At December’s George Washington University (GW) School of Medicine and Health Sciences (SMHS) clinical public health summit, “How Clinicians Can Help Create an AIDS-Free Generation,” first-year M.D. students learned firsthand how they could turn the tide on HIV.
“It is going to be up to you to bring us to an AIDS-free generation, so we need you to apply some real innovation and creativity to potential solutions,” Lawrence “Bopper” Deyton, M.D. ’85, M.S.H.P., senior associate dean for clinical public health and professor of medicine at SMHS, said at the start of the three-day event.
SMHS partnered with the White House Office of National AIDS Policy and the National Alliance of State and Territorial AIDS Directors (NASTAD) for the summit.
The summit consisted of lectures by world-class experts, panels of front-line providers and patient and community advocates created specifically for the Class of 2020 medical students, after which they broke into four jurisdictional groups to create solutions to improve HIV testing and linkage to care; enhance access to HIV care and support services so persons with HIV can get appropriate medications and achieve an undetectable HIV viral load; ; and improve access and acceptance of pre-exposure prophylaxis (PrEP) for persons at risk of acquiring HIV infection. Students worked directly with leading HIV/AIDS officials from Louisiana, Tennessee, Washington, D.C., and San Francisco to learn about and to develop proposals to achieve an AIDS-free generation in those jurisdictions.
On the third day of the summit students presented their plans to a panel of HIV/AIDS experts, led by Amy Lansky, Ph.D., M.P.H, director of the Office of National AIDS Policy for the White House (the AIDS Czar). The panel of experts included Heather Hauck, M.S.W., LICSW, deputy associate administrator of the HIV/AIDS bureau at the Health Resources and Services Administration; Lisa Kaplowitz, M.D., M.S.H.A., senior medical advisor in the Substance Abuse and Mental Health Services Administration ; and Rich Wolitski, Ph.D., director of the Office of HIV/AIDS and Infectious Disease Policy at the Department of Health and Human Services.
The experts were incredibly interested in hearing innovative proposals from students, said Jeffrey S. Akman, M.D. ’81, RESD ’85, vice president for health affairs, Walter A. Bloedorn Professor of Administrative Medicine, and dean of SMHS. The Class of 2019 participated in a similar assignment last year, and two proposals presented by the D.C. group recently became part of the 2016 AIDS Action Plan for Washington, D.C.
“So your goal is to learn how to develop clinical public health ideas,” Akman said, “but then we’re going to provide you the opportunities to communicate them to the leaders of these jurisdictions and hopefully make a difference in these jurisdictions.”
Before the start of the summit, students had finished up their courses, many of which related to what they would learn over the course of the three days.
“I think that it was very nice that the end of our curriculum, our last block [of courses], really tied in well,” said M.D. student Amali Gunawardana. “We had a lot of lectures on HIV, and I think that really prepared us to go into this week.”
The summit allowed students to take that foundation of knowledge and build on it. “We’re moving at such a fast pace, sometimes we don’t have the time to gain greater expertise in something, so it was nice to really delve into this issue from a lot of different angles,” Gunawardana explained.
On the first day of the summit, students also heard from Terrance Moore, deputy executive director at NASTAD, and Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health (NIH).
Fauci spoke about how his career changed course when he first heard about the emergence of a sexually transmitted disease impacting gay men. He began to investigate the new syndrome and formed the first AIDS research group at the NIH.
“One of the lessons I’ve learned is that when you’re in our field, unexpected things happen and career directions are often things that were never on your radar screen when you’re sitting in the seat that you’re sitting in now,” he told the students.
While HIV/AIDS is still a generalized epidemic in D.C., which means more than 1 percent of the population is infected, there has been significant success in combatting the disease, Fauci added. “An extraordinary amount of investment has been made in the scientific approach of unraveling this mystery,” he said. “We really can talk with a degree of confidence about the feasibility of ending the epidemic if we follow the science.”
The summit also presented a panel discussion featuring perspectives from the community. The panel was moderated by David Hardy, M.D., Ph.D. senior director of evidence-based practices at Whitman-Walker Health and featured Marcia Ellis, an HIV health and wellness advocate; Christopher M. Cannon, director of research and evaluation at Whitman-Walker Health; and Tyson Isaiah Evans, senior program associate at DC Care. Dr. Hardy spoke about the trajectory of his career as a clinician, scientist, researcher, educator and advocate. Ellis, Cannon, and Evans spoke about their experiences related to HIV and AIDS both personally and professionally — as patients, community members, researchers, and advocates.
During the summit, students also had the chance to speak with HIV/AIDS program officials from each of the four state/local jurisdictions the students were studying. Students met with Michael Kharfen, senior deputy director of HIV/AIDS, Hepatitis, STD, and TB administration at the Department of Health in Washington, D.C.; Shanell McGoy, director of HIV/STD with the Tennessee Department of Health; Oliver Bacon, associate professor at the University of California, San Francisco, School of Medicine; and DeAnn Gruber, STD/HIV program director for the Louisiana Department of Health and Hospitals.
Proposals presented by the student’s to help improve the jurisdictions’ HIV/AIDS strategies included partnerships with ride-sharing services to help get patients to testing sites and doctor appointments; the creation of apps to improve medical adherence and education; and continuing education for providers on PrEP, a medication that can reduce the chance of HIV infection.
In years past, the proposals were presented to an expert panel led by the AIDS Czar at the White House, but due to scheduling conflicts it occurred in Ross Hall this year. In addition to the presentations and feedback from the expert panel, students also presented a letter for President Obama to the AIDS Czar, thanking him for championing “the cause of health care reform of our country’s most vulnerable.”
“This was definitely in an only in D.C. kind of experience,” M.D. student Brandon Robinson said after the Washington, D.C. group’s presentation.
Akman closed out the summit, telling students that they have the power to use their knowledge from the event in every clinical setting that they find themselves in.
“You can raise this, you can change your faculty members or the folks that you’re working with, you can change their behavior. You can educate them,” he said. “We’re going to continue to generate physicians who are really knowledgeable in HIV/AIDS and are going to go out and make a difference.”
