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Wisconsin AIDS Care a National Model

Erin Toner

Wisconsin recently reported a sharp increase in new HIV infections. They rose nearly 20 percent from 2010 to 2011, with the most new cases in Milwaukee County. While the numbers are alarming and the population sometimes difficult to reach, those who connect early with the AIDS Resource Center of Wisconsin are in good hands. As WUWM’s Erin Toner reports, it has become a one-stop-shop for the many services patients may need and is considered a national model.

Back in 2002, Jim developed a rash and was feeling run down. His doctor recommended he get tested for HIV.

“And being a gay man, I had had sporadic tests, so it wasn’t odd to go and do that at all by any means. I wasn’t afraid. And actually, I was kind of surprised to get the positive result to be honest because I considered myself careful,” Jim says.

Jim quickly linked up with a case manager at the AIDS Resource Center of Wisconsin.

“Whatever questions I had or any type of fear or anything I was going to combat I definitely had a place to go to to talk it over. And they were constantly reassuring and it just felt really nice. It was like an active way to treat my own situation,” Jim says.

Ten years later, the 39-year-old is down from three pills a day to just one, and his disease is undetectable.

There are now effective, easy-to-take medications, according to Dr. John Fangman, the center’s medical director. Fangman says the disease remains horrible if untreated, but if care begins early, there are positive outcomes and fewer complications. He also cites research showing that people with HIV who take their medications faithfully are less likely to spread the disease.

“The risk of transmission drops by 95 plus percent and there’s been modeling that’s demonstrated if we were to provide antiretroviral therapy to everybody who’s infected in the world we could actually get rid of HIV,” Fangman says.

Fangman says the challenge is to test more people in high-risk groups so those infected can start treatment. One target group, based on Wisconsin’s new infection data, is young black men who have sex with men.

“Because there’s so much more HIV in the African American community right now, the risk per encounter is significantly greater and that’s why if we could focus on providing treatment for that population, particularly, we could I think impact favorably the rate of new infections among men who have sex with men, especially in those communities,” Fangman says.

It is in reaching out to members of the high-risk community and providing a range of services to patients that the AIDS Resource Center of Wisconsin has become a national leader.

President and CEO Mike Gifford says 90 percent of people with HIV live in poverty, more than a third have no health coverage, and many struggle with homelessness and drug addiction.

“It really requires robust care delivery systems,” Gifford says.

So the local office and its eight centers across the state have evolved into more than clinics. They provide medical, mental health, and dental care, and medications, regardless of patients’ ability to pay. The centers also offer free groceries, and help with housing and legal matters. Gifford says it’s tough to keep a person healthy if they don’t have a place to live or can’t afford good food.

“We’re proud to offer that service delivery model. We think that’s why we have seen an 86 percent reduction in patient death rate here in the last eight years. That’s a leading national indicator of success. Seventy-six percent of our patients live with an undetectable viral load, that’s as healthy as you can be living with HIV and AIDS,” Gifford says.

The AIDS Resource Center of Wisconsin is one of only two HIV treatment centers in the country that the National Committee for Quality Assurance has accredited as a patient-centered medical home.

Leaders in other states have noticed.

Bill Hardy is president and CEO of the AIDS Resource Center Ohio. He says it designed its new medical center and pharmacy based on Wisconsin’s.

“We’ve been looking at that model here in Ohio for at least a decade, the quality of care is top notch we know that the impact on the health and overall well being of their clients is spectacular,” Hardy says.

The Wisconsin operation has been able to distinguish itself, according to President Mike Gifford, because of generous support from private donors and the state and federal governments. Yet the challenges remain – of caring for a growing caseload, and boosting prevention, especially in Milwaukee, where most of the new HIV infections in Wisconsin occur.