A previously unknown virus infects several, then dozens, then hundreds and thousands of people, leading to an epidemic that eventually kills millions.
Sound familiar? Actually, this situation occurred in the early 1980s, when the disease that later became known as Acquired Immune Deficiency Syndrome (AIDS) emerged. The first cases were reported in 1981, but it took until 1983 for researchers to identify the virus that causes AIDS. Human immunodeficiency virus (HIV) attacks cells that help the body fight infection, making a person more vulnerable to other infections and diseases. Left untreated, HIV infection can progress to AIDS and cause death.
In 1984, Yale New Haven Hospital established what was then called the AIDS Care Program. Working with the sections of Infectious Diseases and Pediatric Infectious Diseases at Yale School of Medicine, the program provided testing, outreach, counseling, inpatient and outpatient clinical care and clinical research trials. A team of physicians, physician assistants, nurses, counselors, social workers and clinical researchers collaborated to care for adults, adolescents and children at risk of or living with HIV/AIDS, and their loved ones.
Testing and treatment advances have significantly reduced the number of people with HIV and AIDS since the 1980s. As of 2023, 1 million people in the U.S. are living with HIV, according to the U.S. Department of Health and Human Services website, HIV.gov. Approximately 13 percent don’t know they’re positive because they have never tested for HIV. At YNHH, 20 (less than 1 percent) of the more than 13,300 patients tested for HIV in the last quarter were positive.
These patients and a number of other people from the community who test positive for HIV are referred to the program now known as YNHH’s HIV Care and Prevention Program. Treatment usually includes medications to help control the replication of the virus, fight infections and eliminate the chance of transmitting HIV to others. Kelly Moore and Filomena Sgambato, program counselors, provide education and support and help newly diagnosed patients navigate their care. Prevention is also a priority.
“Even though HIV has become a chronic, manageable disease, it still needs to be prevented,” Moore said.
More than 500 HIV Care and Prevention Program patients take pre-exposure prophylaxis (or PrEP) medication, which can help prevent HIV infection. YNHH was one of a handful of sites to pilot the use of PrEP in 2012 and fully implemented it in 2014.
Moore and Sgambato also provide one-on-one counseling and community outreach to help people at higher risk for contracting HIV take additional steps to protect themselves and others. The counselors educate clinical staff on how to help their patients reduce HIV risk.
In addition to education, outreach and help with treatment navigation, Moore and Sgambato provide moral support to their patients.
“The people we care for in the program need a nurturing, kind, non-judgmental person to talk to them,” said Anna Andreozzi, RN, Medicine Services operations consultant.
That support is especially important given the persistent stigma around HIV and AIDS. According to HIV.gov, populations disproportionately affected by the virus are also often affected by stigma due to their gender and gender identity, sexual orientation, race/ethnicity, drug use and other factors.
“We don’t just talk to our patients, we listen,” Sgambato said. “We create a safe space so we can get to know them as a person.”
Moore recalled offering a hug to a patient who was overwhelmed by an HIV diagnosis.
“They cried and said, ‘I really needed that,’” Moore said. “Sometimes you just need to stop what you’re doing and provide that human touch.”
October is U.S. AIDS Awareness Month. Learn more about YNHH’s AIDS/HIV Care Program.
