Timely Care, Support Help HIV Patients Reach a Zero-Transmission Goal

Over the last decade, medical care has advanced exponentially for patients living with HIV, so much so that those diagnosed with the virus can now achieve a zero-transmission goal to lead healthier lives. Harris Health and its dedicated care providers at Thomas Street at Quentin Mease Health Center are taking a personal approach to reach the goal. Their program is designed to help newly diagnosed HIV patients receive care quickly to reduce transmission of the virus and show them how to manage their chronic condition much like diabetes and hypertension.

Many people don’t realize that an HIV diagnosis doesn’t mean their life is over,” says Dawn Jenkins, director, HIV Services, Thomas Street at Quentin Mease, which cares for approximately 5,800 people living with HIV in Houston and the extended metropolitan area. “HIV is now akin to a chronic condition like diabetes. Yes, you’ll have to take medication until we find a cure, but you can still have a relationship, a family, and a healthy life.”

HIV care at Harris Health begins with READI, a program with the acronym of Rapid Eligibility and ART (anti-viral therapy) Dissemination Implementation. It is unique in several ways, from how quickly it can get someone newly diagnosed on viral-suppressing medication—sometimes as soon as the same day as their initial HIV diagnosis—to its innovative use of service linkage workers.

“It’s crucial to get people medication as soon as possible,” explains Shapelle Jones Payne, service linkage worker, Thomas Street at Quentin Mease, and a 26-year employee at Harris Health. “Ending the epidemic depends on reducing the gap between diagnosis and treatment. As service linkage workers, we’re there to take the stress off the patient, sort out their medical coverage, and encourage them through the whole process.”

Think of READI service linkage workers like healthcare concierges who walk patients through their first 90 days of care. After 90 days, a patient seamlessly transitions to regular care at Thomas Street, once the nation’s first free-standing dedicated outpatient HIV facility. Upon graduation, these patients are what healthcare professionals call U=U (undetectable equals untransmissible), signifying the patient can no longer transmit HIV to another person.

“Our service linkage workers are a lifeline of support for those newly diagnosed,” says Bianca De Leon, HIV Project Coordinator, Thomas Street at Quentin Mease. “Often, newly diagnosed patients are scared, nervous, shocked, and overwhelmed. Service linkage workers help them get the care they need to reach U=U.”

Service linkage workers have been a main driver of success at Thomas Street. Of the 250 people diagnosed by Harris Health every year, most who complete the 90-day READI program emerge with no detectable amount of virus. Overall, Harris Health’s viral suppression rate is 88%, above the national average of 76%-78%.

“The energy of our service linkage workers is infectious,” Jenkins boasts. “They bring sunshine and hope every day to people in what can be a dark time.”

READI is a five-protocol program, meaning the participant has five unique interactions with Thomas Street staff. For unhoused patients or those with transportation issues, these protocols are combined to lessen the number of times a patient must visit the facility. Upon diagnosis, a service linkage worker like Jones Payne meets the patient as soon as possible, often within 24 hours. In their first interaction, introductions and gathering of vital information like relationship status, sexual history, and other social determinants of health are made, as well as providing the patient an explanation of their care and treatment plan.

The linkage worker facilitates medical coverage for a patient’s anti-viral medications. If they have insurance, great, those that don’t may qualify for assistance through programs like Ryan White, a federal grant program for HIV treatment. As coverage is established, the patient sees a nurse practitioner, nurse with advanced clinical education and training who shares many of the same duties as doctors, who immediately initiates a round of medications and orders lab work and x-rays.

Two weeks later, the patient meets their doctor who helps guide them through managing their condition safely and effectively. Throughout each visit, the linkage worker stays by the patient’s side to offer support and answer any questions. Between visits, the linkage worker is also available.

“I tell them they can call me anytime,” Jones Payne says. “And they do.” 

After six weeks, the patient returns and the linkage worker shows them in real time the progress they’ve made toward being U=U. Often, progress is apparent in as little as 45-60 days. A final visit hopefully shows they’ve reached their zero-transmission goal.

Jones Payne says READI is changing lives for the better and has seen countless success stories since the program began.

“I still get stopped left and right by people who want to give me updates. It can be years later even,” she says. “I love what I do. If I can get you living better and have a healthier life, then I’ve done my job.”

Thomas Street, once a stand-alone building, is now located within the specialty facility of Quentin Mease Health Center. The move last year expanded Thomas Street’s capabilities, increased its accessibility, and provided more services from social works and support groups to physical rehabilitation, as well as bilingual and youth resources, all under one roof.

Jenkins says Harris Health is excelling in HIV care, but cautions that more needs to be done by the community.

“Funding for medication needs to be de-siloed and there needs to be increased access and awareness around testing,” she says. “Testing is key to the READI program’s success. Without testing, a person doesn’t know his or her status. Without that knowledge, unknown transmission will continue.”

Jones Payne reminds everyone to get tested and seek treatment.

“Our goal is to stop the transmission of this virus,” she says. “Eventually, we want to work ourselves out of this job.”

For more information about HIV services and Thomas Street at Quentin Mease Health Center, visit www.harrishealth.org