The Hawaii AIDS Clinical Research Program has brought more than $20 million into the state for patient care and research since the state bailed it out with funding after it lost federal support, says Dr. Cecilia Shikuma, program director.

“;It's been hard work but we're very pleased,”; said the University of Hawaii professor of medicine. “;I guess we're still financially shaky but it's allowing us to survive.”;

The Legislature appropriated $1.2 million to UH-Manoa to support the AIDS Clinical Research Program from 2007 to 2009 after the National Institute of Allergy and Infectious Diseases said the program wouldn't get an expected $1.6 million grant because some clinical trial units were being closed.

The Hawaii program has two major goals: to provide access to and improve care for underserved and disproportionately affected HIV-infected residents, and to develop and maintain a nationally competitive HIV research program.

When the program lost funding, it also lost access to data management and other services that had been provided, Shikuma said.

“;We had to reinvent for our site how to do all those things,”; she said. “;It is a little more challenging and, in a way, exciting. It has taken us to a new level of competence.”;

The Hawaii program is one of eight university sites funded by the National Heart, Lung and Blood Institute to look at the effects of HIV on cardiovascular risk and study ways to lower it. Other functions include the Hawaii NeuroAIDS Research Program, Hawaii HIV Immunobiology and Vaccine Laboratory and a Molecular Medicine and Infectious Diseases Laboratory.

  “;We have done very, very well - even NIH recognizes it,”; Shikuma said, referring to the National Institutes of Health and adding that the program will apply for a new grant next year.

She said the program would like to be designated formally by the UH Board of Regents as a center for HIV training, research and care and be included as part of the UH budget for 2010. The dean of the medical school and UH-Manoa chancellor have been supportive, she said.

The HIV population also has been “;very supportive,”; she said. “;Our research is patient-related. Patients really help us out by coming and participating.”;

The program's Clint Spencer Clinic at Leahi Hospital provides primary care for anyone who wants it and the medical staff is available for consultation for the community and health organizations.

About 439 patients on Oahu and the neighbor islands receive care from the clinic, which sees patients one half day per month each on Maui and Hilo and Kona on the Big Island. However, more than 2,700 people in Hawaii are living with HIV.

Shikuma said Dr. Lisa Marten from the Hawaii AIDS Clinical Research Program completed a “;needs assessment”; study to determine how HIV medical care can be supported in areas without sufficient HIV specialists.

The study found the state “;faces particular problems in maintaining an adequate HIV medical care delivery system due to the relatively small HIV infected patient population, the geographic segmentation of that population, aging of the community physicians providing HIV care coupled with the lack of interest in HIV specialization among young physicians,”; she said.

The program suggests focusing on a system that would allow HIV-infected residents, especially in rural areas, to recover from a physician's departure and to offer multiple patient care options.

The Hawaii AIDS Clinical Research Program also does HIV research and training in Southeast Asia as a partner of the South East Asia Research Collaboration with Hawaii (SEARCH).

It continues to train Vietnamese military physicians to handle HIV/AIDS cases through the Vietnam PEPFAR (President's Emergency Plan for AIDS Relief) program. Funding is provided for HIV care and treatment and HIV prevention efforts.

HIV clinics have been set up in hospitals in Hanoi and Ho Chi Minh City.

The Hawaii AIDS Clinical Research Program also collaborated with the U.S. Department of Defense, which opened and staffed an office in Hanoi this year to help Vietnamese military and family members with education, prevention and treatment of HIV/AIDS patients.