Call: (760) 323-2118
8am to 5pm Monday - Friday

Call: (760) 323-2118
8am to 5pm Mon - Fri

DAP Patients Will Get HIV Meds Quicker U …

DAP Patients Will Get HIV Meds Quicker Under New Rapid ART Program

Palm Springs, CA (September 3, 2020) -- DAP has reached an important milestone in the fight to end HIV, winning designation as a Rapid ART Implementation Site, standing with just 10 other healthcare organizations in the U.S. The Award for Special Projects Of National Significance was won in a competitive grant process and is bestowed by the Health Resources and Services Administration (HRSA).

By joining this national demonstration project and collaboration with HRSA, DAP will share its 36 years of experience in the fight to end HIV, and it will boost resources for its HIV testing and treatment programs for people in the Coachella Valley.

For a three-year period, DAP will continue to build and share its best practices for making sure PLWHA receive antiretroviral therapy (ART) quickly after receiving an initial HIV diagnosis, or immediately after requesting it if they had stopped ART for any reason.

It’s a surprise to many, but people are still developing and even dying from AIDS in 2020, right here in the Coachella Valley. Our early intervention program had 160 referrals for attempts to find patients who had stopped filling their ART prescriptions, ceasing their HIV treatment without explanation. (Based on calendar year 2019)

Falling through the cracks means that some patients whose bodies had stabilized with life-saving HIV meds have stopped taking them, sometimes for five years or more. And for others, it means not starting therapy at all after receiving an HIV diagnosis.

Without accessing care, they are waiting until they are sick from HIV-related illnesses before attempting to resume ART and primary care.

Waiting to begin or resume ART always leaves a dangerous gap of time that could result in catastrophe, such as failing to ever adhere to medication therapy, or even death. Another consequence is the effect on others as sex partners are put at risk for HIV.

This collaboration with HRSA seeks to remedy the problem with a protocol that provides ART ASAP:

  • Same day as HIV diagnosis (some exceptions)
  • Quickly after request is made to resume therapy

The vast majority (about 80 percent) of new HIV infections in the U.S. in 2016 were transmitted from the nearly 40 percent of people with HIV who either did not know they had HIV, or who received a diagnosis but were not receiving HIV care. (CDC)

According to Dr. Tulika Singh, DAP Associate Chief Medical Officer, not all physicians are permitted to treat their patients without administrative obstructions that derail health outcomes.

“Despite having extensive experience in HIV treatment and care, caregivers struggle to reduce high HIV prevalence and rising HIV incidence rates, due to delays in starting ART,” she says. “This is due to previous protocols and practicing traditional HIV medicine,” like having to do unnecessary lab work or jumping through hoops with insurance.

“No more!” says Dr. Singh.

Greater access for ART through this project will be enabled by DAP’s referral and linkage networks, with extensive arrangements with regional medical centers, community clinics and individual providers, in addition to this grant.

“We are able to provide rapid start ART for newly diagnosed persons living with HIV as early as the same day of diagnosis,” she says. “This will help us get to UN 90-90-90 goal sooner than anticipated and help our patients age in a healthy way.”

The Courage To Resume ART
Given what we know about the health consequences of stopping ART, the public health argument is strong for offering the resources to resume therapy quickly and without delay.

When it comes to why people fall out of care, “Every situation is so different,” says C.J. Tobe, Director of Community Health at DAP.

Poverty affects most DAP clients, but it affects PLWHA uniquely. They might cope with denial, depression, and suicidal ideation. Stigma is often made worse by rejection from loved ones, and drug and alcohol abuse are more likely to increase.

But other factors may include housing insecurity, unemployment, lack of transportation, and fear of government due to immigration status. Being a recent transplant to the Palm Springs area from other parts of the U.S. also can also be a reason.

“People are also dying by not accessing all the things you need to make the medication keep working,” says Tobe.  “There’s a lot that goes into getting that treatment, starting with walking through those doors.”

In addition to ART, DAP helps patients thrive with HIV with access to social services they are eligible for, ensuring they receive needed food, housing, transportation, and home health care support if they need it.

U=U Helping End The Epidemic

The more people who are on treatment and undetectable, the fewer new transmissions there will be. According to Prevention Access founder Bruce Richman,

“We need access to treatment and removing barriers, not just for the wellbeing of people living with HIV,” he says. “But also, to prevent new transmissions.”

