November 30, 2021
November 30, 2021
Every year on Dec. 1, people across the globe commemorate World AIDS Day and reflect upon successes for the year and on-going challenges. This year marks the 40th anniversary of the first 5 reported cases of what would become known as AIDS and the 30th anniversary of our community-based, grant-funded program, A Positive Place, supporting people living with HIV in our local area.
This year’s theme for World AIDS Day is “Ending the Epidemic: Equitable Access, Everyone’s Voice” and highlights a commitment to ending the epidemic by focusing on health inequities and ensuring that the voices of people living with HIV are at the center of our work. Ensuring decision-making roles to people with lived experience (as members of APPs consumer advisory board and as employees) and enhancing health equity have guided the work at A Positive Place.
What does health equity look like and how can a health care system achieve it?
At A Positive Place, we used to tell a story – in the form of annual reporting to our grant funders – about exceeding the goals of federally defined metrics tracking rates of connection to care, percentage of clients on medication, and rates of undetectable viral load among our clients living with HIV/AIDS.
Our story read 90/90/90%. Based on national research highlighting disparities by race and ethnicity, sexual orientation, and gender identity, we began, in 2010, to stratify our own data around those metrics. Not surprisingly, we found significant gaps or disparities when looking through that equity lens: Blacks and Latine clients were undetectable at much lower rates than whites, transgender clients were connected to care at dramatically lower rates than cisgender clients, and Black/Latine MSM (men who have sex with men but who may not identify as gay) had lower rates than white MSM on all metrics.
Since more than a decade has passed, we tell quite a different story about how due to that simple act of stratifying data we diversified and made more inclusive our consumer advisory board and staff to reflect our clientele and hired clients with lived experience to help keep us grounded and guide our work.
We revised many policies and procedures based on values of “individual behavior” and “individual choices” over social determinants of health (housing, transportation, food access, employment, education), and developed new policies addressing those SDoH while centering racial, sexual orientation and gender equity. Finally, together with our local partners, we have changed or expanded our models of service delivery, so that all of our clients now meet target goals of 90/90/90%.
This is the kind of work that any department or specialty in our health care system can take on as we all unite against racism and other health inequities.
Celebrating Infection Prevention Medical Director Joanne Levin, MD
Finally, it is perhaps most fitting to end this year’s recognition of World AIDS Day by acknowledging, honoring, and celebrating one of our most esteemed and compassionate partners since the earliest days of the epidemic, Joanne Levin, MD, Cooley Dickinson’s Medical Director of Infection Prevention.
Everyone here at Cooley Dickinson has witnessed the remarkable expertise, guidance and teamwork that characterizes Dr. Levin’s practice, as she shepherded our entire community through all phases of this new pandemic, COVID-19. It is with this same level of expertise, empathy, and equity that Dr. Levin tirelessly supports, advocates, and provides life-saving medical care to HIV+ people across the Pioneer Valley not just here at Cooley Dickinson, but at the Holyoke Health Center, the VA and our local jail.
From the newly diagnosed patient in need of reassurances around medication and emotional support against stigma, to her patients struggling with substance use disorders, to those in need of a provider letter to avoid electricity and heat shut-offs, to the regular “no shows,” to home visits to dying patients, Dr. Joanne Levin truly personifies the words of poet Maya Angelou, who wrote: “People will forget what you said, people will forget what you did, but they will never forget how you made them feel.”