra Morris staff a regional center that offers training in HIV and AIDS to health care providers.

Nine years ago, the Southeast AIDS Training and Education Center (SEATEC) developed the first reference guide of resources for HIV/AIDS in metropolitan Atlanta and rural Georgia. The guide, called Key Co ntacts, was a thin eight pages of double-spaced information. Today in its eighth edition, Key Contacts is a 48-page, single-spaced reference tool of agencies, organizations, and people offering AIDS-related services. With an annual dis tribution of 30,000 free copies, "Key Contacts is one of the most useful, original projects we do," says Ira Schwartz, director of SEATEC. "It lets people with AIDS know that they are not alone. Rather, all of the people and groups in this di rectory are here to serve them."

Funded by the Health Resources & Services Administration (HRSA), US Department of Health and Human Services, SEATEC is one of 15 regional projects that offer training in HIV and AIDS to health care providers. Located within Emory's Department of Family and Preventive Medicine, the southeast branch serves four states: Alabama, Georgia, and North and South Carolina. "In the late 1980s, HRSA recognized that the HIV epidemic was growing so fast that it would be impossible for every HIV-infected person to b e cared for by an infectious disease specialist," Schwartz says. "Therefore, it became important to train primary care providers - physicians, nurses, nurse practitioners, physician assistants, dentists - to treat and care for AIDS patients."

Since 1988, SEATEC has trained 110,016 health care providers in a variety of teaching forums in 160 cities and towns. It has coordinated 2,617 training events, including grand rounds in hospital settings, seminars at state and local health departments, and more intensive clinical training at its Emory hub. Some 1,363 MDs and other clinicians have benefited from this hands-on training, which allows rural practitioners to learn new skills in managing HIV patients during intensive training in Atlanta. "Th e clinical training we do is controversial because it is expensive," Schwartz says. "But as the epidemic expands, and as we can offer people living with AIDS more choices, it becomes more important for Americans to have up-to-date care. The only way smart and well-meaning clinicians can learn these skills is through professional continuing education."

A public health perspective



As one of 15 federally funded regional projects, SEATEC prepares and distributes materials such as these for HIV and AIDS education directed at health care providers. One of its most popular publications is a reference guide to AIDS agenc ies and organizations.

The members of the team that staffs SEATEC come to their work with strong backgrounds in public health. A pediatrician by training, Schwartz has joint appointments at Emory in the Rollins School of Public Hea lth and the School of Medicine. He teaches "The Public Health Implications of HIV/AIDs" for public health and medical students each fall. In 1993, the Rollins Student Government Association chose Schwartz, who works in the area of international health, as the school's professor of the year.

Working with Schwartz are Debra Morris and Felicia Guest, both alumnae of the School of Public Health. "They are premier health educators known around the country," Schwartz says.

Morris, the deputy director of SEATEC, was managing a community health center when she decided to return to school to study public health. "I saw the same patients coming back month after month with the same issues and problems," she says. "The missing link in their health care was health promotion and education." After receiving her MPH in 1987, she joined SEATEC as a trainer and coordinator for the state of Alabama. She next served as deputy director of a national perinatal substance abuse prevention program in Washington, DC. Two years ago, she rejoined SEATEC.

Having worked as both an educator and an administrator, Morris knows how to get things done. "I understand the dynamics of both sides," she says. "I try to make sure that the education needs interface well with the administrative parts of the job - gra nts, contracts, and funding - to make a good marriage."

Guest, a 1991 graduate of the Rollins School of Public Health, was one of the people who wrote the initial grant that led to the establishment of SEATEC. (Kathleen Miner, associate dean for applied health and the first director of SEATEC, was another.) Today Guest serves as the center's director of training. "At first, not many practitioners knew very much about AIDS, so we were the teachers," Guest says.

Guest oversees all of SEATEC's training activities, from the hiring of education consultants to the preparation of written and promotional materials. With a background in counseling and family planning, she also leads some courses herself, teaching how to break bad news to patients or how to develop sound prevention counseling skills.

As a public health educator, Guest wants to offer teaching methods that really work rather than gimmicks. "We teach primary prevention - don't get infected - and secondary messages - if infected, how to keep from spreading HIV to others," she says.

Complementary programs



At the Ponce de Leon Center, a division of Grady Memorial Hospital in midtown Atlanta, Schwartz meets with a clinical medicine team to diagnose a case of AIDS-related tuberculosis.

As new treatments and medicines are being made available to people living with AIDS, the cost of health care for these patients is rapidly rising. Funding for AIDS training now competes with federal dollars s lated for research and primary medical care. Reflecting that competing dynamic, the US Congress last year initially designated no funds to continue the HRSA program that sustains SEATEC. However, the medical community successfully argued for the importanc e of these training centers, and funding was restored.

Schwartz sees other benefits of the center daily. The federal program has allowed Emory to build other projects on the SEATEC infrastructure, including ones that train mental health practitioners and prison health care providers on issues surrounding H IV and AIDS.

A complementary program, the Atlanta Tuberculosis Prevention Coalition, examines the link between TB and HIV. "From a public health perspective, we can't tackle TB without tackling HIV and vice versa," Schwartz says. "And Georgia is a key place to stud y this link. In 1994, if Grady Hospital in downtown Atlanta were considered a state by itself, it would have ranked 25th in the incidence of new TB cases in the nation." With two nurse practitioners, including Maya Yodh, who holds an MPH from the school, the Atlanta TB Prevention Coalition takes its courses on TB prevention to prisons, county health departments, and community hospitals.

Although SEATEC's future is evaluated yearly, Schwartz believes the project is an important supporting player in improving the lives of people living with AIDS. "It serves the community well by training health care providers but avoids the duplication of services," he says. "The value of this training is all too evident. We receive more requests than we can answer, reflecting the great need out there."


Spring 1997 Issue | Our Modern Plague | A Prayer for AIDS | REAL Life Lessons
Putting a Price on Prevention | An Epidemic Ignored | It's MAGIC | Supporting Player
School Sampler | Alumni Sampler
WHSC | RSPH

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