First Ever National Prevention Strategy Unveiled

On June 15th, the US Department of Health and Human Services unveiled its first ever National Prevention Strategy. The prevention strategy is a required component of the implementation of the Affordable Health Care Act, aka Health Reform. Underlying the strategy is a plan that reducing illness will ultimately pay off not only in quality of life, but in less money being spent on disease care. Why should we in the HIV care about this?
Key points put forth by Maria Alvarez, the Director of Health Policy in the Office of Health Policy Reform at DHHS here at HealthCare.gov's blog :
1) Making healthy choices easy and affordable will result in more Americans having access to prevention services such as HIV testing, breast exams, blood pressure checks, etc. Having health care providers focus on prevention in general should result in broader prevention efforts in general.
2) Access to health care in underserved communities will be improved -- having a large impact on illnesses with health disparities such as hypertension, heart disease, and HIV. This will be for both HIV care and for issues around primary care as well.
3) Programs will be better targeted through advance scientific knowledge and innovation through creation of electronic systems to better monitor what is working and what isn't-- we already do this in Ryan White funded clinics through CAREWare.
4) Create a fairer and easier way to understand the health care system - by 2014, insurance will be easier to obtain and there legally cannot be any discrimination against anyone with a pre-existing condition-- opening many options for those with HIV.

DMC Director a Top Doc

Jill Foster, MD, Director of the DMC was named in the Philadelphia Magazine May Issue as a Philadelphia Top Doc in the category of Pediatric Infectious Diseases. This honor results from voting from local physicians who are her peers. Inclusion in this also qualifies her as a Castle Connolly America's Top Docs. Dr. Foster is coming up on her 10th anniversary as program director this fall. She wants to congratulate her entire team for the joint effort that led to this honor for the Center.

New Feature - Follow Us By Email

If you're interested in getting an email every time we make a new posting, just enter your email into the box in the "follow us by email" section in the left column and you're all set. We won't have access to these email addresses, so of course would never use them. If you would like us to know who you are and would like to be on our mailing address, just send an email to stchrisrapidtesting@gmail.com.

Commemorating the 30th Anniversary of HIV

By Jill Foster, MD - Director of the DMC
It was 30 years ago this week that the first official account of a mysterious illness that would become known as HIV was made, in the June 5, 1981 issue of MMWR-- and the beginning of the summer when I would begin my medical career. My personal journey with HIV didn't become evident until two years later, in 1983 with my first job, as a physician assistant at Giuffree Medical Center on 8th and Girard in North Philadelphia-- a hot zone for HIV in Philadelphia. Hearing only whispers in the medical community of what was becoming known as a "gay plague", we started seeing previously healthy young people be admitted and abruptly die. There was fear from the patients as they sickened so quickly and fear from much of the staff that it was contagious. There was a lot more than whispers in the community as people saw friends taken from something ominous.
I have vivid memories of patients and friends from that time. Andre (not his real name) who was a twenty something whom I had cared for and laughed with during several dirty needle related illnesses who came in with PCP and died 2 days later. Phillip who was 2 whose mother had died and he had just been adopted and now had kidney failure from guess what, HIV. We had the "miracle cure" of AZT and ddI for him and he lasted a few years. Michael, my friend, who I begged to get an HIV test after he had a particularly nasty foot infection, but he said, "What would I do different?" The answer to a positive test for him since he was already symptomatic would have been to start preparing for the end and he still had so much life to live.
"What would I do different?" is such a different question for 2011 rather than 1985. Today, we have medications that are not a cure but in the majority of patients can get someone to having no detectable virus in their blood. Someone who knows his or her status can take risk reduction steps to protect him/herself and decrease the risk of transmission to others. Earlier this year, we heard about PrEP (Pre-Exposure Prophylaxis). PrEP from early clinical trials has the promise that we may be able to offer two medications (emtricitabine and tenofovir) and counseling to high risk HIV negative young men who have sex with men to potentially decrease their risk of HIV.
"What would I do different?" now, personally and professionally-- nothing. I remember the first time I ordered an HIV test on a patient and how glad I was to have it available. I also remember the first time I did an HIV test in a church rather than in a medical office and how magical it still seemed. I remember the first person I gave an HIV positive result to (a mother for her baby) and the most recent (a teen 2 weeks ago). I remember the first time I ordered AZT for a patient and where I was driving when I heard the news on NPR that a clinical trial giving AZT to pregnant women had been halted because of its success-- and that we would soon eliminate mother to child transmission. I am looking forward to remembering where I was when I heard there was a cure.
Here's some links to some other pieces on remembrances and other items about the 30 year anniversary. Op-Ed in the Inquirer by Dr. Marla Gold, Dean of the Drexel School of Public Health, features in the Inquirer, a New York Times Op-Ed, a piece by the Smithsonian on an exhibit commemorating the 30 year anniversary, and a message from Secretary of State, Hillary Clinton. View information and panels from the AIDS Quilt.

DMC Testing Program Results Presented at SPH Research Day

Cymara Tolbert, MPH (candidate) spent her year at St. Chris performing a program evaluation of our testing program. She presented these results at the annual Drexel School of Public Health Annual Poster Presentation and Awards Reception. Her analysis showed an overall positivity rate of 2% in our community based testing program, and that we are being successful in reaching our target populations of high risk for HIV youth in Philadelphia. We will continue to refine our testing program based on her findings.

June Star Employee of the Month - Tanya Marrow

Tanya Marrow, the DMC Clinical Coordinator, is honored this month as our Star Employee of the Month. Tanya is the one who keeps everything running at the program-- managing grants, supervising administrative staff, and just generally making sure that everything works the way it is supposed to. We've been a little short handed recently, so Tanya has been filling in for others as well, and is quite relieved that we've filled our vacancies.