Children's Diagnostic & Treatment Center is a Resource for People with HIV
Tuesday Dec. 01, 2020
Fort Lauderdale, Florida -- In addition to annually providing professional healthcare services and compassionate care for nearly 11,000 clients with special healthcare needs in Broward County, Children's Diagnostic & Treatment Center (CDTC) is a one-stop, family-centered approach to addressing the complete healthcare needs of children, youth and women living with HIV.
The number of people diagnosed with HIV continues to rise. The Enhancing Prevention in Communities Biomedical Conference ranks Broward County second in the nation for new HIV infections. When coupled with Miami-Dade and Palm Beach counties, the tri-county area ranks number one for new infections, with much of the spread linked back to MSM.
Two physicians at the forefront of this silent HIV epidemic are CDTC's Lisa-Gaye Robinson, M.D., and Vanessa Rojas, M.D. As CDTC's HIV medical director and principal investigator for clinical research studies and pediatrician, Robinson oversees the non-profit's Comprehensive Family AIDS Program (CFAP), which cares for 2,254 women, children and infants infected and affected by HIV/AIDS in Broward County, as well as overseeing a variety ongoing clinical and long term follow-up studies. CDTC is the lead agency in Broward Country for Part D of the Ryan White Care Act federally funded by the Health Resources and Services Administration.
"We are extremely proud of our Comprehensive Family AIDS Program, which has a tremendous impact on our community, garnering a zero percent transmission rate from mother to baby and achieving a 72% viral suppression rate for youth and 84% for adults last year," said Ana Calderon Randazzo, Ph.D., executive director of Children's Diagnostic & Treatment Center.
CDTC case managers are there for pregnant women living with HIV. They meet daily with them, taking them to scheduled pre-natal appointments and making sure they take their prescribed medications so as not to infect their unborn child with HIV. This has led to the zero 0% transmission rate from mother to baby last year.
"For this vulnerable population, social determinates of health are major factors," said Robinson. "While HIV is still a very serious and potentially life-threatening illness, for some of our patients, HIV may be less of a priority, overshadowed by such daunting issues as intimate partner violence, untreated mental health, homelessness and drug addiction."
According to Robinson, clinical research has enhanced therapeutic options available to patients over the past three decades.
"CDTC has proudly been involved in pre-market phase 2 and 3 research that generated data that allowed pediatric HIV drug formulations to come to market," Robinson added. "Pill fatigue is a reality, but innovative medications and new protocols enable our patients to take far fewer pills and continue to maintain a low viral load."
Now, rather than taking a combination of four or more prescribed pills two times per day, many patients can now take a combination of drugs all in one tablet with minimal negative side effects just one time per day. This results in better tolerance of the medication and greatly improves regular adherence.
A new NIH clinical study Robinson is investigating involves long-acting shots where an adolescent can take two injections every eight weeks, foregoing daily oral medications. Another very exciting "cure" study involves giving very early intensive treatment to HIV-infected infants to achieve HIV remission.
"Once a baby is infected, a small reservoir of virus can lay dormant in the body. It may not even be detected in the blood stream but can hide in one's lymphatic system," said Dr. Robinson. "This promising study will allow us to track how the babies do on the most potent medicines started early, which we hope will decrease the size of the reservoir formed in the babies. Moreover, we hope that after years on the medicine we may be able to wean the now older child off medications indefinitely."
Rojas, a primary care physician at CDTC, oversees more than 400 patients, mostly women between 18 and 88 years of age, who have a range of health issues, including but not limited to HIV.
"CDTC is unique and differs from other clinics in that we offer primary healthcare as well as treatment and case management for HIV all under one roof," said Rojas. "I frequently meet with intergenerational families, caring for the mother, daughter and grandchild."
People with HIV are living longer, and their quality of life has improved. Rojas and CDTC's team of case managers also continue to care for elderly patients, even if they are in a rehabilitation facility or nursing home, providing comprehensive primary medical care and thorough case management.
Rojas finds tremendous fulfillment from the trust she's built with her patients over the past two years.
"Sadly, there is still a societal stigma associated with having HIV. It is not easy to come in to care and put your faith in a healthcare provider," she said. "Initially my patients are afraid of being judged. They are very perceptive, and it's not easy for them to let down their guard. When they eventually do, I find positive health outcomes improve, such as improvement in high blood pressure, diabetes and even improvement in mental health."
While COVID-19 has deterred many people from scheduling regular health screenings and routine exams, Rojas says her patient base has increased, and patient adherence to appointments has been steadily rising.
"Although my patients have compromised immune systems and a variety of risk factors for COVID-19, they have been extremely diligent about refilling their prescriptions to maintain their health so they can avoid being susceptible to the coronavirus," Rojas added.
Clients in CFAP have access to a full array of onsite healthcare services, including primary and HIV specialty care, phlebotomy, gynecological screenings, nutrition and adherence education and counseling. All CFAP clients also have a medical case manager to provide education and support. Additionally, rapid confidential testing with immediate counseling, medical care and treatment is provided to those testing positive.
For nearly 30 years, multiple generations of families have been served through the CFAP. Advances in treatment protocols, coupled with the program's easy access to care and social services, have proven successful in helping clients eliminate the chance of transmission and allowing HIV+ women and children to enjoy healthier and more active lives.
For more information about CFAP, call 954-728-1056 or visit childrensdiagnostic.com/comprehensive-family-aids-program-cfap/.