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IHS Celebrates World AIDS Day

by RADM Sarah Linde, M.D., Acting Chief Medical Officer, IHS

On the first day of December, and along with the rest of the world, the Indian Health Service (IHS) commemorated World AIDS Day Exit Disclaimer: You Are Leaving . The IHS is committed to working in partnership with tribes to deliver high quality health care to the people we serve and we are strongly devoted to our HIV/AIDS program.

IHS, along with our tribal and urban partners, has long valued the strength of our communities and we have been working to prevent HIV infection and to treat AIDS since the earliest days of the epidemic. For the most part, IHS clinics have only a handful of current HIV patients, or none at all. However, two large programs in the Southwest treat upwards of 200 HIV patients each. Each have populations that can be hard to reach due to geography and lack of phones.

But through locally managed, comprehensive programs run by the most devoted care providers in the country, recognized protocols are being followed and culturally relevant services are offered to our Native clients. My sincere gratitude goes out to the tireless front-line health professionals in our IHS clinics - working sometimes seven days a week - to diagnose and compassionately treat the hundreds of Native people living with HIV.

Employees from several HHS agencies at the 5600 Fishers Lane building celebrated World AIDS Day with a program titled, Leadership, Commitment, Impact, through Collaboration.
Employees from several HHS agencies at the 5600 Fishers Lane building celebrated World AIDS Day with a program titled, "Leadership, Commitment, Impact, through Collaboration."

I want to point out that much of the success we see in our HIV treatment programs is owed to our Community Health Technicians. Health reps are community members trained in HIV who speak the local language, and will travel to homes or shelters of HIV patients who are deemed at high risk for non-adherence due to their recent HIV diagnosis, behavioral health issues, denial, lack of understanding, being overburdened by new medicines, and many other factors.

Statistics show that early screening has made a difference. HIV screening - as per national recommendations - is now a core measure of quality of care. This year IHS tied the screening of 13-64 year olds for HIV to a core GPRA measure - as was suggested by the Centers for Disease Control and Prevention- and we expect this move to help prioritize screening in all of our IHS clinics.

I want to bring your attention to a relatively new development in the prevention of HIV. Pre-Exposure prophylaxis, or PrEP, is a way for people who don't have HIV, but who are at very high risk of getting it, to prevent HIV infection by taking a pill every day. In October IHS sent out PrEP Guidelines to our Area chief clinical directors in order to expand access to PrEP. These guidelines are now posted to our IHS website.

Finally, we turn to what the future holds and therefore, we have initiated the "Indian Country Emergent HIV Strategies Collaborative." The aim of the Collaborative is to improve, promote, and facilitate adoption of emergent HIV strategies for prevention, screening, management and treatment in Indian Country, and specifically targets clinicians.

IHS and American Indian/Alaska Native communities acknowledge the complex problems of HIV, and we at IHS continue to look for opportunities to work with and learn from our HHS sister agencies, and to see what more we can do and how we can share our knowledge and experience. We are learning best practices from the field and from people on the ground. We are embracing new frameworks for treatment and learning networks. IHS is continuing to work to ensure HIV/AIDS care is delivered consistently across all facilities in the Indian health system while working to infuse quality into everything we do.

As IHS Acting Chief Medical Officer, RADM Linde, M.D., provides medical advice and guidance to the Office of the Director and staff on American Indian and Alaska Native health care policies and issues. She serves as the primary liaison and advocate for IHS field clinical programs and community-based health professionals.

RADM Sarah Linde, M.D., Acting Chief Medical Officer, IHS