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Supporting Communities to End an Epidemic

In 2013, Kaiser Permanente announced an initiative to provide support to community organizations whose work it is to improve the health of individuals newly diagnosed with HIV in minority communities disproportionately affected by the HIV epidemic.

Seven organizations currently funded by Kaiser Permanente through this initiative are developing innovative approaches to prevent new HIV infections; identifying HIV positive patients sooner, getting them into high quality HIV care sooner and remain in such care.

In light of World AIDS Day, Kyra Nead, senior communications consultant at Kaiser Permanente, sits down with a few representatives of these organizations about the work they are involved in and speaks with Alexandra Caraballo, Manager of Charitable Contributions at Kaiser Permanente about why Kaiser Permanente was interested in creating this initiative.

Check it out below.  The transcript for this recording is available after the jump.

 

What Research is Telling Us About the State of HIV/AIDS in the United States: Interview with Expert Michael Horberg, MD

Michael Horberg, MD
Michael Horberg, MD

Kaiser Permanente recently hosted the 8th Annual HIV/AIDS, Hepatitis, and STI Conference. The event brought together physicians, advanced practice providers, research scientists, and other care providers, offering a constructive atmosphere for exchanging ideas, learning from national experts, and networking with colleagues from across the nation. For insight into the conference, we spoke with Michael Horberg, MD, national director for HIV/AIDS at Kaiser Permanente and member of the Presidential Advisory Council on HIV/AIDS.

 

CTH Blog:
Tell us about the 8th Annual HIV/AIDS, Hepatitis, and STI Conference you recently hosted.

Michael Horberg:
The goal of the conference has always been to bring together physicians, nurses, pharmacists, allied health professionals, and researchers to determine the latest knowledge and best practices in HIV/AIDS and hepatitis. We want to gather all of the people involved in HIV/AIDS care and share our best knowledge and practices.

The idea is to promote the key areas of learning in these fields: new knowledge and new medications for hepatitis; how to care for lesbian, gay, bisexual, and transgender patients; and new aspects of quality HIV, hepatitis, and sexually transmitted diseases care. Most importantly, we wanted to continue developing the Kaiser Permanente community of committed HIV and hepatitis care teams and community providers.

CTH Blog:
You presented a research study at the conference on the “HIV Engagement Cascade,” with participation of many of the HIV clinical and research leaders in Kaiser Permanente.  I understand this was presented earlier this year at the very important Conference on Retroviruses and Opportunistic Infections.  Can you give us some background for those unfamiliar with that concept?

MH:

For a while now, we’ve known that antiretroviral therapy (ART) can significantly improve health outcomes for people living with HIV. We consider ART to be successful when it reduces the viral load of a person living with HIV to undetectable levels. For years, clinical research has shown that people who have undetectable viral load in their blood are more likely to live long and healthy lives and are less likely to pass the virus on to others.

The CDC developed a standardized care order for how HIV care proceeds from diagnosis to ART success. It’s a series of steps or an engagement “cascade”:

1)    HIV diagnosis
2)    Linkage to HIV care
3)    Retention in care after diagnosis
4)    Prescription of ART
5)    Reaching an undetectable viral load

Each of these steps presents a challenge to an HIV-positive person and to the health workers who try to guide them through consistent care. One particular challenge for HIV-positive individuals is

Reflections on World AIDS Day with Michael Horberg, MD

World AIDS Day is Dec. 1; this year’s theme is ‘Working Together for an AIDS-Free Generation’

Michael Horberg, MD, is Kaiser Permanente’s national director for HIV/AIDS. Appointed to Obama’s Presidential Advisory Council on HIV/AIDS in 2010, Dr. Horberg hopes to make Kaiser Permanente’s best practices a part of national policy. Practicing at Michael Reese and Northwestern Memorial hospitals in the Chicago area for 10 years before coming to California, he has spent most of his medical career in the fight against the disease. He also is chair of the board of directors of the HIV Medicine Association, an organization of 5,000 HIV clinicians in the U.S. and abroad.  We caught up with him recently about his work in this field.

CTH Blog:
You’ve been committed to the fight against AIDS/HIV for three decades. What has this journey been like for you?

Michael Horberg, MD:
Professionally, the journey has been extraordinarily rewarding. It has led to a career in advanced HIV care, research and advocacy, with leadership in the HIV Medicine Association, as well as previously the Gay and Lesbian Medical Association. I know I’m a better doctor because of my work in HIV — the continuing education, learning new research and new medications/treatments daily, and the phenomenal collaborations with my Kaiser Permanente colleagues.

On a personal level, the last three decades have also been quite a journey. In the early 1980s, when the first patients infected by the HIV virus were being treated, I was in my third year of medical school. I knew I was gay, but I wasn’t ready for anyone else to know that. It was the fear of rejection, the fear of being ostracized, even in the medical community, of not being able to attract any patients. Ironically, the onset of the AIDS crisis is what finally helped to liberate me. As patients with HIV symptoms, including some of my close friends, began coming to me in private practice, I realized stepping out of the closet would help them get the care they needed and allow me to be a more powerful advocate for specialized care. Furthermore, being able to help my gay and lesbian brothers and sisters fulfilled my desire to meld technical skill with compassion. Especially early in the crisis when there was a limit for what we could do for patients, really caring, really showing love was critical.

CTH Blog:
What continues to motivate you in the fight against HIV/AIDS?

MH:
It’s been more than three decades since AIDS was first reported and the statistics of the epidemic still continue to haunt me. Every day, more than 150 people in the United States become infected with HIV. That adds up to between 50,000 and 56,000 people a year – just in the United States. And racial and ethnic minorities in gay and bisexual men are disproportionately impacted by this epidemic. About half of the nation’s HIV population is African-American – yet African-Americans have a 15 percent greater chance of dying from HIV than white Americans. This is a disease of disparities.

Until we no longer have an epidemic, I will continue to be motivated.

CTH Blog:
At the International AIDS Conference Washington D.C this summer, of which Kaiser Permanente was a key sponsor, there was a lot of discussion about an AIDS-free generation. Do you think that’s possible?

MH:
Yes, there is great hope. It can be achievable, but it requires resources, increased research, and increased access to quality HIV care for all living with HIV. I am proud to support the concept of an AIDS-free generation and working towards that goal. As a leader in HIV treatment, what we are doing at Kaiser Permanente and the tools and research we can share with the world, it’s entirely possible.

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