HOLLI W. HAYNIE

A CCHS HIV/AIDS program patient talks to a counselor.

In 2005, Christ Community Health Services (CCHS) began an HIV/AIDS program to ease the burden on the Regional Medical Center at Memphis, which was handling the majority of HIV treatment in the inner city.

CCHS, a Christian, non-profit organization focused on fulfilling the healthcare and spiritual needs of the underserved population through health centers and outreach programs, already serves 80,000 patients in Memphis. CCHS clinicians and administrators saw that developing an HIV/AIDS program was an opportunity to include a severely underserved population.

Two years later, the CCHS HIV/AIDS program has been given a Center of Excellence designation by the Tennessee Department of Health through 2008. CCHS became one of 13 Centers of Excellence (COE) in the state and only one of three in Memphis.
“Christ Community Health Services is committed to continuing to provide HIV/AIDS patients with high-quality care, and we’re so honored to be selected as a Center of Excellence by the state of Tennessee,” said CCHS executive director Burt Waller. “We treated more than 200 HIV/AIDS patients in 2007, a milestone number for us, so to receive this designation now is very special.”

A COE designation is merit-based and a designated organization must renew its status annually.

State officials have estimated there are thousands of people infected with HIV in Shelby County who don’t know it. According to the Centers for Disease Control and Prevention (CDC), blacks make up nearly half of the population diagnosed with HIV in 2005. In fact, black women make up the fastest growing minority to be diagnosed with HIV. The majority population of Memphis is black, which means the numbers of diagnosed patients continue to rise.

The local population has a 2 percent positive rate, explained Dr. Rick Donlon, medical director of operations for CCHS. By CDC standards, a population with .5 percent should do universal testing. Testing is offered to anyone becoming a patient at a CCHS health center, Donlon said, noting positives have been diagnosed when patients came in for routine check ups such as prenatal care. With 6,500 people tested in 2007, CCHS is making an impact.

“We want to get people diagnosed as early as possible and treated as early as possible,” maintained Donlon.

Once HIV is diagnosed, patients can immediately begin treatment comprised of the latest drug combinations: a “cocktail” of drugs, such as protease inhibitors, which slows down the virus’ ability to replicate itself and progress into AIDS.
After a three-month HIV preceptorship in 2005 under Dr. Melissa Appleton at the Med’s Adult Special Care Center, Donlon launched the program. Since then, he’s trained five partners, plans to train more this year and will eventually expand the program to all CCHS health centers. Currently there are four, with a fifth opening this year, Donlon said.

Nathan Cook, HIV/AIDS program manager for CCHS, said the COE designation weaves into their bigger picture to “integrate HIV care into the primary care setting,” he said. “Treating (patients) for (HIV) at the same place they get primary care, makes them more likely to keep up care.”

Patients have the benefit of anonymity when they walk into CCHS. No one will know a patient is there for HIV treatment, Cook said, which will help them avoid the stigma attached to HIV and alleviate much of the anxiety people feel about receiving treatment, a big reason why some people never seek care. CCHS also works with the Healthy Churches outreach program for education on health issues, including HIV/AIDS awareness in the black community. They are also part of the Mid-South Coalition for HIV and AIDS as part of the Ryan White Part A Planning Council, which brought a $5 million grant to Memphis for HIV/AIDS testing and treatment.

The HIV program represents cohesive partnerships between CCHS internists and infectious disease experts at the Med and the University of Tennessee Health Science Center. UT infectious disease experts review cases and work with CCHS clinicians, most of whom are internists, to ensure care is being properly delivered.

According to literature from the state DOH, the HIV/AIDS COE project was created to focus on improving the delivery of services to persons living with HIV and AIDS within the existing TennCare network. Prior to the implementation of the COE project, the majority of HIV positive patients acquired their care through one of approximately a dozen clinics statewide, most of which were associated with university teaching hospitals. All designated Centers of Excellence utilize uniform treatment protocols developed by experts in the care of HIV and are endorsed by the managed care organizations.

“We’re pleased to add Christ Community Health Services to Tennessee’s network of AIDS Centers of Excellence,” said Jeanece Seals, Tennessee Department of Health director of the HIV/AIDS and STD program. “To receive this designation, the center has demonstrated that they have the capacity, expertise and desire to provide high quality medical care for persons with HIV/AIDS. The addition of Christ Community Health Center increases the access to life saving treatment for those in Memphis for whom living with HIV/AIDS is only one of the many challenges they face in surviving every day.”

CCHS was selected for the COE designation after a lengthy application process and site visit by representatives from Tennessee’s AIDS Center of Excellence Advisory Committee. Criteria for the selection included providing primary care to at least 50 HIV patients two times a year, receiving 10 continuing medical education credits in HIV care and maintaining COE standards of care.

The HIV/AIDS program at CCHS, Cook concluded, “has helped us be able to increase (the amount of) new cases; to find them and treat them. We hope this (COE designation) gives us more recognition among peers within the health department and other providers in the community that HIV care can be done in the primary care setting.”



In 2005 AIDS incidence increased by 28percent and deaths among persons living with HIV/AIDS increased 12 percent in Shelby County.

• 85 percent of the new cases were among blacks, and 13 percent were among whites.
• Two-thirds of the newly reported cases in 2005 were among males, and one third was among females.
• Incidence among males increased by 6 percent in 2005, compared to a 3 percent increase in incidence among females.
• HIV incidence was highest in 2005 among people 35-44 years of age.
• Youth (15-24 years old) comprised 19 percent of new cases, and people 55-64 years old comprised 4 percent of the new cases.