Quarterly Report - Q3/2020
Updated: Aug 23
Treating HCV in-House
"It is literally life-changing. Ten clients have started on medication, six of those have completed treatment, and four have achieved viral load suppression."
Alliance Recovery Center, an MAT in Athens, is now providing HCV treatment for chronically infected clients in-house. "It's been a lot of fun to participate in that because it's such a big deal," says therapist Shannon Corda. "The medication is expensive and most of our clients are low income; they don't have insurance. So when I tell them that we can help them get the medication and that we'll walk them through the whole process, their reaction is first disbelief and then relief."
"It is literally life-changing. We get to witness them start feeling better and then complete treatment. My favorite part is when I get the blood work results showing that they no longer have the virus. I have these little pins that say Hep C survivor. So when I present them with a copy of their blood work, I attach one of those pins. It brings most to tears. It's a really special moment."
HIV testing was up dramatically this quarter says Shannon. "With a caseload of 50 and especially the disruption of COVID, HIV and HCV testing got away from me. But Jess (Director of Nursing Jessica Ross) took it on and in July alone, working together, we did 107 screens."
And as a result, the clinic diagnosed their first HIV-positive client. "This particular person has been dealing with chronic poverty and homelessness, so I was afraid that the additional weight of an HIV diagnosis might be too much. But now that they are linked to HIV care they have access to more resources, they’ve been taking their medication, and they report having more energy, feeling much better. Another life-changing event."
HIV Testing Doubled at DeKalb CSB
"Often clients are unaware of basic information. Most are really excited to learn about PrEP and PEP."
HIV testing at DeKalb Community Service Board rose substantially this quarter – from a previous high of 37 to 73 tests. HIV Coordinator Ashley Randall credits her new schedule of weekly visits to the agency crisis center where she provides education and opt-out testing. "I educate clients every Thursday; we talk about HIV and other sexually transmitted infections. We talk about AIDS, PrEP, and PEP." And depending on where the conversation goes, she shares relevant statistics.* Then she offers free HIV testing.
*Note: AIDSVu is a great source for county-level statistics.
"I started here in September of 2019. For 8 years before that I worked in public health - with a focus on HIV. So this is my first time working with clients who have a substance use diagnosis." Tailoring her education to the clients she is serving, Ashley traces a line between 3 points: why substance use impairs judgment, risk behaviors linked to impaired judgment that could put them at risk for HIV, and how they can protect themselves.
The average stay for clients admitted to the DeKalb crisis center is 5 - 7 days. Ashley provides education to 97% of clients admitted and says most are interested in HIV testing. As a way to de-stigmatize the conversation about prevention, she avoids sexual narratives. "In a crisis center, people have a lot of things going on and I want them to be able to get the gist, to know at least the basics of how to protect themselves."
"To explain PrEP, I break it down - the Pr in PrEP stands for pre and that means before something happens. The narrative I use is this: 'If I go to my heart doctor and he says that I have a blockage in my heart, he puts me on medication. He's putting me on medication to prevent me from having a heart attack. PrEP is medication to prevent you from contracting HIV. If you use needles or if you don't use condoms every time you have sex, then PrEP is something that you may want to consider."
"I was surprised by how often clients are unaware of basic information. Most people are really excited to learn about PrEP and PEP. And I love that lightbulb moment - the moment when the information lands."
Things are changing so rapidly - it's easy to forget to take care of yourself - but if you don't, you're not going to be able to keep anything else afloat.
Jennifer Watson has been HIV Services Coordinator for Serenity Behavioral Health Systems since 2013. These days, most of her testing is done on the crisis unit.
No one is immune from the chaos of the pandemic. Asked how she is rising to the occasion, Jennifer said, "You just have to keep at it and to have your own sense of agency. This work has always called for that." To engage staff members and enlist their support for the program, says Jennifer, "I learned to put myself out there. With turnover - and especially since COVID - people need to be reminded that I'm here and that HIV testing is available. When awareness days are approaching or I find something interesting in the news, I send out an email to my co-workers and most respond." Jennifer has made the Serenity HIV program her own. "I don't know what's coming tomorrow but I know I'll find a way to provide HIV testing to our clients, to this community."
"Things are changing so rapidly. It seems to be one thing after another. I try not to take it all on personally and just do what I can to take care of myself. Just breathe. I consciously support my own resiliency. If you don't take care of yourself, then you're not going to be able to keep anything else afloat."
"When I go home, I leave work at work. I like to sew; or I might knit or listen to music. Then the next day, I take it up again. I try to start each day fresh. A brand new start."
First Time Tester Diagnosed HIV+
"It made me so happy that I was able to help someone get the care they need to have a future."
Of 69 individuals that Debra Wallace tested this quarter, 28 had never been tested before - including one client that she was able to diagnose HIV-positive and link to life-saving care.
"I was amazed that as long as I have been testing people, and as long as testing has been available, there were so many individuals who had never had an HIV test," says Debra. "And It made me so happy that I was able to help someone get the care they need to have a future."
As the COVID pandemic wears on, Debra mused about what most challenges her - and how she addresses the challenge. Wearing masks, gowns, and shields reminds Debra of another pandemic. "When HIV first came out, people shunned HIV+ patients. I worked in a hospital setting and I can remember having to suit up just to enter their room. When we delivered their meals we served them with disposable plastic plates and utensils on a paper tray."
"I love what I'm doing and clients can tell. I think it makes them feel comfortable, knowing that I enjoy the work. I want my clients to feel connected to me and I want them to feel supported. But with that mask on they can't see the smile on my face. When we're sitting far apart, I worry that they think I'm afraid of them. I'm not. I take the virus seriously - for myself and for them. But I love this work and I want them to know it. So I try to break the ice with a little joke. Or get them to talk about themselves. Or talk about something that has happened in the world. I let my caring heart show through my voice."
1,958 HIV Tests, 11 New Confirmed HIV+ Diagnoses
During Q3/2020, Georgia's EIS program tested 1,958 individuals for HIV. Of those, 99% received their results. All 11 newly diagnosed HIV-positive clients were referred to care, 9 were confirmed linked to medical care. This quarter EIS workers provided on-going support to 93 HIV+ clients, served 9 new clients who were previously diagnosed HIV+, re-linking 5 who had fallen out of treatment to medical care.
1,449 HCV Tests, 129 New HCV/RNA+ Diagnoses
During August and September, Georgia's EIS program screened 1,451 individuals for HCV. Of those, 201 tested HCV Ab+ and 129 were confirmed RNA+ or chronically infected with HCV. During the same period, 77 HCV+ clients took the first step in the linkage continuum by completing HCV education and 35 attended their first medical appointment.