While the incidence of HIV in the United States generally has declined significantly over the last 15 years, the incidence in African American and Hispanic men who have sex with other men has seen an increase of up to 80%. HIV rates in the New Haven community mirror this national trend. Matthew Drause, a second-year student in the Physician Associate (PA) Program, observed this concerning trend while he was on a clinical rotation at the Nathan Smith Clinic at Yale New Haven Hospital, which provides comprehensive care for HIV-positive patients.
That experience prompted Drause to apply to the Paul Ambrose Scholars (PAS) Program’s request for proposals for community-based projects that address health promotion or disease prevention. Students who are selected as Paul Ambrose Scholars have a year to work on their projects before presenting their findings to the Association for Presentation Teaching and Research, the organization that administers the PAS Program.
The PAS Program selects about 40 health professional students annually who exhibit a desire to learn and integrate public health into their future clinical practice. Its goal is to prepare the students to lead in addressing public health challenges at both the national and community level. Launched in 2002, the program honors Paul Ambrose, MD, MPH, who was a senior clinical advisor in the U.S. Office of Disease Prevention and Health Promotion; Ambrose was on one of the American Airlines flights that was hijacked on September 11, 2001.
Drause’s specific proposal was to conduct an educational campaign designed for, and targeted to, young African American and Hispanic men who have sex with other men. He believes this outreach will increase HIV testing, use of protection, and, eventually lead to a decline in HIV transmission rates.
Drause was one of six PA students selected for the PAS Program, along with students seeking degrees in medicine, dentistry, graduate nursing, pharmacy, physical and occupational therapy, and public health. “I was thrilled to learn I was selected. I assumed my application was a long shot, based on the prestigious bios of past recipients,” he said. In April 2018, Drause had the opportunity to meet his fellow PAS scholars at a symposium in Philadelphia, which launched the year-long program. Drause “was blown away by the other scholars’ innovative approaches to solving problems, and inspired to see how a myriad of different professions share similar progressive goals, and are actively looking to improve public health in their communities.”
With his results not due until June 2019, Drause is in the early stages of his project. However, he recognizes that what he presents, and how he presents it, are critical to the success of his outreach, and that there are many potential hurdles in this complex undertaking.
For example, Drause is cognizant of the potential stigma for some individuals of identifying as a man having sex with other men, and of HIV more generally. He therefore wants to ensure his materials are judgment-free, and that they provide information about the disease, including risk factors, testing, and preventative measures, without having a prescriptive tone that could be off-putting. He hopes people reading the material will feel a freedom to act upon it in a way that is comfortable for them.
Drause specifically chose to label the category he is studying as “men having sex with other men” and not, for example, gay, bisexual, or homosexual men, because some individuals who exhibit the targeted behavior may not self-identify as any specific category. He plans to deliver information in an unassuming way, to make it most applicable to the broadest audience.
He knows that some of his target audience may not be adequately reached by traditional methods and that he needs to come up with creative approaches to deal with this challenge. Drause’s background as a high school teacher at a charter school outside of Detroit before starting the PA Program may prove helpful in this effort. Drause’s teaching experience has greatly benefited him throughout his PA Program experience to date; it strengthened his ability to explain concepts and be an active listener, skills he finds essential to be an effective PA. “Teaching helped me to prioritize a room, realizing the most important person in it was not me, but rather the person I was trying to teach,” Drause explains.
Drause also recognizes digital accessibility could be a limitation, and so plans to create both web-based and print materials.
Collaborating with community members is one of the goals of the PAS Program, and Drause is researching what local organizations can best assist him with effective outreach. His list currently includes AIDS Project New Haven, Nathan Smith Clinic, various primary care clinics such as the Cornell Hill Health and Fair Haven Health Clinics, and possibly the New Haven branch of Planned Parenthood. Drause hopes this project will eventually expand beyond the New Haven community.
Drause will complete this project after graduating in December. He is open-minded about his career path, being “blessed with an interest in everything.” However, he can envision himself working in emergency medicine, with a primary care mindset, targeting people who do not have access to primary care outside of emergency rooms because of current gaps in our health care system.
Assistant professor and PA program director Alexandria Garino, PhD, PA-C, reflects upon the qualities Drause has brought to the PA Program, and which he will bring to his practice after graduating: “The first thing one notices when they meet Matt is his enthusiasm. He seems to emit positive energy. In fact, his evaluations frequently contain the words: ‘positive,’ ‘passionate,’ ‘thoughtful,’ and ‘compassionate.’ These evaluations go on to describe someone intent on delivering quality care to his patients. It is obvious he loves to learn. More importantly, he is always focused on giving to others. The mission of the Yale Physician Associate Program is to educate outstanding clinicians and foster leadership. Matt Drause exemplifies this mission every day.”