In the Kansas City region, more than 3,700 people are living with HIV. For the last 24 years, the Kansas City, Mo., Health Department has received federal Ryan White funding that provides core medical and support services to individuals affected by HIV. The city’s Ryan White program serves about 2,900 people each year in the 11-county, bi-state region.
Of those, about 2,100 HIV-positive individuals are actively engaged in the region’s Ryan White Case Management Program, which makes sure they are connected to necessary medical care and treatment, are assisted with any financial barriers, and are linked to supportive services to address unmet needs that could damage the success of HIV treatment. Locally, the Case Management Program consists of Good Samaritan Project, Kansas City Care Clinic, Truman Medical Center, and University of Kansas Medical Center, each of which provide a high level of care and support.
The Case Management Program’s success can be measured by the percentage of individuals who are virally suppressed, a term that does not mean they are cured. Instead, it means that the virus is reduced to a level within the body that it is unable to destroy a person’s immune system.
A national group of AIDS directors issued a statement in February 2017 definitively stating that a person living with HIV who has achieved viral load suppression (measured at less than 200 copies of HIV per milliliter of blood) and is on antiretroviral therapy will not sexually transmit HIV to others.
In the United States, only about 30 percent of people living with HIV are virally suppressed. Missouri’s health officials estimate viral suppression in the state at 52 percent. In Kansas City, however, 85 percent of people enrolled in the Ryan White Case Management Program are virally suppressed. Directives to quickly link newly diagnosed clients to care and to start antiretroviral treatment early have played a huge part in making the program a success in Kansas City.
Kansas City’s Ryan White program will continue its work to improve health outcomes and enable those affected by HIV to live full and healthy lives. Increased efforts are now being made in the region to reach people living with HIV who have dropped out of HIV medical care or who have never engaged in HIV care. The program works to connect newly diagnosed patients to HIV care within 30 days after diagnosis.
The program is also creating new housing opportunities for people with HIV who are affected by intimate partner violence and integrating data systems between housing programs and case management to encourage collaboration and increase client success.
There is much to celebrate, but the path ahead is not without challenges. The Affordable Care Act, also known as Obamacare, was a big step forward for HIV-positive individuals. The ACA’s essential health benefits has guaranteed coverage at no additional cost for those with pre-existing conditions, such as HIV, and guaranteed coverage for medications prescribed by a doctor. Those benefits are vital to the well-being of individuals with chronic illnesses like HIV. The removal of annual and lifetime limits for insurance payments that the ACA provided is also critical. Uncertainty in the health-care landscape and any new legislation will pose challenges to people with HIV and to the Ryan White program.
The program is also adapting to an aging client population. Currently, 51 percent of Kansas City’s Ryan White Case Management clients are age 45 or older. Although most new infections come from younger populations, older individuals who contract HIV are more likely to be diagnosed at a later stage in the disease. Because they begin treatment later, there is an increased chance of damage to their immune system.
Those who have been living with HIV for many years often face complications from chronic inflammation caused by the immune system’s active response to the virus. This inflammation can increase an individual’s risk of cardiovascular disease, osteoporosis, anemia, and impairments to physical functions. Addressing all of the medical needs of HIV-positive individuals is important because co-existing medical conditions can complicate and compound one another, can often require highly coordinated treatments, and can delay or become a barrier to one’s HIV treatment if left unchecked.
Another challenge faced by the Ryan White program is reaching and engaging vulnerable populations such as youth, minorities, and transgender individuals. These groups have seen some of the greatest increases in HIV, and they are often some of the more challenging populations to engage and retain in treatment and care. Efforts for outreach, testing, and education to these groups is ongoing but will need to be intensified to ensure that those who are positive get connected to the care they need and that those who are not understand the risks and how to protect themselves.
Within the Ryan White system and the many AIDS Service Organizations of Kansas City, several amazing programs are dedicated to outreach and engagement with these vulnerable populations, including BlaqOut, Passages, Kansas City Transgender Empowerment Program, the HIMM Project, the Tool Box, Proud to Be Latino, CLEAR Program, and Represent Your Cupcake.
The Kansas City HIV and Ryan White communities have an incredible number of supportive individuals and agencies dedicated to combating HIV and making sure that those affected are able to live healthy, productive lives. Despite the challenges ahead, the Ryan White program, the Kansas City Health Department, and all the community partners seem well-positioned, prepared, and committed to overcoming challenges and working toward common goals of serving the HIV-affected and vulnerable populations.
Sean Ryan, MSW, is the medical case management system administrator for the Kansas City Missouri Health Department.
Editor’s Note: Information about Ryan White and the legislation in his name can be seen here: https://www.youtube.com/watch?v=UKB42cOtXrc#action=share
HIV Testing is available at:
Kansas City, Mo., Health Department
2400 Troost Ave. 816-513-6379
Kansas City Care Clinic
3515 Broadway 816-753-5144
Good Samaritan Project
3030 Walnut 816-561-8784
For more information visit: igotmineinkc.org
If you are a person living with HIV looking to engage in treatment or care, please call the Kansas City Health Department’s HIV Hotline at 844-552-8420.
If you are a person living with HIV, an ally, or an advocate looking to get more involved in HIV programs, outreach, or planning, please visit the Kansas City-TGA Planning Council Facebook page: https://www.facebook.com/KCTGARyanWhitePlanningCouncil/
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