Ochsner Baton Rouge Joins Global Effort to Detect and Combat HIV/

By Andrea Blumstein

Although the HIV/AIDS epidemic first reached public consciousness in the United States in the 1980s, the stigmas surrounding the virus still endure today — and resources for those affected remain scarce in many areas of the country. Ochsner Baton Rouge is tackling these healthcare challenges head on, implementing systemic changes that anticipate and respond to longstanding community-wide problems.

Almost 20,085 individuals are living with an HIV diagnosis in Louisiana, according to a 2016 report published by AIDSvu — an online resource that transforms HIV data into a visual representation of the epidemic’s impact in the country.

Created in partnership with Emory University’s Rollins School of Public Health, Gilead Sciences, Inc. and the Center for AIDS Research at Emory University, AIDSVu also reports that approximately 3,911 cases of HIV in Louisiana are located in Baton Rouge. In addition, partner site HepVu estimates that 50,700 people in Louisiana are currently living with Hepatitis C (HCV). As a part of the effort to combat these illnesses — and the social stigmas surrounding them — Ochsner Baton Rouge secured funding from Gilead Sciences in order to mobilize on the Centers for Disease Control’s recommendations to integrate infectious disease screening into clinical settings. This will help to normalize and sustain testing for blood-borne viruses like HIV and HCV, and it will in turn produce positive outcomes for all Louisianans.

“One of our main goals is to do what’s right for the patient,” said Susan Green, Director of the Nursing Unit and Emergency Medical Services at Ochsner Baton Rouge. “Undoubtedly, the research was there that a large population exists that either know and are untreated, or don’t know and are untreated — both of whom are spreading the viruses.”

Susan collaborated on the screening program with Lauren Sevier, Project Coordinator at Ochsner Baton Rouge.

“We want to reduce the stigma around these two diseases locally and let patients know that it is treatable, and it is manageable,” said Lauren. “Getting them into care and staying there so that they are virally suppressed and no longer transmitting is our focus.”

In 2017, Gilead Sciences launched its COMPASS (COMmitment to Partnership in Addressing HIV/AIDS in Southern States) Initiative, a 10-year, $100 million partnership with communitybased organizations working to combat the HIV/AIDS epidemic in the Southern United States.

“When considering where to develop partnerships, we identify communities with high prevalence for HIV. Because the surveillance systems are not as mature for HCV, we look at substitute markers, such as the rate of drug use in the area as reported by drug overdose hospitalizations and deaths. We also determine prospective community and clinical partners with readiness to make the systemic change necessary to implement the FOCUS pillars,” said Sylvia Andrews, a director within the FOCUS program who oversees partnerships within Louisiana and Mississippi.

“In places like Louisiana, even though we have Medicaid expansion, there is still a high number of patients who use emergency care as their primary, or only, source of care,” said Sylvia.

In October 2018, Ochsner Baton Rouge submitted a full proposal to Gilead Sciences FOCUS program 1 to routinize HIV and HCV screening as part of emergency care. They hoped this initiative would identify patients earlier in the disease progression and quickly link them to the first medical appointment following their diagnosis.

“The great thing about this project is how truly collaborative it is,” said Kristin Petry, Manager of Corporate and Foundation Relations at Ochsner. The team working on the project included representatives from across Ochsner Health System, including the Emergency Department, Information Systems, Revenue Cycle and key system leadership. The group worked

There are approximately 3,911 people living with HIV in Baton Rouge.

on the proposal for about eight months.

“We not only worked with Gilead Sciences FOCUS program to make sure the proposal was good, but also with Ochsner Baton Rouge leadership to ensure we could hit the ground running if the project was funded. Together, we worked to preemptively change the algorithms that fire off in the emergency department so that a nurse could be properly notified of essential next steps without interrupting patient care,” said Kristin.

Modifications to the Epic Medical Record System will improve HIV screenings of eligible patients from 0.5% to 35%, while screening for HCV will increase from 0.2% to 35%.

Scientific advances in HIV prevention have fundamentally changed our ability to prevent new infections and the approaches that are needed to make this happen. A 2016 report released by the National Institutes of Health evidenced that early HIV treatment reduces HIV transmission by 93% among heterosexual couples.

According to the Centers for Disease Control, Southern states experienced 52% of new HIV infections in 2017, despite being home to a relatively smaller portion of the country’s population. The cause of this surge, they say, is similar to other societal disparities like poverty, housing stability and food security. A variety of community-based solutions are required to reduce stigma and increase access to care for atrisk populations, but the collaboration between Ochsner and Gilead is already demonstrating positive results.

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Infographic adapted from AIDSVu.org

Just as the project was getting off the ground in early 2018, a patient came into Ochsner’s Emergency Department with shortness of breath. Her blood was drawn as part of this program, panels were sent to the lab for testing, and the patient was diagnosed with chronic HIV. It is believed that she likely carried the transmittable HIV infection for several years without knowing her condition and that without medical intervention, she would not have survived. Since the implementation of Opt-out HIV/Hepatitis C (HCV) testing in February 2019, the emergency department at Ochsner Medical Center Baton Rouge has screened over 5,000 patients. Of those, nearly 150 had positive results.

Such instances prove that philanthropic partnerships like the one with Gilead Sciences are key to saving as many lives as possible — and the impact is only made greater by ensuring these initiatives are made available to communities in need.

“We want to make sure we emphasize that this is a great thing for our community,” said Lauren. “We are reducing the stigma, spreading the word that these diseases are medically managed, are treatable, and individuals do not need to fall to the outskirts or feel exiled from our community.”

If you would like to help increase screenings in emergency departments , please visit , Ochsner.org/FOCUS or contact Kristin Petry, Director of Development , at 504 - 842 - 8467 or kristin.petry@ochsner.org.