Arlington AIDS/HIV Clinic Replaces Whitman-Walker Facility

By Ibby Caputo
Washington Post Staff Writer
Thursday, July 23, 2009

Large orange koi still swim in the pond in what used to be known as the healing garden at the former Whitman-Walker Clinic site in Arlington County. But the clinic's name on the side of the building has been painted over, and some of the only remnants of its former use are two white LabCorp boxes next to the entrance, empty except for a few manila slips that state "No specimens in box."

The clinic, which served the Northern Virginia HIV/AIDS community for more than a decade, closed this year because of financial constraints.

Two blocks down the road, at 5015 Lee Hwy., a clinic has opened to take its place, the sixth site of the Inova Juniper Program, which offers health care to people infected with HIV. The other clinics are in Springfield, Dumfries, Manassas, Mount Vernon and Reston.

Whitman-Walker transferred 170 of the 678 people treated at its Arlington site to one of the six Inova Juniper Program sites, said ReGina Newkirk, director of development, communications and community relations for Whitman-Walker. An additional 143 patients were transferred to one of two Whitman-Walker sites in the District, and a small number were moved to other providers, such as the Casey Center in Alexandria, the Carl Vogel Center in the District and George Washington University, Newkirk said. Other patients who had been seen by the clinic could not be reached, Newkirk said.

Charles is 59 and living with AIDS. He asked that only his first name be used because he has not shared his diagnosis with most of the people in his life. He was treated at Whitman-Walker's Arlington site before it closed. He had his first appointment at the new clinic June 25.

"They both care," Charles said of the clinics, adding that it bothers him that Whitman-Walker closed. "If I've known you for five years and then you move, I feel sad. I lost my friend."

Charles, who works as a consultant in Washington, said that he had a gap in treatment for several months and that he felt alone. He said he had questions about his medicine but did not want to go to another medical facility.

"It becomes frustrating to go somewhere where they are going to ask you 150 questions before they are going to answer any," he said.

Charles, who said he considered committing suicide after finding out he was HIV-positive, said he has kept his diagnosis a secret from everyone except his wife and health-care providers.

"It can very easily destroy you," he said. Charles said he feels comfortable at Inova Juniper because he knew some of the staff members previously. David Yoho, the doctor who diagnosed him as HIV-positive in 2004, is going to be his primary physician, he said.

"It's good for them to see familiar faces when they come in," said Michael Givens, a nurse at the new clinic who used to see Charles at the Whitman-Walker site in Arlington.

Although the new Inova Juniper Program site is much smaller than the Whitman-Walker Clinic (1,500 square feet vs. 7,200 square feet on two levels at the Whitman-Walker facility), it has two exam rooms, a waiting room and a counseling room.

The majority of HIV/AIDS testing in Northern Virginia is done at local health departments.

Karen Berube, the director of the Inova Juniper Program, said the standard of care in Juniper is that patients are seen by their doctors every three to four months. All patients have blood work done and are assigned a team of health-care professionals that includes a physician, a physician's assistant or nurse practitioner and a social worker. If a patient has advanced illness or needs extra care, a nurse case manager will also be assigned. A psychiatrist is available to prescribe medication if necessary, Berube said.

"Part of what is so great about the clinic is that we are [the patients'] primary medical home," Berube said.

New patients meet with an eligibility counselor to determine how their care will be financed. Juniper has a sliding-fee scale based on income, but the majority of patients do not pay anything, Berube said. Instead, they are funded by Medicaid, Medicare or private insurance, or they receive charity care through government and private donor grants.

"We work very hard to make sure it is not a stratified system of care," Berube said. "Whether you're insured or not, you get the same level of care."

Not many charts are on the shelves at the new clinic, but, Berube said, that will change quickly.

"The HIV community is very close-knit," she said. "Once people know about it, they will come."

As of late last month, the Arlington clinic had 198 clients, Berube said. Eighty-seven of the clients are black, 61 are Hispanic, 44 are white, 5 are Asian and 1 is of mixed race. Sixty-nine clients are female, one is transgender and the rest are male.

Berube said she expects that by the end of the year, the new Arlington site will have 250 clients.

At the end of last year, there were 1,314 patients living with HIV or AIDS in Arlington, according to the Virginia Department of Health. Loudoun County had 236, Prince William County had 687 and Fairfax County had 2.091, according to the state.

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