Conversations from AIDS 2012: Dr. Lisa Fitzpatrick on the AIDS fight in America

WASHINGTON, DC—Dr. Lisa Fitzpatrick is medical director of the infectious diseases care center at United Medical Center in Washington,D.C., and now has about 100 HIV-positive patients. From 2005 to 2007, she also was the Centers for Disease Control and Prevention chief of party for the Caribbean. She spoke at several events in and around the conference, including a showing of the PBS Frontline film Endgame: AIDS in Black America. She was featured in the film, wrestling with issues around stigma and disclosure with her patients. She spoke to John Donnelly about what should be happening in the AIDS fight in America.

Q: What guides you in your work?

A: I love quotes, like ‘Life shrinks or expands in proportion to one’s courage.’ Another one: ‘Leap and the net will appear.’ They have been relevant throughout my career. You have to push the envelope. In order to get further than where you are now, you have to keep pushing things.

Q: What keeps you energized?

A: You have to remember who you are doing this for. You have to remember your patients.

Q: What’s your assessment of the domestic fight against AIDS?

A: I’m very worried. We have plateaued. We need to drastically reduce infections. We‘re not there yet. We still need to reach people on testing. A lot of the myths from 20 years ago are still out there. Things like, treatment makes you sicker than actual disease, or we still hear that HIV is a gay disease, and the only black men who have HIV are really gay. We have to address these myths.

Q: What about the efforts in DC to do community outreach to expand testing?

A: I don’t want to diminish the efforts. We’ve challenged a lot of people. For those who test, 0.9 percent test positive. It’s pretty low. But we are missing people. I know because they walk into my office in the hospital.

Q: What’s the answer?

A: I want to figure out how to do door-to-door testing. This is an amazing lesson we can learn from Africa. I want to look at the feasibility of door-to-door testing in a neighborhood in Ward 8 in DC. I think you need to get people excited about health screening, not just HIV. Testing vans are good, but we can make so much more impact on testing if we can get testing into a community. … If they can do this in Africa, they should do it here.
Wouldn’t it be wonderful if we set aside one year and test everybody in the US? That’s probably pie in the sky. But everyone who enters care, they should get an HIV test. That will give us surveillance data we need. We need to screen more people to figure out if this a really black epidemic. I’m not sure it is.

Q: What bothers you in your work?

A: There is a lot of waste in the system, a lot of program redundancy. People say the system is too big to try to change it. It is very difficult, but it can be done. We are spending $22 billion on the epidemic in the United States annually. So why do we have patients on waiting lists for drugs?

Q: What are the best strategies for preventing infections in the US?

A: The best strategy is education. It sounds trite. But people still don’t have enough information. There are some critical partnerships we need for people to talk about HIV, such as with the church or high-profile people in government. We need the entertainment industry.

Q: Is the church doing enough in DC?

A: We still have people who haven’t acknowledged the epidemic in the community. There is a pastor in Ward 8, his name is Bishop Matthew Hudson, and he is preaching about HIV/AIDS. Then you have ministers in the Endgame film who say HIV is God’s scourge on the homosexual life. Unfortunately, the latter is more common than Bishop Hudson. They wield such incredible influence. They are counselors, they are friends, they have so much credibility in the black community.
 

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