About Desert AIDS Project

Desert AIDS Project (DAP) is a humanitarian healthcare organization in Palm Springs, CA offering DAP Total Care – a combination of medical, dental, counseling, social services, support groups, alternative therapies, in-house pharmacy and lab, and other health and wellness services. DAP’s sexual health clinic, The DOCK, offers STI testing and treatment, Pre-Exposure Prophylaxis (PrEP), Post-Exposure Prophylaxis (PEP), and HIV and HCV testing. DAP’s Get Tested Coachella Valley campaign, the nation’s first region-wide free HIV testing and access to care initiative, was recognized by the White House for helping to bring about an AIDS-free future. DAP has earned a “Four Star” rating from Charity Navigator for the twelfth consecutive year – landing DAP in the top 6% of nonprofits rated. The distinction recognizes that we exceed industry standards in terms of our financial health, accountability, and transparency.

Visit www.desertaidsproject.org. 

About U=U & Prevention Access Campaign

Prevention Access Campaign is a health equity initiative to end the dual epidemics of HIV and HIV-related stigma by empowering people with and vulnerable to HIV with accurate and meaningful information about their social, sexual, and reproductive health. Find out more here.

Undetectable = Untransmittable (U=U) is a growing global community of HIV advocates, activists, researchers, and over 990 Community Partners from 102 countries uniting to clarify and disseminate the revolutionary but largely unknown fact that people living with HIV who are on treatment and have an undetectable viral load cannot sexually transmit HIV.  

About UNAIDS 90-90-90

Removing barriers to ART is in support of UNAIDS 90-90-90, the global plan to end AIDS as a public health threat by 2030.

The goal is that globally,

90% of all people living with HIV will know their HIV status, and  

90% of all people with diagnosed HIV infection will receive sustained antiretroviral therapy, and

90% of all people receiving antiretroviral therapy will have viral suppression.

According to its 2020 update, “the response could be set back further, by 10 years or more, if the COVID-19 pandemic results in severe disruptions to HIV services.”

###

D.A.P. Revises HIV Prevention Guidelines

For Immediate Release
April 25, 2017
Contact: Tom Tarr, Director of Client Development
Tel: 760-656-8460
Email: ttarr@desertaidsproject.org

Desert AIDS Project revises its prevention guidelines in light of support for new research

Desert AIDS Project joins other national HIV prevention organizations by embracing a recent policy statement of the National Association of State and Territorial AIDS Directors (NASTAD). That policy titled, “Risk of Sexual Transmission of HIV from Virally Suppressed People Living with HIV” affirms the related scientific evidence and aligns prevention policy with that of many in the public health community.

“Recent research has shown that treating people with HIV and helping them maintain an undetectable viral load (less than 200 copies/ml) prevents the sexual transmission of HIV,” said Bruce Weiss, Director of Community Health at D.A.P. “The studies demonstrated no new transmissions occurred when the HIV positive partner was virally suppressed. This provides an additional prevention strategy for HIV-positive persons and their sexual partners which can also help end new HIV infections.”

In light of this new research, D.A.P. now recommends the following to prevent new HIV infections:

  • 1. Commitment to ongoing treatment for HIV – ongoing treatment for individuals with HIV is vital to the success of this prevention strategy
  • 2. Regular healthcare and viral load testing – staying healthy and regular testing is necessary for individuals utilizing this prevention strategy
  • 3. Steps need to be taken to prevent Sexually Transmitted Infection (STI)
    • Because of rising STI rates in the Coachella Valley, D.A.P. recommends that individuals having sex with more than one partner continue to use condoms. Condoms are the only proven strategy to help prevent new infections of STIs such as Syphilis, Gonorrhea and Chlamydia.
    • Regular STI testing is also recommended at least every three months for those having sex with multiple partners, in order to detect infections early and ensure proper treatment.

“We’re excited about the confirmation of effectiveness that the research provides and the prevention community has embraced,” said David Morris, MD, Medical Director at D.A.P. “But to be effective, it’s important that people commit to taking their medicine as directed, as well as seeing a healthcare professional for regular monitoring and care. Without this commitment, this prevention strategy becomes ineffective.”

