HJAR Sep/Oct 2019

HEALTHCARE JOURNAL OF ARKANSAS I  SEP / OCT 2019 39 Nathaniel Smith, MD, MPH Director and State Health Officer Arkansas Department of Health To apply for the program, people must be HIV-positive, live in Arkansas, and have a household income between 100– 500 percent of the Federal Poverty Level. Those with a household income less than 100 percent generally qualify for Medicaid. Participants are rescreened every six months to ensure they still meet the eligibility requirements. Once enrolled, they can get help with primary medical care, lab services, dental care, insurance premiums, copays, deductibles, translation services, assistance to medical appointments, and substance abuse services. The AIDS Drug Assistance Program (ADAP) is a state- administered program that will also help with HIV-related medicine. ADAP pays for and mails participants’medications to their preferred address. The third important way healthcare providers can contribute to ending HIV is to choose to provide care to people with HIV. HIV treatment no longer needs to be provided by a specialist. The medication used for treatment is tolerable, has fewer side effects, keeps the virus undetectable, and combines multiple therapies into one tablet. It is important for HIV care to be offered alongside primary care so it is widely available and accessible statewide. The University of Arkansas for Medical Sciences and the RyanWhite program offer HIV telemedicine programs to help patients receive HIV care closer to home and to help primary care providers with education about care. TheADH also offers in-house training to interestedmedical doctors to become HIV providers. The fourth and critically important way healthcare providers can help end HIV transmission inArkansas is to prescribe pre- exposure prophylaxis (PrEP), a medicine that helps prevent HIV, to patients who are at risk and test negative for HIV. PrEP is a single tablet taken daily, which contains two medications that are 99 percent effective in preventing sexual transmission, and 74 percent effective when used by people who inject drugs. Arkansas needs more PrEP providers because there are more people at risk for HIV than people already infected. The state will not eliminate HIV transmission simply by testing and treating patients who are HIV positive; prevention is also important. Patients with health insurance may receive co-pay assistance from drug manufacturers or patient advocacy foundations. The ADH is looking at ways to identify high-risk people who could benefit from PrEP, while also encouraging healthcare providers to offer PrEP services. ADH staff are available to train any healthcare provider interested in offering PrEP services at their practice. Online training and continuing medical education credit is also available on PrEP from organizations such as the AIDS Education and Training Center (AETC) Program, which is the training arm of the Ryan White HIV/AIDS Program, and the International Antiviral Society-USA. Important contributions from the healthcare community can make an end to HIV a reality for our state. For more information on HIV testing or treatment and the Ryan White program, please visit the Arkansas Department of Health’s website at www.healthy.arkansas.gov . The RyanWhite Program inArkansas can also be reached by calling 501-661-2408. n “Important contributions from the healthcare community can make an end to HIV a reality for our state.”