Present tense

BY HANNAH HERNER

When Amna Osman took the helm of Nashville Cares in 2019, two of her goals were to diversify funding streams and knock down barriers to HIV testing and treatment. Both goals soon became key in the organization’s growth while weathering the COVID-19 pandemic and threats of funding cuts from the state.

When the COVID-19 pandemic hit, Nashville Cares clients still needed services, and with limited places to refer clients, the organization expedited the opening of its own clinic. It allowed patients to stay in the building, where they can also get help with insurance, housing and counseling, among other services. Nashville Cares takes pride in its speed. If a person tests positive for HIV, it is a maximum of 72 hours before that person is linked to treatment. e clinic also provided an additional funding source for Nashville Cares, which used some of the revenue to put a mobile clinic on the streets this year. At the mobile clinic, people can get tested for HIV, prescribed a sample dose of HIV prevention drug PrEP (pre-exposure prophylaxis) and even receive prescriptions for HIV treatment if needed.

“Because we cover such a large geographical area of 17 counties, some people drive two-to-three hours to actually nd a clinic,” Osman says. “If we can take the services to them, … if they have to drive ve-to-15 minutes, that’s a game changer.”

PrEP is e ective at preventing HIV when taken regularly, and patients are protected from infection within just a few days of taking the drug. For those who have HIV, taking treatment medications can get them to the point of “undetectable,” which means they cannot transmit it to anyone else. At the same time, about 1 in 8 people who have HIV doesn’t know their status, according to the Centers for Disease Control and Prevention.

HIV could become obsolete with enough routine testing, and political will, Osman says. She hopes the mobile clinic will inspire more PrEP uptake, especially for people of color, who are disproportionately a ected by HIV.

“Unfortunately, the uptake in Black and brown communities is not as great as we had hoped,” she says. “We thought, you give people a pill, they’ll take it, you convince them, and they’ll continue to take it. at is not the case. ere’s a lot of mistrust, a lot of education that’s needed.”

As the previous AIDS director for the state of Michigan, Osman was on the other side of the equation. She saw the struggles of nonpro ts and wanted to prevent Nashville Cares from hitting the same pitfalls.

“We gave them dollars, and when they didn’t compete well, and did not receive the dollars after a three-year cycle or veyear cycle, they had to close their doors,” she says e goal of diversifying funding streams became a lot more urgent this spring, when the Tennessee Department of Health announced it would no longer be accepting a CDC grant. at choice takes $315,000 annually out of Nashville Cares’ pockets, or about 45 percent of the organization’s prevention dollars.

People often talk about HIV/ AIDS in the past tense. ere was an AIDS epidemic, but now there is an HIV epidemic, Osman explains.

“Back in the day, when people got to a clinic or got to an organization, they had an AIDS diagnosis,” Osman says. “So we were, at that time, sitting at people’s bedside, just supporting them and giving them the love they needed, because they were dying. Today, it’s very di erent. People are thriving.”

People are living much longer and healthier lives with HIV, but Osman says testing and quick treatment, like what is o ered at Nashville Cares, are the keys to taking the next step.

“I’m hopeful, and I believe we have the tools to end the HIV epidemic,” she says. “It’s an exciting time for us with everything that’s happening. It’s just continuing that ght, and pushing forward.”