Dr. Steven Klemow, with his Partners Clinic staff. (David Taffet/Dallas Voice)
PrEP, trans health and new alternatives for people with HIV are available around DFW
DAVID TAFFET | Senior Staff Writer
Advances in care for people with HIV or those looking to avoid HIV infection are happening at a rapid pace, and North Texas’ transgender population is also seeking services in higher numbers. And now, services offering those treatments are expanding to meet the need.
AOC, Planned Parenthood, Methodist Hospital and others are offering new PrEP clinics, transgender health services and STI testing and treatment clinics.
AIDS Outreach Center
AIDS Outreach Center, Tarrant County’s largest HIV services agency, is now offering several new health services.
AOC recently opened its new transgender clinic offering hormone replacement therapy, counseling and navigators at no charge. Currently, the clinic is open on the first and third Saturdays of the month. Patients should call for an appointment.
“We’ve gotten great feedback from people who’ve come in,” said Shannon Hilgart, AOC’s CEO.
She said about 30 clients have already taken advantage of the new services, and some said the clinic is the best medical experience they’ve ever had.
“I’m so glad we’re filling a need,” Hilgart said.
Navigators help clients with any referral to get through the system, whether it’s to another doctor for any other medical procedures or with a pharmacy for hormones or other medication needed.
AOC has also expanded its sexually transmitted infection clinic to include testing and treatment for syphilis, chlamydia and gonorrhea, all at no charge. Hilgart said funding for the STI programs comes from AIDS Healthcare Foundation, which operates an HIV/AIDS clinic in the same building that houses AOC. But these new programs are run by AOC.
The clinics also offer free HIV testing Monday through Thursday until 8 p.m. Call for an appointment. Hilgart said treatment at AOC is cheaper than anything offered by the county health department.
And in addition to the new AOC clinics, AHF also has a PrEP clinic planned.
Hilgart said that AOC and AHF are looking for more nurse practitioners and physicians to work part-time in the clinic. And when they find the right people, not only will the PrEP clinic open, but evening hours will be added to the transgender clinic as well.
Once that starts, Hilgart said, AOC navigators will be involved in that program as well.
“Navigators will insure those health outcomes are positive,” she said.
For more information, visit AOC.org.
Planned Parenthood has launched gender-affirming hormone services at five of its Texas clinics, according to spokeswoman Autumn Keiser.
And, she added, the agency is committed to expanding those services to all 21 of its health centers in the state.
Currently, trans healthcare services are offered at the clinics in Plano, Arlington and Denton in North Texas and at the North Austin and downtown health centers in Austin
In addition, every Planned Parenthood clinic in the state is offering PrEP and PEP.
Keiser explained that Planned Parenthood doesn’t provide counseling, but does offer hormone therapy through “informed consent.”
“Informed consent means you can demonstrate understanding of both the risks and the benefits of hormone therapy, and you and your clinician have both decided that this is the appropriate time for you to begin this process,” the organization explains on its website.
Planned Parenthood does not require patients to provide a letter from a therapist in order to begin hormone therapy.
Keiser said that Planned Parenthood does recommend counseling as part of good, comprehensive care and offers referrals to clients who would like to speak to a therapist before beginning hormone treatments.
Planned Parenthood follows the World Professional Association for Transgender Health guidelines and requires patients to be able to give informed consent, be at least 18 years old, have persistent gender dysphoria and have other medical or mental health issues reasonably well controlled before they can begin hormone therapy.
Keiser said its clinics are offering PrEP to more than just gay men., but noted 12 percent of Planned Parenthood’s patients already are men.
“Gay men are more likely to already know how important PrEP is as a tool to prevent HIV,” she said.
Keiser said Planned Parenthood is also reaching out to other vulnerable populations, such as women of color, in offering PrEP treatments. For those without insurance, the organization is helping clients fill out forms to receive assistance through the drug company.
For more information, visit PPGreaterTx.org/transgendercare.
Methodist Dallas Medical Center
Methodist Dallas Medical Center was one of the first hospitals outside New York and San Francisco to offer transplants to people with HIV. So it may be surprising that it’s just opening its first full-scale HIV/AIDS clinic.
Dr. Steven Klemow, who worked for years at Parkland Hospital’s Amelia Court, approached Methodist about their teaching program. His new clinic is training residents working with infectious diseases as well as treating people with HIV, their partners and others working to avoid becoming infected.
