January 2019

Fighting for the Future

UMC Wellness Center Introduces a Plan to Improve Detection and Treatment of HIV

By Scott Kerbs

Driven by a shared passion for helping community members living with HIV, the physicians and nurses at the UMC Wellness Center stood alongside their long-term patients and many community leaders on World AIDS Day (December 1, 2018) to announce a bold vision for the future of HIV treatment and detection in Southern Nevada.

Led by Medical Director Dr. Jerry Cade, a trusted leader in HIV care who has dedicated his career to saving lives and offering valuable advocacy for patients, the UMC Wellness Center has served Southern Nevada since 1985. HIV care has transformed significantly since the UMC Wellness Center began caring for patients, and Dr. Cade says he and his colleagues take pride in providing community members with access to powerful new medical therapies that can completely suppress the virus.

“If we have enough people on therapy, this virus will die out,” Dr. Cade says. “For more than three decades, the UMC Wellness Center has served as a trusted leader in HIV care, and our team looks forward to building upon our strong foundation as we work toward the elimination of HIV in Southern Nevada.”

Dr. Cade began his career in the early 1980s, a time marked by stigma and fear of HIV/AIDS across the nation. Many medical professionals did not want to treat HIV-positive patients, but early in his career, Dr. Cade stepped up as others retreated. He served as a pioneer in HIV care while offering compassion, life-saving treatment, and valuable advocacy for those impacted by the virus.

For patients like DeMarco Estrada, who was diagnosed with HIV approximately 20 years ago, the UMC Wellness Center serves as a vital resource, offering high-quality treatment, counseling, and access to a wide range of other services.

“The UMC Wellness Center saved my life,” Estrada says. “It has been pretty much the cornerstone of my well-being. They have the resources to assist you with everything.”

Estrada, a past president and current member of the Wellness Center’s Consumer Advisory Board, attended the clinic’s World AIDS Day announcement event. He beamed with pride as the Wellness Center team announced a new strategy to improve the level of HIV detection, treatment, and viral suppression in Southern Nevada.

As part of this plan, UMC became the first hospital in Southern Nevada to introduce universal opt-out HIV testing for patients in the hospital’s Adult Emergency Department. Emergency Department patients who have their blood drawn will now automatically receive HIV testing, unless they choose to decline the screening. This additional testing will improve HIV detection in the community while allowing HIV-positive patients to begin treatment sooner, Dr. Cade says.

A 2015 analysis by the U.S. Centers for Disease Control and Prevention found that more than 90 percent of new HIV infections could be avoided by diagnosing people with HIV and providing them with “prompt, ongoing care and treatment.”

“A significant number of new infections occur through contact with those who do not know their status,” Dr. Cade says. “In addition to caring for those already diagnosed with HIV, we are working to prevent new infections in Southern Nevada.”

Improved HIV detection, however, is only part of UMC Wellness Center’s newly announced plan to further elevate the level of HIV care and education in Southern Nevada. Supported by UMC’s robust health care system, the Wellness Center aims to help the community reach an ambitious set of treatment targets identified by the Joint United Nations Program on HIV/AIDS. Known as 90-90-90, the plan calls for reaching the following goals by 2020:

  • 90 percent of people living with HIV will know their HIV status
  • 90 percent of people diagnosed with HIV will receive sustained antiretroviral therapy
  • 90 percent of people receiving antiretroviral therapy will have viral suppression, reducing their viral load to an undetectable level

The UMC Wellness Center plans to reach the 90-90-90 treatment targets through a variety of initiatives, including improving access to care through valuable community partnerships. UMC will also focus on community education and the prevention of new infections through pre-exposure prophylaxis (PrEP), a medication designed to prevent HIV infection. If taken correctly by a person who is HIV-negative, PrEP can reduce the risk of contracting HIV through sex by more than 90 percent.

With modern approaches to controlling HIV infections, a diagnosis today is no longer a death sentence, and many people now live long, healthy lives with HIV. In addition, modern antiretroviral medication for HIV is far less complicated, has fewer side effects, and is significantly easier to take than the medicines available just a few years ago.

“In general, most people with HIV can take one pill, once a day,” Dr. Cade says. “In most cases, it’s no more complicated than treating high blood pressure.”

In addition, Dr. Cade explains, if an individual’s viral load is completely suppressed by antiretroviral medication, the person cannot transmit the virus, preventing new infections .

As a result of the advanced medication used to treat HIV, Estrada says his viral load has remained at an undetectable level for more than a decade.

A combination of advanced medical therapy, preventive medication, and local needle exchange resources in Southern Nevada will contribute to the reduction of new infections, Dr. Cade says.

“Consistently using any or all of these strategies could easily bring the HIV transmission rate down significantly — and eventually bring the number of new HIV infections to zero,” he says.

The 90-90-90 initiative has proven successful in other communities, including San Francisco, which saw its number of new HIV infections drop from 455 in 2012 to 221 in 2017. Clark County recorded 439 new infections in 2017, nearly double the number reported in San Francisco during the same year.

Using San Francisco’s success as a model, Dr. Cade and his colleagues at the UMC Wellness Center will utilize the latest breakthroughs in HIV care as they guide a community-wide initiative to save and improve lives in Southern Nevada.

“We have the tools today to help eliminate this virus from the planet,” Dr. Cade said. “Our world-class team of medical professionals at the UMC Wellness Center remains committed to fighting for a future free of HIV.”

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