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    <p class="art-author"><b>Authors:</b>Abiola Ruth Adimula<sup>1</sup> and Ignatius Nnamdi Ijere<sup>2*</sup></p>
    <p class="art-affl"><sup>1</sup>Department of Pediatric, Brown University, Providence, RI 02912, USA<br><sup>2</sup>Saint Damien Pediatric Hospital, USA</p>
    <p class="art-aff"><b>*Corresponding author:</b> Ignatius Nnamdi Ijere, Associate Teaching Professor, Department of Public Health, Falk College, Syracuse University, New York, USA, Tel: 315.443.9393, E-mail: inijere@syr.edu</p>
    <p class="art-aff"><b>Received:</b> August 5, 2015
    <b>Accepted:</b> August 17, 2015
    <b>Published:</b> August 24, 2015</p>
    <p class="art-aff"><b>Citation:</b> Davey SE, Koster M, Excellent ML, Gautier J. Review of a Physician HIV Training
    Program for Pediatric Providers. <i>Madridge J AIDS</i>. 2015; 1(1): 1-8. doi: <a href="https://doi.org/10.18689/mja-1000101">10.18689/mja-1000101</a></p>
    <p class="art-aff"><b>Copyright:</b> &copy; 2015 The Author(s). This work
    is licensed under a Creative Commons
    Attribution 4.0 International License, which
    permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited333.</p>';
}
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    $abstract = '<p class="art-para"><b>Background:</b> Haiti is one of the most severely resource-constrained countries in the Americas, experiencing high rates of HIV. Access to HIV care is the paramount barrier with a paucity of specialized care providers throughout the very rural country. As of 2012, about 150,000 out of a population of 10 million living in Haiti (1.5% prevalence) were HIV-positive, with 12,000 of 3.6 million children under the age of 14 years old (0.3%
    prevalence).</p>
    <p class="art-para"><b>Methods:</b> A total of 42 providers have been trained by the HIVTP as of September 2014. A survey organized into questions regarding program length, lecture content, lecture modalities, and current engagement in pediatric HIV care was distributed to all graduates. Results were analyzed by computing frequencies of survey responses. Pre- and post-test assessments of knowledge that were administered to program participants were evaluated as markers for participant improvement. A focus group was held among program staff and administrators to collect qualitative data regarding program structure and modalities. Quantitative and qualitative results were cross-analyzed in order to assess the effect of the program in expanding human resources for pediatric HIV in Haiti.</p>
    <p class="art-para"><b>Results:</b> Out of the 42 surveys administered, a total of 14 were completed and returned, for a response rate of 33%. Of the respondents, 79% of HIVTP participants continue to practice pediatric HIV care in Haiti. Trainee satisfaction of the program, measured by survey responses to agreement with questions about topic content and length, was 86%. Program pre- and posttest results indicated a positive improvement in knowledge after the program. Focus group and survey results indicated that there should be revisions in program length and modality, preferably through a mixed methods model including case-based, hands-on, and online modalities.</p>
    <p class="art-para"><b>Conclusion:</b> There was a high rate of HIVTP trainee respondents who are currently providing care for pediatric HIV in Haiti with an overall high satisfaction rate of participants. Revisions to program modality and length could strengthen the effect of the program. Better retention of graduates and improving focus on task shifting could help to decentralize delivery and contain costs.</p>
    <p class="art-para"><b>Keywords and Abbreviations:</b> ART: Antiretroviral therapy; GDP: Gross Domestic Product
    HIVTP: HIV Training Program at St. Damien; MOH: Ministry of Health; PEPFAR: Presidents Emergency Fund for AIDS Relief; PMTCT: Preventing Mother to Child Transmission; SDH: St. Damien Pediatric Hospital; TB:
    <i>Mycobacterium tuberculosis</i>; UNAIDS: Joint United Nations Program on HIV/AIDS; WHO: World Health Organization</p>';
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$introduction = '<p class="art-para">This study aims to identify the effect of the Saint Damien HIVTP in increasing the human resource pool for pediatric HIV in Haiti. We hypothesize that the HIVTP has been successful in meeting the objective of increasing the number of pediatric HIV providers practicing in Haiti. Within this study, the primary outcome is defined as the number of HIVTP physicians who continue to practice pediatric HIV care out of the total number of physicians trained in the program. A secondary aim of the study includes measuring HIVTP participant satisfaction with the program through a structured survey, assessing knowledge improvement through pre- and post-test scores, and identifying barriers and areas for improvement through focus group discussion with program administrators and facilitators. Suspected barriers to providers being able to deliver care include: poor access to the internet and technology, budget and funding constraints, and time limitations. Although this particular study focuses on a training program specifically for physicians, it is intended to support the research for expanding human resources for health across multiple disciplines.</p>
<p class="art-subhead">Methods</p>
<p class="art-para">
Methodologies were three-fold with collection of survey responses, program test data, and focus group responses.</p>
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$references = '<li class="ref"><div id="1">Green A, de Azevedo V, Patten G, Davies MA, Ibeto M, Cox V. <a href="http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0098389" target="_blank">Clinical mentorship of nurse initiated antiretroviral therapy in khayelitsha, South Africa: a quality of care assessment.</a> <i>PloS one</i>. 2014; 9: e98389. doi: 10.1371/journal.pone.0098389
&nbsp;&nbsp;&nbsp;<a href="#ref1"><i class="fa fa-level-up" aria-hidden="true"></i></a></div></li>
<li class="ref"><div id="2">Abrams EJ, Simonds RJ, Modi S, et al. <a href="https://www.ncbi.nlm.nih.gov/pubmed/22797731" target="_blank">PEPFAR scale-up of pediatric HIV services: innovations, achievements, and challenges.</a> <i>J Acquir Immune Defic Syndr</i>. 2012; 60: S105-S112. doi: 10.1097/QAI.0b013e31825cf4f5
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