Black males have the highest HIV incidence and AIDS mortality rates in the United States despite two decades of advances in AIDS research and care (Kaiser Family Foundation, 2006). In North Carolina, African Americans represent 24% of the population yet account for 66% of AIDS cases. In 2003, among males ages 13 to 24 who were newly diagnosed with HIV, more than 70% were Black (NC Department and Health and Human Services [DHHS], 2003). At least half of all new HIV cases in the United States occur among people under the age of 25 with a substantial proportion of these infections occurring among young men who have sex with men (MSM) (Centers for Disease Control and Prevention [CDC], 2007).

Current HIV research reveals an urgent need to address macro-environmental factors such as social barriers (e.g., poverty, racism, and homophobia) that contribute to health inequalities for HIV-infected populations (Beatty, Wheeler, & Gaiter, 2004; Brown, Trujillo & Macintyre, 2003). Promoting cultural competency among health professionals is one strategy to address these disparities (US DHHS, 2000).

This dissertation evaluates the outcomes of a cultural competency training for North Carolina Disease Intervention Specialists (DIS). In North Carolina, DIS are “first responders” after HIV diagnosis and play a vital role in connecting HIV-infected persons to care. The study sample includes DIS (n=54) who attended a two-day training to increase their effectiveness in interacting with clients who are gay, bisexual, and transgender (GBT). The specific outcome measures evaluate changes in providers’ knowledge, awareness, attitudes, and skills related to working with GBT clients with a focus on clients of color. Overall, the majority of DIS showed an increase in knowledge related to GBT issues and population, yet demonstrated no change related to attitudes, awareness and skills in working with GBT clients. Implications for research and practice are discussed.