AIDS treatment goes suburban

Health care providers increasingly tend to patients outside city

May 13, 1999|By Jay Apperson | Jay Apperson,SUN STAFF

A clinic that for years has treated AIDS patients at its Mount Vernon headquarters is expanding to suburbia, reflecting a move by health care providers to treat a growing population of HIV and AIDS patients outside the city.

Chase Brexton Health Services is to mark the opening today of its Pikesville offices, an expansion that occurs amid signs that specialized care for the potentially deadly disease is in high demand in the suburbs and the far-flung areas of the state.

Even as Chase Brexton settles into its new location, the Johns Hopkins medical system AIDS clinic is planning to expand services at its satellite office in Baltimore County, and public health clinics on the Eastern Shore and in Western Maryland are for the first time treating patients who have human immunodeficiency virus and acquired immune deficiency syndrome.

Chase Brexton's expansion also occurs as studies show that Baltimore County residents account for an increasing percentage of new HIV infections in Maryland -- and that the Reisterstown Road-Liberty Road corridor of northwest Baltimore City and Baltimore County is particularly a hot spot.

"It speaks to the evolution of the epidemic," David Shippee, Chase Brexton's executive director, said of the statistics. "Many have opted not to acknowledge that HIV has permeated the county. Now, the evidence is there. That we and Hopkins are going there speaks to that."

Statistics collected by the state health department's AIDS Administration show that about 19,000 Marylanders have been diagnosed with AIDS since 1979. More than 2,300 new HIV cases were diagnosed last year, including 170 in Baltimore County.

While Baltimore City residents account for the majority of HIV and AIDS patients in the state, health care providers seek to make specialized treatment more convenient for patients who don't want to go to large AIDS clinics in the city.

"Some patients are seeking a more intimate setting a little more off the beaten path," Shippee said. He said some patients craving anonymity shy away from crowded waiting rooms in AIDS clinics, preferring to be seen at smaller offices that provide a range of medical services.

Some are fearful of venturing into the city, and others want treatment closer to home and work, Shippee said. He also said some patients out-side the city might have a more difficult time finding "nondiscriminatory" care from private doctors.

Dr. Liza Solomon, director of the state AIDS Administration, said, "Unfortunately, there is still stigma and discrimination, and I think that many people who are dealing with what is still a life-threatening illness want to be in an area where they feel welcome and where they will not experience subtle or not-so-subtle discrimination."

The effort to bring specialized services to the patient is important because evidence suggests that their prospects suffer if they limit their care to visits to their primary care doctor.

"Multiple studies have shown that people live longer and do better if seen by HIV experts. Yet people are willing to see someone who is not an expert rather than drive into the city," said Dr. Joel E. Gallant, director of Hopkins' Moore Clinic for AIDS patients at Hopkins Hospital in East Baltimore.

Gallant said that the demand for treatment at the Moore Clinic's satellite office at Green Spring Station in Baltimore County, which opened last year, has prompted plans to expand. Open two days a week, the clinic would be open daily under the planned expansion. "We sort of underestimated the demand," Gallant said.

County health departments across the state have expanded services for HIV and AIDS patients. Public clinics have opened during the past year in Western Maryland and on the Eastern Shore. A public clinic that opened in Frederick County in October has expanded, said Dr. Laura Cheever, director of the Johns Hopkins HIV Care Program to Maryland Counties, which provides services through grants and contracts with county health departments. "Every time we open up a clinic, the demand increases much more than we ever thought it would," she said.

Range of services

Chase Brexton's new location is in a three-story, brick professional building near Old Court Road and Naylors Lane. The organization began phasing in its operation there in February.

Shippee said the organization will provide a range of medical services beyond HIV treatment to the needy and those with private insurance.

Shippee said the demand for services beyond city limits is partly owed to a shift in demographics since the organization was founded two decades ago as the Gay Health Clinic for Venereal Diseases. He said many gay men, especially professionals with the means to relocate, have in recent years moved to suburbia to escape perceived city ills.

"Mount Vernon is not the enclave for gay men to live that it used to be," he said.

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