By Bobby Feingold
“I thought my life was over,” he said. “My heart dropped when I first heard the news. I didn’t know what to do next, if I would tell my family, how old I would live to. All I knew is that my life as I knew it was over.”
“Kyle,” a senior at Northeastern, was sitting in the Fenway Community Health Clinic when he saw the photocopied paper with “positive” printed boldly on top. “Kyle,” whose name was changed at his request, had been diagnosed with HIV.
According to the Centers of Disease Control (CDC), he is one of almost five million new infections worldwide each year, nearly half of which occur in people ages 15 to 24.
Fortunately, HIV/AIDS treatment has vastly improved in the past two decades. Researchers now know how the virus works, a plethora of antiviral medicines have been released and celebrities even endorse educational campaigns. But according to the CDC, HIV still infects about 40,000 people in the United States each year.
In a city filled with college students, Boston represents both the hopes of medical achievements and the fears of negligent spreading. According to the Massachusetts Department of Public Health, as of October 2006, there were roughly 16,000 people living with HIV in the state, a 30 percent increase from 1999.
Northeastern School of Nursing clinical instructor Catherine O’Connor, with the help of many dedicated nursing students, is addressing the spread of HIV/AIDS in Boston through a new program.
O’Connor heads Project Health Moves, a program that uses the Northeastern Health In Motion van to offer free HIV testing and education to populations at high-risk for HIV exposure. These patients, she said, are often uninsured, or may be newcomers to the country unaware of community resources available to them for testing.
This month, O’Connor and her team of nurses and nursing students will undertake a “huge initiative” at Boston’s Gay Pride Festival. Parked at one of the celebration’s block parties, the group will join forces with the Massachusetts Department of Public Health HIV/AIDS Bureau, Fenway Community Health Center and the Boston Public Health Commission in offering on-site health screening, vaccinations and education to Pride participants – free of charge.
O’Connor and her students have previously taken the van to local gay clubs like Machine and Ramrod and areas of the city where marginalized intravenous drug users congregate.
“It takes several months of planning with many community partners to go to non-traditional venues and implement clinical services,” O’Connor said.
O’Connor is fighting HIV, both in Boston and statewide, her own way. Funded by the Massachusetts Department of Public Health AIDS Bureau, O’Connor provides clinical supervision for Project Health Moves. The project is regarded as a valuable clinical training opportunity among Northeastern nursing students, O’Connor said.
The van sees 25 to 40 patients per night twice a month, spending 45 minutes to an hour on average with each patient. Participants get on the van, where they receive HIV and STD risk reduction information from nursing students and are tested. They can then get the results of their tests one to two weeks later at their local health center.
In addition, O’Connor, who has specialized in HIV exclusively since 1988, and a group of senior nursing students take the Northeastern van every Wednesday to one of two local needle exchange programs as part of the clinical education experience offered in a community health course called “Care of Vulnerable Populations.”
The van goes to each needle exchange program in Boston and Cambridge twice a month for six hours a week, offering a cadre of services that have included HIV and STD screening and education, TB screening and education, and vaccines for viral hepatitis, community acquired pneumonia, flu and tetanus. Students have conducted mental health assessments, taught participants how to avoid overdoses and reviewed vein care strategies to reduce participants’ risk for acquiring hepatitis C and other blood borne infections. Students also assist patients in accessing detoxification services, fill out medical insurance forms and link patients to comprehensive health care services.
“We talk to patients about harm reduction,” O’Connor said. “What are they prepared to do to reduce their individual risk for acquiring HIV? For example, patients may tell us that they don’t want to use condoms during oral sex so we need to try to engage them first by having them describe what they might be willing to consider as strategies to reduce their individual risk.”
O’Connor said cultural barriers do exist, for example a Columbian man said he knew he wasn’t at risk for HIV because he cleans himself with rubbing alcohol after sex. O’Connor said she had to inform him that this practice actually makes him more vulnerable to disease transmission.
The van opens its doors at 10 p.m. and closes when there are no longer people waiting in line. The success of the program, O’Connor said, is linking the services to locales where clients are most comfortable and not waiting for people to come into an office.
“Where the epidemic is sited has changed,” she said. “These people are often poor, under-served, newcomers to the U.S., uninsured. That’s where the epidemic is now. We have to go to the people. We can’t wait for them to come into clinics with advanced HIV infection. The sooner people know their status, the sooner they can start health care and not infect others. It’s no longer an epidemic of upper-middle class gay men.”
With an estimated one third of the population unaware of its infection status, HIV education and testing are pivotal.
Northeastern groups have addressed the epidemic through on-campus interventions of their own.
“People think they are exempt because of their social class or sexuality, but they’re not,” said Caitlyn Keckiessen, Northeastern Bisexual, Lesbian and Gay Association (NUBiLAGA) director of education and advocacy. “People need to know it’s not just afflicting people that are poor. It’s not just afflicting people that are of one gender or one minority. It’s not just afflicting people that are in a developing country. It affects everyone.”
Last December, NUBiLAGA held a week-long series of events during AIDS Awareness Month that featured a discussion forum, public speakers and a fund-raising concert. A show at afterHOURS attracted fans of local bands, bringing in people not affiliated with NUBiLAGA and educating them about HIV.
Keckiessen said the events were a success and plans to continue the educational series next year.
“There is an HIV crisis in Boston,” Keckiessen said. “Eighteen- to twenty-five-year-olds should be invested in learning how the disease is spread. Education is effective. If people just take the time, it would have a great effect.”
“Kyle” said he knows all about the horrific truth of facing HIV. But after the initial shock, “Kyle” found a world-class healthcare provider and began reevaluating his life. With highly active antiretroviral medication promising years of life once thought impossible for someone HIV positive, his world certainly is far from ruined.
“I don’t think my life is over anymore,” “Kyle” said. “In fact, for the first time, I think it’s just beginning.”
