Clinical Excellence

July 27, 2012

Kaiser Permanente’s Unwavering Commitment to Addressing AIDS Epidemic

Researchers and activists from around the world participate in AIDS 2012

There are currently more than 34 million people around the world living with HIV. Yet talk of wiping out the epidemic entirely is right around the corner. Kaiser Permanente is joining more than 20,000 of the world’s leading HIV researchers and activists in what they hope to be the beginning of the end of the HIV epidemic.

This week, July 22–27, representatives from nearly 200 countries arrived in Washington D.C., for the 2012 International AIDS Conference (referred to as AIDS 2012), the premier gathering for those working in the field of HIV, as well as policymakers, persons living with HIV and other individuals committed to ending the pandemic.

“It is exciting and awe-inspiring to be really talking about an AIDS-free generation, and potential paths to that reality,” said Michael Horberg, MD, director of HIV/AIDS for Kaiser Permanente, executive director of research for Mid-Atlantic Permanente Medical Group, and a member of the Presidential Advisory Council on HIV/AIDS. “I am so proud that Kaiser Permanente can play a key role in realizing this international goal.”

As a leader in HIV treatment and key sponsor of AIDS 2012, Kaiser Permanente will be sharing best practices and research with conference attendees.

“HIV is a complex, chronic condition, both due to the infection itself, the conditions and diseases that can be associated with it (like diabetes, depression, substance use, cancer), and the treatments necessary,” Dr. Horberg said. “Coordinated care treating the whole patient is not only beneficial, it’s absolutely necessary to get good results and outcomes. That is where Kaiser Permanente, through its coordinated care, shared medical information and all services under one roof, particularly excels.”

Earlier this year, Kaiser Permanente announced the HIV Challenge, which was created to help health care providers nationwide improve health equity for people living with HIV by increasing access to HIV care and improving health outcomes.

Challenging others to lead

The crux of the HIV Challenge (kp.org/hivchallenge) is to challenge other private health care providers and public and community health clinics to increase the number of HIV-positive people getting effective treatment by sharing Kaiser Permanente’s toolkit of clinical best practices, provider and patient education materials, mentoring, training and health IT expertise.

Through its integrated, patient-focused approach, Kaiser Permanente has an outstanding record of successful HIV clinical care outcomes:

• HIV mortality rates that are half the national average
  
  
• 94 percent median treatment adherence among Kaiser Permanente patients who are regularly in care and on antiretroviral therapy
  
  
• No disparities among Kaiser Permanente’s African American and Latino HIV-positive patients for both mortality and medication rates, compared to a 15 percent higher rate in the U.S. for mortality and medication
  
  
• 89 percent of Kaiser Permanente’s HIV-positive patients are in HIV-specific care within 90 days, compared to 50 percent in the U.S. within one year
  
  
• 69 percent of Kaiser Permanente’s HIV-positive patients have maximal viral control compared to 19 percent to 35 percent nationally
  
  

Location, location, location

It’s been 22 years since the United States has been chosen to host the International AIDS Conference.

The IAS Governing Council voted to hold AIDS 2012 in Washington, D.C., following U.S. President Barack Obama’s October 2009 announcement that the nation would end its entry restrictions on people living with HIV effective Jan. 4, 2010. The conference was last held in the U.S. in 1990 in San Francisco.

The location of AIDS 2012 couldn’t have been more appropriate, as it is one of the U.S. jurisdictions that continue to have among the highest prevalence rates for HIV and AIDS.

On June 28, Kaiser Permanente Mid-Atlantic States convened three subject matter experts on HIV and AIDS care, prevention and education. The event brought together representatives from local safety-net clinics and community organizations to share best practices and challenges around HIV and AIDS care. In addition to representation from Kaiser Permanente, panelists included Bradley O. Boekeloo, professor of the Department of Behavioral and Community Health and director of the Prevention Research Center at the University of Maryland School of Public Health, and Catalina Sol, chief programs officer, La Clinica del Pueblo in Washington, D.C.

“In the early days of the epidemic the public providers in America really were the organizations that stood up immediately and embraced the epidemic and care for people with HIV and led the way,” said Raymond J. Baxter, senior vice president, Community Benefit, Research and Health Policy, Kaiser Permanente. Baxter recalled when he was director of public health in San Francisco in the early 1990s, knocking on Kaiser Permanente’s doors, urging the organization to increase efforts in caring for people with HIV. “That changed over time as Kaiser Permanente became really one of the leading providers of HIV care,” Baxter said.

Baxter recalled when he was director of public health in San Francisco in the early 1990s, knocking on Kaiser Permanente’s doors, urging the organization to increase efforts in caring for people with HIV.

“That changed over time and, in fact, it changed radically over time, as Kaiser Permanente became really one of the leading providers of HIV care,” Baxter said.

Activating and educating communities

For more than two decades, Kaiser Permanente has been reaching out to millions of youth about HIV prevention through its Educational Theatre Program.

“In the early days, when many organizations were uneasy about talking about sexual behavior and prevention of HIV to adolescents, Kaiser Permanente wasn’t,” said John Edmiston, national manager, community engagement, Kaiser Permanente.

In 1989, Kaiser Permanente’s Northern California ETP created the live production “Secrets,” aimed at educating young people about the growing epidemic. Since 1989, it’s been shown to 1.5 million youth in Northern California alone. The Southern California ETP production, “What Goes Around,” tells the story of five friends navigating their final days in high school, when one of them learns he has contracted two sexually transmitted diseases. The program has been seen by 233,401 high school students since 2007.

“Almost all of our theater programs, which serve communities where Kaiser Permanente is present in eight states and the District of Columbia, have adopted a production dealing with HIV prevention in one way or another. We continuously work with educators, community groups and Kaiser Permanente physicians, to update our productions to meet the needs of our communities,” Edmiston said.

More notable outreach by Kaiser Permanente:

• Part of Kaiser Permanente’s larger work is to identify, measure, research and eliminate disparities in health and health care in the United States. In May 2012, Kaiser Permanente committed $2 million to award to eight community health organizations focusing on eliminating racial and ethnic disparities in health care and health outcomes, specifically related to HIV disease. The first four recipients will be chosen later this year. Application submissions for the next four awardees will open May 2013.
  
  
• Each year since 2006, Kaiser Permanente has recognized individuals and groups outside of the organization through its HIV/AIDS Diversity Awards. The awards were developed to recognize meritorious achievement, excellence and innovative work in advancing health equity in the provision of HIV/AIDS prevention and care. A $10,000 grant is given along with each award.
  
  
• In 2007, Kaiser Permanente’s National Diversity Office sponsored a seminar as part of community outreach and educational strategy to increase public awareness and encourage prevention. The seminar addressed the issues of stigma, limited health care access, sexual and other cultural dynamics, along with other factors that have made it difficult to halt the spread of the virus in the black community and ensure that people who are affected get needed treatment and support.