Celebration of Our Physician Assistants

Earlier this month, was Physician Assistant Appreciation Week and we definitely appreciate our PA's. Pictured (from left to right) are Daisy Rivera, PA-C and Carmen Rocha, PA-C. (Maria Garcia-Bulkley, PA-C is our third PA, but not pictured here.) The theme this year is "I'm a PA-- Ask Me What That Means". Despite PA's having been around since the mid-1960's out of a class of Navy Corpsmen returning from Vietnam, the public is less familiar with PA's than with nurse practitioners.
PA's are trained in a medical model to work collaboratively with physicians to provide care to patients in a wide variety of settings-- from remote primary care settings in rural areas to operating rooms in large university hospitals. They attend rigorous training programs with the majority these days graduating with a master's day and then take a national certifying exam-- hence the PA-C after our PA's names. In most states, PA's can prescribe medications and perform most of the same duties as a physician.
There are 151 PA Programs nationally-- locally there are programs at Drexel, Philadelphia University, Arcadia, Philadelphia College of Osteopathic Medicine, and University of the Sciences.
In 2006, Money magazine ranked PA's as the 5th best profession in the US. We like to think that our PA's are in the first best PA's in Philadelphia. Our celebration included this lovely cake, made by Pamela Hadley-Thornton.

DMC Staff Present at Family Planning Council Conference

The Dorothy Mann Center was well represented during the Family Planning Council (FPC)'s Conference as Roberta Laguerre, MD was the opening speaker - her talk topic: Routine HIV Testing in Family Planning Settings (Opt-Out Testing in Healthcare Settings). Daisy Rivera, PA-C was among the closing speakers - her talk topic: Best Practices to Engage HIV+ Adolescents & Young Adults in Care, Treatment and Family Planning.

In the photo (from left to right):
Tracy Graham, PA-C (FPC), Daisy Rivera, PA-C (DMC), Kathy Nixon, CRNP (FPC), Roberta Laguerre, MD (DMC), Barbara L. Bungy, MPH (DMC) pictured

Poverty and Heterosexual HIV - CDC Issues a Report

In the August 12, 2011 issue of the Mortality and Morbidity Weekly Report (MMWR), the CDC outlines results of a study examining heterosexual HIV in 25 metropolitan areas-- Philadelphia included. The study was done as an anonymous survey, asking people in areas with known high rates of HIV about various demographics facts and their HIV status. What they found were HIV rates:
- twice as high in those who hadn't completed high school (2.8% vs. 1.2%)
- twice as high in unemployed (2.6% vs. 1.0%)
-twice as high when living in poverty (2.3% vs. 1.0%)
-similar among men and women
-by race/ethnicity were not as different as it is in the general population
It was NOT associated with different levels of crack cocaine use, exchanging sex for drugs or money, or rates of STDs once the statistics were controlled for differences in poverty.
The editors, in tying together HIV and poverty as the most important factors noted that "Low SES and other adverse social conditions can increase the risk for HIV infection through sexual exploitation, marital instability, unstable sexual partnerships, poor mental health, substance abuse, and limited access to health care and preventive services. In addition, socioeconomic segregation confines low-SES persons to sexual networks with high underlying rates of HIV and other STDs, thereby further increasing their risk for HIV infection". Their conclusions were that future prevention efforts need to especially focus on those who live in poverty in areas with high rates of HIV.
Philadelphia's own, Dr. Kathleen Brady and Althea Kirkland, of AACO are cited at the end of the report as contributors.

August Star Employee - Marie Spencer

This month's star employee is Marie Spencer. Hailed by her colleagues as being: lovable, hard working, team player, helpful, always smiling, a breaker of barriers. Marie works at the DMC as an HIV tester. She is well known by staff at area homeless shelters in particular for her efforts in HIV testing there.

Summer Newsletter Now Available

Your summer newsletter should soon be in your email box. For a preview click here.

Treatment Impacts Prevention

In a New England Journal of Medicine article, published on July 18, 2011, Dr. Myron Cohen of the University of North Carolina, Chapel Hill and his colleagues make the case for "early" treatment of HIV as a means of HIV prevention. In their study, they looked at nearly 2000 serodiscordant couples (one partner HIV+, one HIV-), predominantly from Africa. HIV medication was given to half of the HIV positive partners while treatment was deferred in half until the CD4 count dropped or development of HIV related symptoms-- the standard of care in these areas without enough medication for everyone. The goal of the study was to see if this "early" treatment would result in fewer infections among their HIV negative partners (while also monitoring them to see if early treatment made a difference in the positive partners' health).
The result was that of the 28 infections that were proven to be transmitted from one partner to the other, only 1 was in the treatment group. Individuals on treatment also had fewer HIV related clinical problems.
In a companion editorial in the same issue, Dr. Scott Hammer of Columbia University makes the case for expanded access for medications, "this is precisely the wrong time to limit access to antiretroviral therapy in resource-limited settings, since we have the tools in hand to maintain or restore health in infected persons and reduce transmission to their sexual partners."

The DMC "Hearts" Dr. Laguerre

Dr. Roberta Laguerre is our July Star Employee of the Month. As the sign she is holding says, she is fabulous, dedicated, and beautiful. Chosen by popular vote of our staff, our employee of the month gets to enjoy a month's worth of honors.
Dr. Laguerre is the Clinical Director of the DMC so is no stranger to our patients and is becoming increasingly well known by physicians in the area as she travels for her infamous lunch discussions about the importance of routine HIV testing for teens.