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White House: Preparing the Future HIV Program a Collaborative Community Model for Nation

In a city where one of every 40 people older than 13 is HIV positive, the JACQUES Initiative (JI) of the Institute of Human Virology (IHV) at theUniversity of Maryland, Baltimore (UMB) has mobilized a "model" program of unprecedented health, psychosocial, and legal resources called Preparing the Future (PTF) that could make HIV testing and linkage to care more routine and normalized, say federal officials.

A central component of PTF brings together graduate students into teams from the University's dentistry, law, medicine, nursing, pharmacy, and social work schools to address the goals of National HIV/AIDS Strategy (NHAS), including identifying new infections of HIV and increasing access to care for people living with HIV, says Jamie Mignano, MSN, MPH, RN, director of JI development and information dissemination.

The PTF program has so far educated and trained 334 students. Each student takes a basic HIV classroom course, then performs community service to test and counsel patients on seeking appropriate care and medications, says Neha Pandit, PharmD, assistant professor at the School of Pharmacy and one of the PTF instructors.

At its current pace, the program will test more than 7,000 people for HIV in 2013.

The program is supported by a grant from Gilead Sciences' HIV FOCUS Program, for the JACQUES Initiative, which is in the UMB School of Medicine, Institute of Human Virology directed by HIV co-discoverer Robert Gallo, MD. The JI program provides long-term holistic HIV care for urban populations.

JI staff coordinate the didactic and hands-on curriculum for the PTF students, equip current providers to routinize HIV testing in their clinical practice and facilitate linkage to care for persons identified as HIV positive.

The director of the White House Office of National AIDS Policy, Grant Colfax, MD, says that such a "commitment to a multidisciplinary approach to fighting the epidemic could be a model for other communities across the country."

The PTF is "about a lot of communication and a lot of community," says Pandit. "And it is about explaining to patients what it means to be on medications, to stay adherent to medication, and what are some of the things that make the progression to good HIV care."

The program also includes the University of Maryland Medical Center, the hospital on the UMB campus. All patients admitted in the Department of Medicine are now routinely offered HIV tests, with streamlined linkage to care and supportive services, in partnership with JI. "The goal is to capture a good number of the patients with a potential of several thousand a year tested," says Mangla Gulati, MD, FACP, FHM, assistant professor of medicine. "It is very timely and we have very engaged patients and very engaged residents who are very excited and open with the patients about it."

PTF is also a good match with existing efforts in University of Maryland School of Dentistry, which has recruited both dental students and dental hygiene graduate students for the program. The School has operated the PLUS Clinic since 1989, where students work closely with faculty members to treat HIV-positive patients. Also, in partnership with the JI, the School has implemented protocols for offering routine HIV testing and linkage to care in its extensive public dental clinics.


Valli Meeks, DDS, MS, RDH, associate professor, teaches students that proper infection control is vital for all patients, not just those suffering from HIV. And she hopes that students in the PTF, as well as those in the PLUS Clinic, learn lessons in tolerance as well as dentistry. "I tell them: Before assuming you can't treat an HIV patient, look at the whole picture. It is still a little bit of a stigma, but it is changing."

Indeed, the PTF is as much about creating broad awareness of HIV issues among all UMB graduates as it is about testing and helping patients, says Derek Spencer, MS, CRNP, executive director of the JI. "You have to expect the students to come in with their own biases. Many go through a transformation, a new openness. The questions they ask they couldn't ask before. We are making a big difference."

Mignano says HIV "is a chronic disease that is treatable, like high blood pressure or diabetes. And students are learning how to address a public health crisis, that with treatment has potential positive impacts on the health of the entire community."

Through the PTF, the University's Francis King Carey School of Law contributes to a special clinic held each Tuesday at the JACQUES Initiative by law students and preceptor attorneys. They meet with new HIV patients to discuss insurance, benefits, financial support, and more. Jeff Weaver, a physicians' assistant, says it is an "amazing" collaboration.

"I tell them what I learned about the patient and they see the patient on the spot," Weaver says. "It is another professional side of HIV health. Every individual school and profession has their own ethical and professional background and they can come together and better help the patient."

Throughout the 2012-2013 academic year, teams of interprofessional students from all the schools have discussed thousands of cases with each other as they tested and counseled people at locations such as Walgreens Community Pharmacy on Baltimore's busy downtown Howard Street.

Recently, a delegation from the White House Office of National AIDS Policy visited the JACQUES Initiative on April 30 for an update on the University's innovative Preparing the Future program. Colfax, the office director, says he "very much enjoyed" the visit, adding, "I know [Preparing the Future] will continue to be an important partner as we implement the national HIV/AIDS strategy."

The JACQUES Initiative (Joint AIDS Community Quest for Unique and Effective Treatment Strategies) was initiated by IHV in 2003 by the Institute of Human Virology in memory of Joseph William Jacques, PhD well-known contributor to the field of HIV and AIDS activism.

Posting Date: 05/22/2013
Contact Name: Steve Berberich
Contact Phone: 410-706-0023
Contact Email: sberb001@umaryland.edu