The clinic is located on the third floor of the Golden Cross Clinic, across the street from the main hospital at the intersection of Beckley and Colorado avenues in Oak Cliff.
“By the end of their training, these doctors will be HIV providers,” Klemow said of the residents training at his clinic. “They will have a good understanding of the ambulatory care of HIV.”
The medical center hopes to attract more residents by offering this specialty.
To create the most effective practice, Klemow said he’s hired a pharmacist to help patients with drug compliance and point them to 340B pharmacies throughout the area. The 340B Drug Discount Program is a federal program that requires drug manufacturers to provide drugs to eligible healthcare organizations at significantly reduced prices.
To make medications available at the best prices to his patients throughout the area, Klemow said he’s already made arrangements primarily with Walgreens pharmacies located in zip codes with the highest rates of HIV throughout Dallas. But if he finds that some of his patients are not being served, he can locate pharmacies closest to them and expand his network.
Klemow said his new practice is the only hospital-affiliated HIV practice in Dallas. For patients with HIV, he said, “If you’re admitted to Methodist, I will be involved in your care.”
When HIV-positive patients are in the hospital for something not related to HIV, Klemow said it is important to monitor their HIV drug adherence and interaction between HIV medications and any other drugs. That was something Methodist was careful about when it began doing transplants for people who were positive, because HIV medications aim to boost the immune system but transplant patients take drugs to suppress the immune system to help prevent organ rejection,
Methodist will offer its infectious disease medical residents a rotation in HIV. Few hospitals offer this specialty and few doctors are being trained in providing care to people with HIV.
At Parkland Hospital, Klemow partnered with Trans Pride Initiative to offer healthcare to the transgender community. Because of that experience and treating trans people with HIV, Klemow said he welcomed those patients as their primary care physician and would manage their hormones as part of their overall care.
The clinic is known as Partners Clinic at Methodist Dallas and is located at 122 W. Colorado Blvd. Surface parking is available in a lot behind the building. Parking can be accessed off Madison Avenue. The clinic is open Monday-Friday from 8 a.m.-5 p.m. For an appointment, call 214-947-6780.
Dr. Steven Pounders
Dr. Steven Pounders, one of the most experienced HIV specialists in Texas, has opened a PrEP clinic in his office. Rick Porter is running the clinic on Saturdays, from 9 a.m.-1 p.m.
“We’re reaching out to people who are not necessarily patients — anyone having trouble getting access to PrEP,” Porter said.
He said he’s heard from people whose doctors are unwilling to prescribe the preventive treatment or inexperienced in treating people with HIV.
Some patients have come in and said their doctors have equated PrEP with a license to have unprotected sex. Others use that as an excuse not to treat their gay patients, he said.
Porter said he thinks of PrEP the same way he thinks of vaccines: PrEP prevents disease.
The first consultation will take about 30 minutes. Some blood work is necessary to make sure prospective patients are candidates for PrEP. Clinic staff confirms that a patient is indeed HIV-negative and then check the patient’s liver function.
Subsequent visits should be no more than 15 minutes and four visits per year are necessary, Porter said.
The office takes insurance, and Porter said he’s working on a cash price for people without insurance. That price will include assistance from Gilead, maker of Truvada, the drug used in PrEP.
“The community needs more PrEP providers,” Porter said, noting that some people prefer a more casual setting, which is being offered elsewhere, while some prefer to have PrEP offered in a doctor’s office.
To make an appointment, call 214-520-8833 ext. 201 or 203.
AIDS Healthcare Foundation
AIDS Healthcare Foundation has opened a new pharmacy in the atrium of Building B at Medical City Hospital, adjacent to the AHF office.
“Doctors have embraced having a pharmacy there that can service the specialty needs of their patients,” said Bret Camp, AHF Texas regional director.
This is AHF’s second pharmacy in Dallas. There’s another in the organization’s Out of the Closet thrift store on Cedar Springs Road as well as one in it’s facility in Fort Worth, in the same building as AOC.
In addition, AHF has expanded in Texas, with three clinics in Houston, and the agency has plans to open facilities in Austin and San Antonio.
The Medical City office has expanded its services by adding a staff of four to do case management and medical case management. And AHF’s STI clinic has a new app that Camp likens to a medical record portal.
The app reminds patients when it’s time to make an appointment to come in for testing, gives results and stores them and even allows a patient to check in for an appointment without going to the window.