“It is important to increase awareness of this prevention strategy,” said Karen Mark, MD, Ph.D., Chief of the Office of AIDS in the Center for Infectious Diseases at the California Department of Public Health. “We’ve made great strides in our efforts to prevent new HIV infections. This strategy can play a key role in ending or reducing HIV-related stigma and allow partners to select prevention methods that work best for their relationships.”

For more information about D.A.P.s policy, the NASTAD position, and related research, please visit these pages:

NASTAD Policy: Risk of Sexual Transmission of HIV from Virally Suppressed People Living with HIV
PARTNER Study: How to Interpret the Zero Transmission Results
HPTN 052: Study Summary

About Desert AIDS Project

Desert AIDS Project (D.A.P.) is a Federally Qualified Health Center in Palm Springs, CA offering D.A.P. Total Care – a combination of medical, dental, counseling, social services, support groups, alternative therapies, in-house pharmacy and lab, and other health and wellness services.  D.A.P.’s sexual health clinic, The DOCK, offers STD testing and treatment, Pre-Exposure Prophylaxis (PrEP), Post-Exposure Prophylaxis (PEP), and free HIV and HCV testing. D.A.P.’s Get Tested Coachella Valley campaign, the nation’s first region-wide HIV testing and access to care initiative, was recognized by the White House for helping to bring about an AIDS-free future.  D.A.P. is rated a “Top 20 HIV Charity” by About.com. Visit www.desertaidsproject.org, www.thedockclinic.org, and www.gettestedcoachellavalley.org to learn more.

# # #

Printable version: Desert AIDS Project Press statement Viral Suppression Prevention Strategy 04.25.2017

D.A.P. tests new treatment for drug-resi …

Desert AIDS Project is studying a new treatment for a very pervasive sexually-transmitted infection (STI) that’s now become drug-resistant.

Under the direction of Dr. Steven Scheibel, D.A.P. is studying the efficacy, safety, and side effects of a drug that combats Nesseria gonorrhoeae, the bacteria that causes gonorrhea.

Gonorrhea is the second most common STI and a major source of morbidity worldwide. Without treatment, it can cause infertility, cervicitis, proctitis, urethritis, pelvic inflammatory disease, and pharyngitis. Babies grow outside the womb in some women and the infection makes both genders more susceptible to HIV, according to GlaxoSmithKline, sponsor of the study. They go on to say:

“The ability of Neisseria gonorrhoeae to develop resistance to antimicrobials has complicated the management of the disease, leading to an urgent need for new treatment options.”

D.A.P. is one of eight medical centers testing the new drug, called GSK2140944. The study invites 60 adults with gonorrhea infection to take a single dose of either 1,500-mg or 3,000-mg of GSK2140944. The study wants to know if the smaller or the larger dose works best. The study last about a week with two scheduled visits. On the first visit, doctors will dispense the drug and gather baseline information from the study subject. A follow-up visit, called the Test-of-Cure visit, occurs between day 4 and 8 and determines the subject’s response to the drug. That includes success, failure, and adverse effects. Although there are two scheduled visits, bad reactions to the new drug will be monitored until they are resolved.

So far, D.A.P. has enrolled three subjects in the study, to meet the six-subject goal for each site. Our clinical administrators are working on identifying additional subjects. “Right now, though, we have more subjects than any other site and we’ve enrolled them quickly,” says Rod Hagan, D.A.P.’s Clinical Research Coordinator. D.A.P. began accepting subjects about six weeks ago, while other sites have been at it since January. “We have a concentration of people in the Coachella Valley, who need support in fighting gonorrhea infection, so our services have to be cutting edge and we must be fast out of the blocks,” Dr. Scheibel states.

Although the name of the drug sounds like a chemical weapon from an action hero comic strip, the problem and the need for an immediate answer is very real.

According to the study protocol, a variety of antimicrobial agents have been used over the years for the treatment of gonorrhea. Effective treatment options for gonorrhea have diminished rapidly because of the emergence and worldwide spread of antimicrobial resistance to many drugs previously used or considered the first line. The study goes on to list six drugs that patients are taking to almost no effect.

