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Keystone Health Center's Community Outreach Clinic
Working Vanessa McDowell,
Keystone Health Center's Community Outreach
Coordinator, uses a model of the virus to explain
the life cycle of HIV. Currently, rapid increases in HIV infection are showing up among minorities, specifically in the African American and the Hispanic communities. As the Center for Disease Control and Prevention's HIV/AIDS Surveillance Report of December 1994 states, "Among reported cases, 1994 was the first year when Blacks and Hispanics together accounted for the majority (53 percent) of all cases reported among men." According to the Henry J. Kaiser Family Foundation's December 2000 statistics, there were 24,660 cumulative AIDS cases in Pennsylvania alone, 11,341 of which were Black and 2,645 Hispanic. While race and ethnicity are not risk factors, cultural barriers can result in increased risk factors including lack of medical coverage or transportation. Also, rural areas are not equipped with enough medical facilities or physicians to provide convenient health care. In rural, South-Central Pennsylvania, Joanne Cochran, president and CEO of Keystone Health Center, along with Vanessa McDowell, the Center's Community Outreach Coordinator, are working to provide minorities with adequate education and affordable health care as well as transportation to clinics in an effort to dispel the current stigma associated with HIV and AIDS. "The HIV/AIDS Lady," as she is know throughout the community, Ms. McDowell spends much of her week going out into the community providing free counseling and testing for HIV to those who are interested. Invited to attend group functions, churches, schools and employee meetings, Ms. Dowell will go anywhere she is wanted or needed. "I've administered the tests everywhere," Ms. McDowell says. "I've even tested someone in the back of their car." She is often found sitting in parks because, as she puts it, "people want to remain anonymous and fear that they might be recognized at a clinic - they feel safer in their own territory. But, I make a deal with them. If I'm testing them on their terms they have to get the results on my terms, at the clinic." Tuesdays are spent at Keystone Health Center where free HIV testing is offered as a service to the community. Ms. McDowell begins each encounter, both in the clinic and out in the community, with pretest counseling. "I get to know each patient personally, so they become trusting and comfortable around me," she says. "We go over the individual's risk behaviors, such as past or current substance abuse, unprotected sexual contact, or tattooing, that may have exposed them to the virus, making sure they fully understand the magnitude and life altering affects of the virus." She also explains the "window period." The "window period" is the time it takes for a person who has been infected with HIV to test positive for HIV antibodies. According to the Center for Disease Control, "antibodies generally appear within three months of being infected, but may take up to six months in some persons." Therefore, if the person has engaged in any high risk behaviors within the last three months, they will need to be retested again in three months providing they abstain from any additional high risk behaviors. The test is then performed. OraSure is a highly accurate, bloodless HIV-antibody test using cells from the patient's mouth. HIV antibody tests measure the presence of antibodies to HIV, which the body creates to fight the virus. It takes two minutes to complete the test and five days to receive results. Before the results are handed to the individual, Ms. McDowell explains what a positive or negative result means for the individual. "If the result is negative, we discuss reducing risk behaviors such as using condoms, getting clean or for those who aren't willing to end their addiction, methods of sterilizing needles," she explains. "I tell them, I've given you a new lease on life. You are empowered now. Take control and stay healthy." In the case of positive results, Ms. McDowell offers the patient a full range of medical treatment that is available through Keystone Health Center at no cost to those who apply. "I usually begin by setting the person up with one of our counselors, since most have a hard time dealing with a positive diagnosis," noted McDowell. I also explain that the diagnosis is not necessarily a death sentence. A person can live for many years, so starting the right course of treatment early can mean many more healthy years." Ms. McDowell tries to reach everyone in the community with her program, but particularly women. "Women, specifically minority women, represent the highest risk group. It's a vicious cycle - men infect the women and the women pass it on to their children." This, however, is not the case at Keystone Health Center. "We've had much success with pregnant, HIV-positive women or women who think they may have been exposed to the virus while seeking care," Ms. McDowell said. "If a pregnancy is monitored and followed through with drug therapy, the baby will most likely shed its mother's antibodies after 12-18 months and test HIV-negative. It goes to show that knowledge is truly power." Education is currently the only means of stopping this deadly virus. "We need to start with the children and push to abolish the myths surrounding HIV," urges Ms. McDowell. "Although there is still no cure for the virus, we've certainly come a long way. We have patients that have been with us for twenty years. That's some statistic." With a mission of providing quality health care in a compassionate manner to everyone in the community regardless of ability to pay, race or culture, or particular disease, Keystone Health Center reaches out to at-risk children and families, immigrants, migrant farmworkers, homeless people, the frail elderly, residents of public housing, a broad range of racial, ethnic and language groups, as well as those at risk for HIV/AIDS, substance abuse, and other chronic and catastrophic diseases. Keystone currently operates five primary care sites: Keystone Health Center family practice, Keystone Dental Center, Keystone Women's Care, Keystone Health Center-Path Valley satellite family practice, and the State Migrant Farmworker Administration Office. Keystone also operates one, year-round migrant and seasonal farmworker site in Berks County and one seasonal farmworker site in Adams County. Services are also provided through outreach workers and contracted providers in counties across the Commonwealth. Keystone Rural Health Center receives funding from the Health Resources and Services Administration (HRSA) and the Public Health Service Act. HRSA has designated the migrant farmworker and low-income populations and almost all of Franklin County a Health Professional Shortage Area and a Medically Underserved Area. Currently, Keystone Rural Health Center generates the majority of its revenues through services paid by Medicaid, Medicare, health maintenance organizations and private insurance companies. Keystone Health Center receives additional funding through the Ryan White III program. Title III early intervention services focus on counseling and testing for HIV and linkage to primary health care as early in the disease process as possible. For more information regarding Keystone Rural Health Center, please visit the website at www.keystonehealth.org. For more information regarding this news release, please contact Karen Gross at (717) 975-2148, or visit the newsroom at www.hersheyphilbin.com. |
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