UW Health HIV/AIDS Comprehensive Care Program: 30 Years of Caring for Patients

Providers and clinical staff at the UW Health HIV/AIDS Comprehensive Care Program gather at a morning meeting, marking the start of one more day in over three decades of HIV care. Front row: Jill Strayer, PharmD; Sarah Affeldt, PA-C; Theresa Aguilar, CNA; Susan Gold, RN BSN ACRN; David Neff; Jennifer Bellehumeur, MSN RN. Back Row: Ryan Westergaard, MD PhD; Rachel Luzbetak, MSW; Teresa Chapman, BSN RN. These individuals are among the 43 UW Health staff members who are involved in the HIV/AIDS Comprehensive Care Program.
 
When the HIV Care Program at UW was founded in 1985, medical understanding of the pathology and epidemiology of HIV was still in its infancy. It had only been four years since the first Centers for Disease Control and Prevention report on June 5, 1981 of a cluster of patients in San Francisco with what appeared to be an acquired immune deficiency; by the end of 1981, there were 270 reported cases and 121 reported deaths in the United States. Within short order, the magnitude of the epidemic became clear. Infectious disease specialists at UW-Madison began seeing HIV patients as early as 1983, and by 1985 a clinical program was founded to offer an integrated approach to multidisciplinary care. The effort evolved into the UW Health HIV/AIDS Comprehensive Care Program, which today is a major provider of HIV clinical care in south-central Wisconsin. 
 
On the 30th anniversary of the program—as well as World AIDS Day on December 1, 2015—physicians and staff emphasize that HIV care continues to progress. “There have been tremendous advances in HIV treatments and prevention, but we can’t lose sight of the fact that there are still 50,000 new cases each year in the United States. There are currently 1.2 million people living with HIV nationwide, and over 6,900 here in Wisconsin,” said James Sosman, MD, professor (CHS), General Internal Medicine and Infectious Disease. Dr. Sosman serves as medical director of both the UW Health HIV/AIDS Comprehensive Care Program and the Midwest AIDS Training and Education Center of Wisconsin (MATEC-WI). 
 
The UW Health HIV/AIDS Comprehensive Care Program emphasizes a team approach that involves the coordinated effort of physicians, nurse practitioners, physician assistants, nurses, pharmacists, social work medical case managers, and medical assistants. Services that address specific needs of patient subgroups include an on-site addiction medicine service, partnership with Journey Mental Health Center to facilitate psychiatry consultation, smoking cessation services, and hormone therapy for HIV-positive transgender individuals. The HIV program also provides pre-exposure prophylaxis for at-risk HIV-negative individuals, and post-exposure prophylaxis when needed.
 
The team views access to care regardless of ability to pay as imperative. “We’ve received financial support from the federal Ryan White Program since 1998, which helps us reach uninsured patients. Recently, we’ve developed new ways to support patients who are insured but need assistance with out-of-pocket costs for medication, co-payments, and co-insurance,” said Dr. Sosman.
 
In addition to innovative solutions for financial support, the program also employs six social work medical case managers and leverages unique case management approaches. “One of our medical case managers, Norah Boynton, serves as a Linkage to Care Specialist who focuses on providing short-term, intensive medical case management to newly diagnosed patients or those who are at risk of falling out of health care,” explained Dr. Sosman. For example, a primary care provider might request that the Linkage to Care specialist be available as a resource to speak to a patient upon request at the point of diagnosis, so that he or she has access to an informed, listening ear that can help orient them to resources available to HIV-positive individuals. Norah Boynton, associate clinical social worker, Infectious Disease, said, ”The CDC recommends routine HIV screening for all patients aged 13-64 years. As a provider, if you identify a new HIV positive patient, enlisting my support as a Linkage to Care Specialist can ease the tension and anxiety of disclosure and will also ensure that the patient gets linked to HIV care."
 
As members of the program look toward the future, they remain committed to ensuring access to patient-centered care for all individuals living with HIV. “We are invigorated by both scientific evidence and our own personal experiences that show HIV treatment works, and that patients can lead long, healthy lives,” said Dr. Sosman. 
 
Several media outlets covered stories in honor of 2015 World AIDS Day and the 30th anniversary of the UW Health HIV/AIDS Comprehensive Care Program: