Since the Centers for Disease Control and Prevention identified San Antonio as having the largest of 16 HIV clusters in Texas two years ago, local health care officials have stepped up efforts to prevent and treat the disease.
The latest effort aims to begin HIV retroviral treatment for patients the same day they are diagnosed, a strategy the World Health Organization recommends for better outcomes. In some cases, starting drug therapy immediately can result in patients having undetectable traces of the virus that causes AIDS in just a few months.
“If they are diagnosed in their 20s, get on medication and stay on it, they can live to their 70s,” said Amanda Miller, a physicians assistant with CentroMed, a health care nonprofit supported by federal, state, and donated funds. “The faster we get them into treatment the better for them.”
Providers including the San Antonio AIDS Foundation, CentroMed, Alamo Area Resource Center, and the San Antonio Metropolitan Health District said Wednesday that they have combined forces to form the Rapid Start treatment program to “connect HIV patients to resources to help them live long and healthy lives.”
The local public health department and area health care providers have worked to reduce both the number of cases of HIV diagnosed and the number of people not receiving adequate treatment since 2017. At the time, the average amount of time it took to get a person into treatment was around 32 days after diagnosis, said Dr. Junda Woo, Metro Health’s medical director.
“We want to use the collaborative to help tell people ‘there is no wrong door,’” she said. “They can call any of the clinics providing treatment for HIV and get connected to a provider that can get them into treatment somewhere that same day, which can lead to an undetectable status in one to two months.”
Health care providers participating in the initiative worked together to get the pilot program running, and have been collaborating to ensure same-day patient care since June.
At its Santa Rosa Street location, CentroMed has been offering same-day diagnosis and treatment since April 2018, Miller said.
“CentroMed was the first large treatment clinic to begin same-day diagnosis and treatment, and it takes a lot of planning because of time constraints and how it impacts workflow,” Miller said, noting that a new patient typically has an initial assessment and then returns for follow-up appointments.
Now, if patients are diagnosed with HIV they will either begin treatment at the same clinic where they were diagnosed, or be referred to any of the partner providers who can provide same-day services.
“Working together has really shortened the wait time,” Miller said. “For some people it’s down a day or two, and for others it was down a couple of weeks, depending on what their needs are
Most HIV patients are treated with a once-daily pill to suppress their viral load, a far cry from the toxic treatments of years past, where the handfuls of pills people were required to take often caused additional medical issues such as kidney failure.
Health insurance generally covers the cost of the antiretroviral medications needed to reduce the viral load in body fluids, lessening the likelihood of transmitting the disease. For those without health insurance, case managers working with health care providers help connect patients to a clinic that offers care through the Ryan White HIV-AIDS Program, a U.S. Department of Health and Human Services program that helps cover the cost of care low-income or uninsured people.
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Currently, one in five people in San Antonio who has HIV doesn’t know that they have it, Woo said.
“We want to use the collaborative aspect of this program to not only get those people diagnosed, but to get them into treatment as soon as possible so they can take advantage of the medical advances available now that help people live longer and have healthy lives,” Woo said.