Growing demand for patient care and an aging HIV medical workforce create a looming crisis.
A growing shortage of medical providers with the knowledge and expertise to care for HIV/AIDS patients, particularly those in hard-hit minority groups, is threatening many of the gains made in the treatment and prevention of this complex disease. Two promising young physicians, Maya Green, MD, MPH, and Albert Slezinger, MD, have been awarded this year’s Minority Clinical Fellowship Awards by the HIV Medicine Association (HIVMA), part of an effort to address this disparity, and the broader shortage in the HIV medical workforce.
Today, 30 years after the first cases of HIV/AIDS were reported, many HIV clinicians are nearing retirement or have already left the workforce. At the same time, demand for HIV care continues to grow, with more than 50,000 new cases of HIV infection occurring annually. Minorities bear a disproportionate burden: More than a million Americans are living with HIV/AIDS today, and African Americans and Latinos account for 69 percent of the AIDS cases in the United States. But there are few African American or Latino physicians in this field of care, a trend seen in medicine generally.
“To end this pandemic, we must do more to ensure that patients in underserved minority communities have access to routine HIV testing and the expert HIV care and treatment services they need,” said Kathleen Squires, MD, HIVMA chair. “One of the best ways to accomplish this is by providing a pathway for talented minority health providers to focus on HIV medicine, which is why HIVMA created the Minority Clinical Fellowship program, now in its fifth year. Previous fellows are continuing careers in HIV medicine and working with these populations.”
The results of a major study (HPTN 052) from the National Institutes of Health, announced in May, showed definitively that early HIV diagnosis, followed by appropriate care and treatment by qualified professionals, can save lives and reduce the spread of HIV disease. “The challenge we face today, here and around the world, is translating our scientific advances into practice for all those who need lifesaving care,” Dr. Squires said. “These impressive young physicians, with their commitment and dedication to serving minority communities, will help reduce HIV-related disparities by providing expert HIV care in underserved communities.”
Each of this year’s fellows will receive funding to support a year of dedicated HIV clinical training, beginning in July, and mentoring and clinical support from an experienced medical professional in clinics that serve large minority populations. Dr. Green will complete her fellowship at Rush University Medical Center in Chicago and will receive mentoring and clinical instruction from Kimberly Smith, MD. Dr. Slezinger will complete his fellowship at Bronx-Lebanon Hospital Center under the mentorship of José Tiburcio, MD, a 2007 recipient of an HIVMA Minority Clinical Fellowship. The fellowships provide a stipend, plus benefits, as well as financial support for each fellow’s mentor for one year.
In 2011, HIVMA received support for the fellowships from the Gilead Foundation, Genentech, and Tibotec. Applications for 2012 are currently being accepted. Information is available at www.hivma.org.
About the HIVMA Minority Clinical Fellowship 2011 Recipients
Maya Green, MD, MPH
Maya Green, MD, MPH, grew up on Chicago’s South Side, in a community bearing the brunt of a growing HIV epidemic. A family member’s death, caused by HIV, shaped her decision to go into HIV medicine. “I didn’t know it then,” Dr. Green said, “but that loss would initiate a pivotal change in my personal and professional life.”
Her career path led her to pursue family medicine training as well as a master’s degree in public health. Dr. Green’s experience working as a health educator in Chicago also led her to investigate community health risks and implement strategies for interventions to address them. “My favorite activity was working with high school seniors in Chicago,” Dr. Green said. “We identified illnesses prevalent in local communities by talking with residents and local churches. We researched interventions and hosted health fairs where students worked together to create a presentation and screening booth where community members could learn about illnesses, be screened, and be linked to follow-up care.”
Treating individual patients is more effective when paired with community interventions, Dr. Green noted. “My personal and professional experiences have prepared me to offer both to those infected with HIV and those at high risk for becoming infected,” she said.
Working in family medicine showed Dr. Green first-hand the community-wide needs of underserved and underrepresented minority populations. “Understanding someone in the context of their environment enables physicians to better address that person’s needs,” said Dr. Green, noting that the factors that led to destructive behaviors in her childhood surroundings are the same ones that put patients at high risk for HIV or not staying in treatment after they are diagnosed with the infection. “I am fortunate that I can use those same past experiences to provide a broader perspective and an approach that combines the biological, psychological, and social.”
The HIVMA Minority Clinical Fellowship will complement the tools Dr. Green will use as she returns to her childhood community to provide much-needed medical treatment and community education, she said. “I look forward to making a powerful impact and encouraging others to walk in their own positive path.”
A graduate of Alabama A&M University in Huntsville with a degree in biology/zoology, Dr. Green earned her medical degree and master’s of public health degree from the University of Illinois College of Medicine in Chicago. Dr. Green’s fellowship will take place at Rush University Medical Center with mentoring and clinical instruction from Kimberly Smith, MD.
Albert Slezinger, MD
The career path of Albert Slezinger, MD, wound through Venezuela, the United States, and different medical specialties before reaching HIV medicine. During his residency specializing in family medicine at Bronx-Lebanon Hospital Center in New York City, however, he discovered a passion for working with HIV-infected patients from underserved populations.
For three years, he worked in a low-income neighborhood primarily populated by Hispanics and African Americans, where he learned important lessons about HIV treatment and prevention in these underserved groups. “I learned about inpatient and outpatient management of the disease, and also how important the role of primary care is in educating the community,” Dr. Slezinger said. “It is the most effective tool to avoid the disease.”
His training at Bronx-Lebanon Hospital Center working with HIV-infected patients led Dr. Slezinger to expand his experience by pursuing the fellowship. “I felt it would be the perfect way for me to progress in the HIV field,” Dr. Slezinger said. His goals include completing the foundation of his training in the prevention, diagnosis, and treatment of HIV disease using a multidisciplinary approach; using a variety of community and academic resources to help patients; and retaining a primary care approach to caring for those with HIV. “I want to help people with HIV/AIDS by responding to their needs in a culturally sensitive manner,” he said.
The training offered by the HIVMA Minority Clinical Fellowship will allow Dr. Slezinger to continue this important work in an area of great need for HIV/AIDS care, he said. “It will also give me the opportunity to share the knowledge I gain with others as I continue in my career, since I am interested in working in hospitals in underserved communities.”
Dr. Slezinger graduated with his medical degree from the University of the Andes School of Medicine in Mérida, Venezuela. Dr. Slezinger’s fellowship will take place at Bronx-Lebanon Hospital Center with mentoring and clinical instruction from José Tiburcio, MD, who was a 2007 recipient of an HIVMA Minority Clinical Fellowship.
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The HIV Medicine Association (HIVMA) is the professional home for more than 4,600 physicians, scientists, and other health care professionals dedicated to the field of HIV/AIDS. Nested within the Infectious Diseases Society of America (IDSA), HIVMA promotes quality in HIV care and advocates policies that ensure a comprehensive and humane response to the AIDS pandemic informed by science and social justice. For more information, visit www.hivma.org.