SHEILA: If all of my care team was right here in this room right now, I would say to them,
“You guys are awesome.
I love you from the bottom of my heart…that you care for me the way you do.
With all my heart and all my love.
You guys are really awesome.
Coleman Terrell: Philadelphia is the poorest of the ten largest cities in the United States,
and over 12 percent of our population are in deep poverty, which is living at half the
Federal poverty level.
Alexandra Shirreffs: We have about 19,000 people living with HIV in Philadelphia and
a little over 3,300 who are coinfected with hepatitis C.
ANA LAPP: HIV is definitely a challenge here in Philadelphia.
Esperanza in general…we serve around 16,000 patients.
There are sub populations and sub-neighborhoods where the HIV rates are high and the rates
of HIV were like three or four times the national rates.
Coleman Terrell: We have a really strong HIV group and we have 87 percent viral suppression
in our Ryan White Care site for people who are in care.
Yajaira Hassett: Just dealing with HIV itself is a lot of burden--I mean, having to take
medications all the time.
Most patients don’t want to share with their family members what they’re dealing with,
so it’s almost like they’re by themselves.
So they deal with all that, and then having Hep C on top of that.
It’s just like a double whammy for them.
SHEILA: The Hep C, I wasn’t really vocal about that.
That was a personal journey, and the only person knew was me and God and my mother [laughs].
I was diagnosed in in 1987, and
here I am today:
non-detectable, cured of Hep C,
sky’s the limit.
Coleman Terrell: About 36 percent of people had been cured back at the beginning this
project, and now I think we’re up at 59 percent of people who are RNA-positive have been cured.
ANA LAPP: Ryan White has really been a safety net, particularly for patients who are uninsured
or underinsured.
We definitely could not provide all of the services that we provide for our HIV patients
without their support.
Alexandra Shirreffs: The Ryan White funding has been critical to the success of Hep C
integration, not just at a clinical site level, but at a Health Department level.
Coleman Terrell: We envisioned this program as starting off with data and evaluation,
capacity building and technical assistance, linkage to care, and service integration.
We started off by really working to match our viral hepatitis program data with our
HIV surveillance data.
Another important source of data is our Ryan White Program data, which we use CAREWare for that.
Alexandra Shirreffs: Our data component of our project is really exciting because it’s
not something a lot of other jurisdictions have.
We’re able to match our hepatitis data with our HIV data, and so we can actually see a
hepatitis C continuum.
I also love the training and capacity-building component because it just really builds off
of a lot of the great relationships that exist.
Susan Thompson: We have intensive clinical training, which is called the Preceptor Program,
where a clinician spends 2 days didactic and 1 day in a clinic with about 1,800 positive
HIV men and women.
That connects them up to an expert that they can then consult with.
And then we offer onsite consultation; you can call us up for consultation, or we can
come onsite and do a program for you.
So, it’s a variety of onsite consultation, technical assistance, and preceptor.
Yajaira Hassett: One of the things that they told us was to start slow.
Take your time with the patients that you have.
That really makes a difference, rather than just trying to have a big number and trying
to do everything all at once.
I think one by one, little by little, you will get there.
ANA LAPP: And even the people that I’ve encountered in HIV when we go--when we meet
at Ryan White meetings or things like that, I think that’s one of the things that I
also really love about HIV care, about Ryan White, is that people care.
People are in HIV because they love what they do, and they really want to reach out to patients.
So, I’d just say thank you, and keep doing the good job that you’re doing.