Meeting the Cultural and Linguistic Needs of People Living with HIV/AIDS: A Multilevel Intervention to Implement the CLAS Standards in an Integrated Healthcare Delivery System

ISSUES: People living with HIV/AIDS (PLWHA) are a special population with diverse needs. Culturally and linguistically competent health services can improve access to care, treatment adherence, chronic disease management, and health outcomes. DESCRIPTION: AIDS Healthcare Foundation (AHF) is a global organization providing cutting-edge medicine for PLWHA through an integrated healthcare delivery model. AHF undertook a three-year program to integrate the National Standards for Culturally and Linguistically Appropriate Services (CLAS) into its existing Cultural and Linguistic Program. Baseline assessment included group needs assessment, self-assessment checklist for health care workers providing primary care services, and focus groups with PLWHA. Areas for improvement were identified. Actions taken were medical staff and healthcare center training and development of a community referral network. LESSONS LEARNED: Multilevel assessment of individual and organizational cultural competence is an effective mechanism to identify gaps in health care services for PLWHA. Multidisciplinary and cross-functional exploration of alternative approaches to improve individual and organizational competency is imperative to improve the experience of care. Use of an already proven framework like the CLAS Standards for organizational assessment is effective. RECOMMENDATIONS: Use CLAS Standards as a guide for self-assessment and identifying opportunities for improvement. Create and implement data-informed and targeted interventions to address competency gaps. Establish comprehensive programs using professional interpretation services for Limited English Proficiency members, improve culturally sensitive care for Latino/as and gay men, and institute best practices when providing care to transgender patients. Perform ongoing competency evaluation through member satisfaction surveys, posttests from staff trainings, and facility site reviews.