Clinic is back on track
The University of Hawaii AIDS Clinical Research Program, on the brink of closing a year ago, has $5.8 million in federal grants and a thriving operation.
The Legislature kept the program alive in the John A. Burns School of Medicine after it learned just before World AIDS Day last year that it would not receive a new grant from the National Institutes of Health because requirements had changed.
"We're very grateful to the state Legislature," said Dr. Cecilia Shikuma, program director. "This whole thing would have fallen apart on us except we had state funds to rely on. We still have 100 percent of our staff (about 30 people), and the fact that we're still around enabled us to accept NIH funding from other grants."
The Legislature allocated $1.2 million a year for the program for two years, starting July 1, this year. "So, in essence, we've already doubled their investment in us" with new federal grants, Shikuma said.
The state funding continued the program's Clint Spencer Clinic at Leahi Hospital to provide consultative and primary care for HIV-infected patients, she said.
The team cares for a relatively indigent population - about 300 patients on Oahu and an additional 125 on the neighbor islands.
"We have taken very seriously the mandate we felt from the state Legislature that we are supposed to be supporting the infected HIV community in Hawaii," Shikuma said.
A statewide HIV/AIDS needs assessment is under way to gather data for a plan to support HIV care throughout the state, she said. Lisa Marten, who has a background in public health policy, and Peter Whiticar, chief of the state Health Department's STD/AIDS Prevention Branch, are conducting the study.
The UH AIDS research
program has five faculty doctors, a nurse practitioner and clinic coordinator and patient advocate who care for patients at the clinic at Leahi Hospital and on the neighbor islands, Shikuma said.
Kona and Hilo clinics are held once a month, and a Maui Clinic was opened last week, she said. The clinic coordinator and patient advocate, Nicole Valcour, a registered nurse, knows all the patients and is able to address their concerns, she said.
At the request of the Life Foundation, the state's largest AIDS organization, the UH program held a clinic in October on Waianae beach, Shikuma said. A foundation outreach worker tried to help HIV-infected patients who had not had any follow-up because of homelessness or substance abuse.
The Waianae clinic might continue on an as-needed basis, Shikuma said, explaining, "You're very limited in what you can do out on the beach but can make some sort of contact where we could determine how they're doing."
In a recent status report on the program, Shikuma said the most critical HIV/AIDS problems are on the neighbor islands and in rural Oahu.
But problems are looming on Oahu because some community doctors who care for a large number of HIV patients are reaching retirement, she said. "Younger community physicians have not shown an interest in developing expertise in HIV."
She said the needs assessment "will investigate the possibilities for providing support on all islands through satellite clinics or through technical support to local care providers."
The group is involved in a number of research projects supported by other federal grants, including evaluating HIV therapies, HIV dementia, the impact of HIV on exercise capabilities and other aspects of the disease and treatment. The group has requested funding to add dental services to the clinic at Leahi Hospital.