Revolutionizing HIV Care: Jefferson Einstein Center's Journey from Stigma to Success

PHILADELPHIA -- The Immunodeficiency Center at Jefferson Einstein Philadelphia Hospital has witnessed significant advancements in HIV care since its inception in 1994. Initially founded to support 40 patients who struggled to find doctors willing or knowledgeable enough to treat their HIV, the center has now expanded its services to cater to over 1,000 patients, offering psychiatric, dietary, and social work support alongside medical treatment. Dr. Jody Borgman, an infectious disease physician and one of the center’s earliest employees, has been instrumental in this evolution. Recently stepping down as the center's medical director, Borgman reflected on the transformation of HIV treatment over the last three decades. "HIV treatment has come a long way from the early days," Borgman noted. "In the beginning, our patients faced complex regimens of 15-20 pills a day, accompanied by numerous side effects. However, by 2006, we were able to simplify treatment significantly, introducing a single tablet containing three medications that many patients could manage with just one pill daily." One of the most promising developments in HIV prevention is pre-exposure prophylaxis (PrEP), a medication aimed at individuals at high risk of contracting the virus. Although PrEP has been available for about a decade, its adoption has surged in recent years. Borgman emphasized its potential as a tool to mitigate the HIV epidemic, explaining, "If we can identify those at risk and get them on an effective treatment regimen, we can dramatically decrease not only the risk of infection but also the transmission to others." A notable innovation in this effort is TelePrEP, a telemedicine initiative that allows individuals to access PrEP without the need for a physical office visit. This model has made it easier for patients to obtain necessary prescriptions through online consultations and receive medications via mail or at a local pharmacy. However, Borgman acknowledged the ongoing challenge of reaching those who may not be aware of their risk. "Education is crucial," she said. "We focus on high-risk groups, including men who have sex with men, people who use injectable drugs, and those engaging in unprotected sex. Our outreach includes targeted advertisements and public awareness campaigns to inform the community about available resources." The landscape of HIV care has shifted, with a notable reduction in stigma within the healthcare community. Borgman remarked that primary care doctors are now more inclined to treat HIV patients, although some individuals still grapple with societal stigma. "While we've made great strides, there are still patients who feel they need to hide their status from family and friends," she explained. Despite this stigma, the advancements in treatment mean that many patients are now able to lead healthy lives, with HIV becoming a secondary concern. "For many of our patients, their health issues have expanded beyond HIV," Borgman said. "We find ourselves managing conditions like diabetes and high blood pressure, while for some, HIV is just a footnote in their medical history." What this means for specialized centers like the Immunodeficiency Center is a shift in focus. As HIV becomes increasingly manageable, the center can dedicate more resources to addressing comprehensive health and psychosocial needs. "Our patients are now thriving, and the tailored support we offer is invaluable," Borgman added. "This kind of personalized care might not be feasible in a standard primary care setting, where the focus is not solely on HIV." With the ongoing evolution of HIV treatment and prevention methods, there is optimism about the future. As Borgman concluded, "We have come a long way, and while there is still much work to be done, the trajectory is promising. The goal is to ultimately eliminate the HIV epidemic, and with innovations like TelePrEP, we are making strides toward that vision."