“Azithromycin was the big tah-dah,” Rod says. “But N. gonorrhoeae has become resistant to it and there’s nothing else in the pipeline. Without a new treatment, it could be like it was at the turn of the century again and it could be fatal.”

D.A.P. is trying to keep that from happening. We’re participating in this study and several other clinical trials that aim to improve the lives of patients and clients living with HIV. The search for a new antimicrobial is one of five that D.A.P. has conducted in the past 12 months. Those studies include Medication Therapy Management, a study on HIV, aging, and the brain, a study that searches for a milder antiretroviral that we’ve called Switch, and a new treatment for anal dysplasia. These studies represent a new function we’ll perform for the HIV community here and abroad. Beyond those in disadvantaged communities in the Coachella Valley, many others — nationally and globally — will benefit from our findings.

“Our search for a new treatment for this drug-resistant strain of gonorrhea is one of the most important things we can do,” Dr. Scheibel says. “We have to get out in front of this challenge because it threatens us locally and globally.”

 

Exciting breakthrough in treating dyspla …

Dr. Steven Scheibel, Medical Director at Desert AIDS Project, believes he’s found a new way to treat the conditions that can lead to anal cancer. The new therapy uses human papillomavirus (HPV) vaccines in conjunction with an immune-boosting cream to kill anal dysplasia, which is often a gateway to anal cancer. This therapy promises to be an alternative to surgery as well as a way to address soaring rates of HPV and resulting dysplasia, which weighs so heavily on gay men and those with HIV.

Dr. Scheibel, along with Dr. Praveena Yetur of LabCorp in Monrovia, wanted to treat anal dysplasia, which manifests as lesions in the anal cavity. These lesions can range from mild to severe and may morph into cancer. Working with a 55-year-old man with moderate to severe anal dysplasia, the patient was given imiquimod cream followed by injections of an HPV vaccine called Gardasil. By intervals of three to four weeks, the treatments were delivered over a two-year period. “The patient was screened for high-risk HPV on a weekly basis and had multiple biopsies to identify possible dysplasia,” Dr. Scheibel says. “The result was no virus and a normal anal Pap smear.”

Treatment for HPV and anal cancer is essential at D.A.P. because they pose growing threats to many of our patients. HPV is the most common sexually-transmitted virus circulating today, with up to 75% of sexually active people contracting it in their lifetimes, according to Boston Medical Center’s website. Medical experts agree that HPV infection is even higher in people with HIV. And, although anal cancer is still relatively rare, its prevalence is growing fast, particularly among men who have sex with men (MSM) and those who are HIV-positive, says BioMedCentral.com.  In fact, anal cancer among MSM with HIV is rising at 80 times the rate of the general population, Dr. Scheibel reports. Therefore, D.A.P. is busy searching for answers to HPV, anal cancer, and other clinical issues that challenge our patients.

HPV also is a key factor in head and neck cancer, for which we offer free screenings to clients, staff, and the general public once a year through the Annette Bloch Cancer Care Center. Dr. Scheibel leads a movement to increase clinical research performed under our roof and has made notable headway in the area of HPV and anal dysplasia. The treatment has shown so much promise that Dr. Scheibel will present his findings at “HPV 2015,” the 30th International Papillomavirus Conference in Lisbon, Portugal, held September 17-21.

Researching disease and sharing results with international colleagues, is not new to the internist, who specializes in infectious disease and is AAHIVS credentialed as an HIV Specialist. Dr. Scheibel has done clinical research on HIV and AIDS for decades and was a researcher as well as co-founder and Associate Medical Director of the Community Health Network in Rochester, N.Y., in 1989. He’s been on teams whose work is cited in books such as “Public Health Behind Bars: From Prisons to Communities.” Dr. Scheibel has presented at the Conference on Retroviruses and Opportunistic Infections, the Symposium on Cell Biology of Virus Entry, and he’s traveled to such cities as San Francisco, Casablanca, and Yokohama, Japan, to appear at the International Conference on AIDS.

Nevertheless, presentation at the HPV conference is special, says Rod Hagan, D.A.P.’s Clinical Research Coordinator: “If we could demonstrate a potential treatment for dysplasia that would prevent the need for the invasive surgical solutions that are out there, then this is huge. And getting the rate of HPV among our patients in line with that of the general population… yes, the potential of this is pretty exciting.”

 

X