With her glass-half-full outlook on life, Andrea Stubbs isn’t easily discouraged. This trait comes in handy for the manager of the Community HIV Program at St. Jude Children’s Research Hospital.
Two-thirds of Memphians diagnosed with HIV, the virus that causes AIDS, are ages 15–34. Memphis is among the nation’s top-10 cities with the highest HIV rates.
But these grave revelations don’t stop Stubbs in her tracks. Instead, they spur her to action.
For more than 10 years, she has led a local community coalition, Connect to Protect, or C2P. Its 25 members, including the local health department and county schools, work to improve HIV prevention and care for youth. Stubbs, Aditya Gaur, MD, clinical director in the St. Jude Infectious Diseases department, and C2P members are determined to eliminate new cases of HIV in Memphis by 2030. Their efforts are part of a global movement called Ending the Epidemic, or ETE.
Our plan can’t focus only on the physical aspects of infection and transmission, but also the social, spiritual and mental aspects that make up a total person.
For years, St. Jude has been the only comprehensive care center for HIV treatment in children and youth in Memphis. That work had its genesis in 1987, when the hospital’s founder, Danny Thomas, declared AIDS a catastrophic disease of childhood and prioritized HIV/AIDS research.
Through the decades, the hospital’s research and treatment efforts have contributed to far lower rates of the virus passing from pregnant mothers to their babies. The focus now is to replicate such gains in youth. Stubbs and Gaur hope to keep these individuals healthy through aggressive HIV prevention strategies.
“Of course, we can treat them once they’re diagnosed,” Stubbs says, “but how can we get to them before they take part in risky activities? We have opportunities to think broadly and creatively — and we’re using the community to help us develop novel and innovative ways of education.”
A holistic approach
ETE aims to prevent new infections and provide medication for everyone who is HIV positive. This would maximize patients’ health. It would also lower the chances of passing the virus on to others.
But eliminating new HIV cases requires overcoming social factors. Southern states are particularly hard-hit by HIV. Stubbs says “certain conversations aren’t happening in homes” about prevention tactics.
Memphis’ high infection rate is also tied to poverty, underemployment, single-parent households and lower education levels.
“We have to consider all those factors,” Stubbs notes. The coalition’s tactics include boosting awareness, busting stigmas and changing laws so youth under 18 can consent to taking an HIV prevention drug.
“Our plan can’t focus only on the physical aspects of infection and transmission,” Stubbs says, “but also the social, spiritual and mental aspects that make up a total person.”
HIV has come a long way, but continues to be a disease that, if untreated, can be catastrophic. What we and this coalition do fits perfectly with the St. Jude mission.
Between 30 and 50 new patients arrive at St. Jude each year for initial HIV treatment, with 250 to 300 receiving ongoing care. St. Jude is taking part in a clinical trial to test a long-acting HIV prevention drug in youth who are HIV-negative but at-risk.
“HIV has come a long way, but continues to be a disease that, if untreated, can be catastrophic,” Gaur says. “What we and this coalition do fits perfectly with the St. Jude mission.”
A major target of ETE is called 90-90-90.
Stubbs explains: “We know if we can get 90% of individuals who are HIV-infected but don’t know it to their first medical appointment, get 90% of those to take their medication, and then get 90% of those to have the virus suppressed in their system, we could achieve our goal of zero new infections by 2030.”
An added benefit is that quick testing and treatment, like that offered at St. Jude, often helps young HIV patients embrace the future instead of dreading it. Stubbs relishes putting the pieces in place for young people so they can successfully deal with something “so adult” as HIV.
“That’s why I do the work,” she says. “I always tell them, ‘Put me out of a job.’”
From Promise, Summer 2019