The inaugural South Bay HIV Provider Conference was held on Dec. 14 at the LAX Hilton, bringing together more than a generation of expertise in HIV and AIDS medicine in Los Angeles. Organized by Dr. William King, MD, JD, the conference featured presentations focused on diagnosis and interventions, and most significantly, the need to address systemic issues and stigma in HIV and AIDS medicine.
The free conference was sponsored by Gilead, VIIV Healthcare, and a UCLA-CDU CFAR grant, with support from Anthem Blue Cross, Merck, Capitol Drugs, The Center for HIV Identification, Prevention, and Treatment Services (CHIPTS), Your Choice Insurance Services, and Napo Pharmeceuticals.
Dr. King notes that the South Bay HIV Provider Network, which brings together physicians, nurses, pharmacists, social workers, and other stakeholders to address health disparities for Black people in HIV care and prevention, wanted to provide a platform for their members’ wealth of experience. He stated that one of the primary goals of the conference was to propel primary care providers to step up, due to the shrinking numbers of HIV specialists and the dearth of new practitioners due to business decisions or the stigma still attached to treating the disease.
“I’m a cisgender, heterosexual African American male,” said Dr. King.
Links:
https://www.wkingcares.com/speaker
“When I first started my practice… I wasn’t married [and] people assumed I was gay. Somebody else may not be comfortable with these assumptions … they may not want to have that homophobia attached to them.”
The conference also highlighted systemic factors such as poverty, lack of information, and homelessness that keep patients from testing for HIV and getting treatment, despite the dramatic medical advancements over the last 40-plus years.
Derrick Butler, MD, MPH, chief medical officer at To Help Everyone Health and Wellness Centers and an assistant professor at Charles Drew University, pointed out that while Blacks make up 45 percent of people living with HIV in the United States, they are only 12 percent of the overall population. He said this continues despite the 99-plus effectiveness rate of pre-exposure prophylaxis (PrEP) medications and that lack of information and historical mistrust of the medical system by Black people are major factors.
“We all know about the Tuskegee experiments where the medical system … harmed Black people in experiments they did with syphilis,” said Dr. Butler. “Those kinds of instances [have] also affected people’s ability to look for prevention.”
Dr. Butler said that patients can effectively stop the spread of HIV when on medication.
“We can’t cure HIV, but you can suppress it to the point where it’s not active in your blood, it’s an undetectable number,” he said. “This is what people don’t know. Basically, there’s nothing for you to transmit to anybody.”
Dr. LaShonda Spencer, MD, FAAP, AAHIVS, professor of clinical pediatrics/internal medicine and director of Drew CARES at Charles R. Drew University of Medicine and Science, spoke on women and HIV. She echoed the triumph of PrEP in terms of perinatal care, saying that, “Today, across the United States and particularly in Los Angeles … vertical transmission [to babies] should not happen. We have lots of good medications and treatment for women that are living with HIV. Treatment of both the mom and the baby … will prevent transmission as well.”
From 1986 until his retirement in 2015, Dr. Orlando Pile, MD was a member of the L.A. County Sheriff’s Department Medical Service and served as the first chief of communicable diseases. He spoke on serving patients at the largest jail in the United States, which during his time held between 17,000 and 22,000 inmates. He described the need for “compassion that goes along with taking care of patients.”
“When I was there, we had medical personnel who didn’t want to be next to an AIDS patient, for fear of contracting it,” said Dr. Pile. “I had to educate the staff there – ‘You’re committed to… take care of a patient that happens to be an inmate.’”
Dr. Ron Jefferson, MD, has been a provider at the OASIS Clinic, with expertise in AIDS Dementia Complex, and AIDS Dysmorphic Syndrome. He says that these subcategories of the disease are rare today due to the success of current interventions. He also observed that HIV can affect patients at any age, from 18 to 80.
“I have a lot of patients who were diagnosed 25 and 30 years ago, so they would [now] be in their 60s and 70s,” he said. “They were diagnosed older. Older people are doing better than they used to do [and] are still sexually active.”
Dr. Jefferson underscored the fact that HIV and AIDS are no longer a death sentence.
“A lot of Black patients, when they first come in, would tell us they thought if you had HIV, you were going to die,” he said. “If they take their medicines, the vast majority of them will live a normal life.”
