Pneumocystis Pneumonia – A Community Response

Last Saturday, I received an email from our clinical director, Margaret Flinter sharing her reflections on 30 years of HIV.  It is a long, but very meaningful message, and I am posting it here in its entirety with her permission. – Aldon

Good morning, everyone, 

Every once in a while, something causes us to stop and take a deep breath and reflect on momentous changes and challenges we have faced at CHC, in healthcare, and in our communities.  I had such a moment when the Bureau of Primary Care sent out a message  yesterday to all health centers about the need for health centers to develop full HIV/AIDS services as part of providing culturally and clinically responsive health care services.  It was sent in the context of the 30^th anniversary of the publication of the CDC Morbidity and Mortality Weekly Report (MMWR), which appeared on June 5, 1981.  I was commenting to Daren earlier today that I have a crystal clear memory of Carl Lecce and I reading the report and saying “Wow, what is this!”.  What “it” was, was the harbinger of the AIDS epidemic…five young, previously healthy men, all diagnosed with pneumocystic carinii pneumonia, an infection almost universally associated with severe immunodeficiency.  The men did not know each other.  All were described as active homosexuals. Nobody knew or understood was  happening.

It wasn’t very long before the AIDS epidemic was at our doorsteps.  Patients seemed to appear as new patients, and to die quickly.  Our arsenal of treatment was pitiful.  Fear was everywhere.  It is hard to convey how much concern there was on the part of the healthcare establishment, especially dental and medical providers.  Our Board, under the leadership of the late Jerry Weitzman, devoted a meeting to a discussion of how we would respond; when others were refusing treatment to at risk individuals, they of course took the right course of saying we needed to act to serve everyone, and to protect everyone to the fullest extent we could.  We hired our first HIV “counselor and tester, Virginia Alread,  when all testing was anonymous.  A local AIDS coalition formed in Middlesex County under the leadership of our Domestic Violence Shelter Director, Shawn Lang and community activists like Sally Baumer, and before long we had created the “Oasis” program of support for persons living with AIDS… today our PR/ Media team now are based in what was then the 3^rd floor walk-up Oasis Center on Main Street, above our dental building.  Yvette  Highsmith Francis joined the team as an HIV case manager, eventually taking over the leadership of our entire HIV/AIDS services program. Other services quickly followed.  By 2000, with treatment advancing in complexity and effectiveness, though with awful side effects, CHC made a commitment to delivering HIV/AIDS medical intervention integrated with primary care.  We sought and received a planning grant for a Ryan White program, recruited Carola Marte from NYC, a nationally recognized HIV/AIDs expert to come join us, and she launched our first full medical treatment program in Meriden and New Britain, soon expanding to Middletown.  All of that laid the groundwork for the tremendous HIV/AIDS program we have today, with Dr. Marwan Haddad and Kasey Harding leading the clinical and social services, along with their teams of nurses, case managers, outreach workers, counselors and testers, and others—and achieving a level of positive clinical and social  outcomes that was just unimaginable twenty years ago.  We admire and respect the incredible work they are doing every day, along with the work of all of CHC staff on education, prevention counseling, risk reduction, and early detection of HIV/AIDS.

So with thanks for all that has been done, much work remains, of course.  Our own platform of services is not equal across our sites, partly because every one of our communities has had different responses to meeting the healthcare needs of persons with HIV/AIDS.   As the Bureau’s message suggests, this is a good time for us to review the needs in each of our communities, and to consider what additional work we may need to do to ensure that HIV/AIDS care is integrated with primary care. 

I have enclosed a copy of that June 5, 1981 CDC MMWR report below.

Pneumocystis Pneumonia — Los Angeles