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Center Gives L.A. AIDS Patients New Hope

Los Angeles Wave, News Report, Leiloni De Gruy Posted: Mar 06, 2009

The doors opened this week on the S. Mark Taper Foundation Center, a 2,500-square-foot one-stop shop of vital services for persons living with HIV/AIDS.

Founded by the non-profit AIDS Project Los Angeles, the new facility, located on the campus of the former Martin Luther King Jr.-Harbor Hospital, includes a full-service dental clinic with three operatories, a waiting room, a one-on-one consultation room, a lab, a sterilization room, a kitchen for food demonstrations and a food pantry.

The new center will complement the nearby OASIS Clinic HIV/AIDS Program, which provides medical care such as hormone therapy and care management, and the Drew Center for AIDS Research, Education and Services (Drew CARES), an affiliate of the adjacent Charles Drew University of Medicine and Science created to provide outreach services to the community.

I always had a fear of dentists [because of] the health of my teeth, said Wanda, a client and 55-year-old Los Angeles Unified School District retiree who would not disclose her full name but says she sexually contracted the disease from her late partner, an intravenous drug user. Then I had a phobia because at the time people didnt understand HIV and AIDS so I was afraid to tell the dentist not knowing that they know [just by] looking in your mouth, she said. I was afraid that they might sue me or I might get in trouble because of the bleeding. I didnt know the complexity of the HIV [disease] itself. I was still learning. So, I just started letting my teeth go because I was scared to go to the dentist, not realizing the infection that I was causing myself.

As a result she suffered from complications with eating and upset stomach due to tooth abscesses. After a long, painful wait, her physician at the OASIS Clinic, recommended AIDS Project L.A. Dental Services near downtown Los Angeles.

I felt more cared about. They talked to me to calm my fears and walked me through every procedure, she added. We talk about different things like where Im at with the virus and how I feel. They make me feel good, like somebody loves me. You know, like Im not out here by myself. According to APLA, more than 70 percent of HIV-positive people in L.A. County need dental care, but fewer than 10 percent receive it, due to financial hardship, lack of transportation, and the fear of letting their status being known.

But APLA Executive Director Craig Thompson, who has worked for the organization for almost 12 years, added that many who attempt to get dental services from normal dental clinics are turned away. In the early days the discrimination was against the fear of HIV. Now, we have universal precautions.

So, no one should be worried about that but they still are, he said. The bigger issue really for most [dentists] is that HIV dentistry takes longer because [the] HIV disease has oral manifestations and it actually complicates normal dental procedures.

For a patient without HIV, he said, a typical visit or procedure can take 30 minutes. For someone with HIV, it may take 45 minutes or more. So dentists dont [particularly] want to serve people with HIV because they dont get paid anymore and it takes twice the time. There has been a significant economic disincentive for them to do it.

Dr. Steven Vitero, a medical director at APLA Dental Services who previously owned his own private practice for 18 years, said that during his practice There was so much that was unknown and private dentists didnt want to treat patients anymore. They were afraid of the unknown, there were even classes on how to legally get rid of patients.

Even today, Vitero said, he talks to new clients who say they have been turned away, sometimes from dentists theyve gone to for several years.

Some oral conditions include fungal infections, chronic gum disease, shingles and intraoral herpes, but Kaposis Sarcoma dark lesions remains the most frequent oral malignancy.

In rare cases, we will see certain lesions that are rare in the general population with a person with a poor immune system. Well see warts, well see fungal infections but theyre rarely seen, usually those are indicators that the T-cells are down, that the immune system is not working as well as it should be, Vitero added.

This is why, he said, dental care is just as vital to those living with HIV/AIDS as is medical care and nutrition.

The new centers Necessities of Life Program food pantry will coincide with the work they do at the facility.

Proper nutrition is a powerful tool for the successful management of HIV disease, said a statement from APLA. People living with HIV often have deficiencies in essential vitamins and minerals needed by the immune system to fight off infection.

Based on a 2,000-calorie diet, every Thursday from 10:30 a.m. to 4 p.m., clients in the program will receive free pre-bagged groceries with dairy products, frozen meats, whole grains, fresh fruits and vegetables, canned and dry goods as well as personal hygiene products and cleaning products donated by vendors. Each person can access any of the organizations nine food pantries a maximum of four times a month equivalent of up to 16 bags of groceries. The pantry is expected to service 400 people annually.

One of those clients will be a 65-year-old retired labor worker, who was diagnosed with HIV in 1997. She volunteers at many of the food pantry sites as does she make her own four monthly visits. Receiving a small check each month for disability, she says, she wouldnt be able to afford medication and food without the help of the program.

They give you good nutritional food so you stay healthy, she said.

NOLP program manager Tonya Hendricks said people line up at some of their other sites three hours before opening. For many of our clients, we are their primary source of food, she said. In our program, we think of ourselves as trying to take away the struggle of Do I buy food for my family or do I get my medications this week?

In addition to an income screening, eligibility is contingent on each person seeing a dietitian or participate in a number of nutritional classes that focus on such things as diabetes, high blood pressure, food-water safety and how to understand food labels.

APLA Dental Services, established in 1985, was the nations first community-based dental clinic exclusively for people with HIV/AIDS and serves an average of 2,500 clients between its two already-established facilities and expects to service up to an additional 500 people at its new Watts/Willowbook facility.

Fees and co-pays are also based on income, but the reality is that 95 percent of the people that will use the dental clinic will be poor enough that they have no co-pay or they will have denti-cal, said Thompson. Their income cannot exceed more than $1,395 per month. The other five percent typically have a small co-pay.

Most of their operating expenses will be covered by a grant from the L.A. County Public Health Office of AIDS Programs and Policy, which also helps fund their mobile dental clinic.

The dental clinic at the facility will operate three days, Tuesday and Thursday the last day has yet to be finalized a week from 7:30 a.m. to 4 p.m. Vitero anticipates that the clinic will be open full time within the next year or two once it has grown its client base.

The construction of the facility/clinic, as well as the equipment inside, costs approximately $900,000.

The S. Mark Taper Foundation, to which it is named after, gave APLA a $300,000 grant, the rest was gathered through public and private partnerships one being the M.A.C. AIDS Fund.

The land on which it was built on was donated by the County of Los Angeles. Thompson credits former 2nd District county Supervisor Yvonne Braithwaite-Burkes involvement for the facilitys completion.

Burkes successor, Supervisor Mark Ridley-Thomas said dental care for people with HIV/AIDS has been identified as one of the most-needed services by people living with HIV/AIDS in L.A. County.

Thats why Im thrilled that this [new] AIDS Project Los Angeles [facility] is conveniently located near this areas largest provider of HIV/AIDS services, the OASIS HIV/AIDS Clinic.

This is the second time the S. Mark Taper Foundation provides funds to APLA. In 2004, the foundation donated approximately $25,000 to fund an APLA mobile clinic.

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