Foundation reviews triumphs, challenges of AIDS fight

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In the future, researchers could develop an injection to prevent HIV/​AIDS, and those who have the disease could become so adept at managing it that they might have to visit their doctors only once a year.

For now, though, health care and social workers must meet new threats posed by the disease, including its spread among young members of the black and Hispanic communities.

The themes of progress made and battles yet to be won dominated a panel discussion Monday sponsored by the Jewish Healthcare Foundation, Downtown. Besides hosting the discussion, the foundation devoted the July issue of its magazine, Roots, to the story of Pittsburgh’s fight against HIV/​AIDS since the 1980s.

In waves, the disease initially rocked the gay, hemophilia and IV drug-user communities. The worrisome spike now is among 13- to 24-year-olds in the black and Hispanic communities, said Richard Smith, program director for the foundation’s fiscal agency, and Emanuel Vergis, associate professor of medicine at the University of Pittsburgh and an HIV clinician at University of Pittsburgh Medical Center.

That age group can be difficult to reach, partly because young people “feel invincible” and partly because they communicate by text message and other means that aren’t standard for health care organizations, Dr. Vergis said.

In the 1980s, said Keith Kanel, the foundation’s chief medical officer, the medical profession didn’t know what to call the disease, let alone know how it was transmitted or how to treat it.

Some health care professionals and civil servants refused to interact with patients or their families.

“The early days were marked by many funerals,” said Cyndee Klemanski, president of Shepherd Wellness Community, a Bloomfield-based AIDS community center.

Grass-roots organizations sprang up to provide services. Yet stricken patients — middle-class, white gay men were the first public face of the disease — lost everything as the disease withered them. Alan Jones, a counselor at the Pittsburgh AIDS Task Force, recalled one patient who slept in a bathtub because he didn’t have a bed.

In the 1990s, treatment and funding improved. The foundation became the fiscal agent for HIV/​AIDS funds flowing into the region from the federal, state and local governments. It set performance benchmarks for service agencies.

Yet progress remained halting on some fronts.

When Caroline Acker moved to Pittsburgh in 1994, the city had no needle exchange program, so she helped start one, even though the initiative at the time was illegal.

Her first station was a street-corner card table, Uptown.

“We were illegal for seven years,” she said.

Thanks to medications available today, panelists said, HIV/​AIDS has become a chronic disease that patients and their health care professionals often are able to manage well.

Karen Hacker, director of the Allegheny County Health Department, said treatment advances have left some of the original grass-roots organizations “trying to figure out, where do I belong in this mix?”

There’s even a medication, Truvada, that is prescribed for HIV prevention, but cost and access have been issues for some.

Dr. Vergis said he envisions a day — perhaps still far off — when people will be able to get an injection for prevention.

He also said there will come a time when patients, many of whom now see their doctors every six months, will only have to be seen annually.

Mr. Smith said current challenges include keeping patients compliant with medication regimens so they keep the disease in check and returning to treatment those who have fallen away because of substance abuse, mental illness or other problems.


Joe Smydo: jsmydo@post-gazette.com or 412-263-1548.

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