St. Louis Magazine – July 2019

đĒ stlmag.com July 2019

The wraparound services are

important, Brown says, because

many HIV patients aren’t only

thinking about how to get access

to a doctor for treatment: “Many

of us have never had a time where

we didn’t have access to transpor-

tation, to a doctor, to food in the

house, to a stable home—most of

us have never had to think about

those things and then deal with a

disease. A lot of people with HIV

are thinking about those things

all the time and have to deal with

a disease.” To access services,

many patients have to go to mul-

tiple places, using up what little

resources they have in the pro-

cess. With this new model, plus

a combination of routine-based

testing and a regimen of PrEP,

a medication that lowers the

chance of infection in those at risk

for exposure, Brown envisions a

future in which all people living

with HIV in St. Louis achieve an

undetectable viral load—meaning

that they can’t transmit the virus.

Mitchell Ballesteros-Lynch,

a patient, compares EFA’s ease

of access to urgent care. “They

work alongside you, and as much

effort as you’re going to put into

it, they’re going to match that,”

he says. “They’re going to do everything they

can to keep you moving forward.” He has a com-

munity nurse, health coach, and case manager.

He can text one a question, and by the time he’s

taking a break at work, he has a response.

One thing that still surprises Brown is when

she encounters people who don’t know that this

system of care exists, which would be essential

to getting every HIV patient in St. Louis to an

undetectable viral load.

“Leave aside that we’re about to transform

HIV care in the St. Louis region because of this

model,” she says. “They don’t know that there’s a

system at all. We’re decades into this and we still

haven’t done a good enough job of letting people

know that there’s support, that you don’t have to

be scared? There’s more work to do.”

About 6,200 people in St. Louis
live with HIV, but just 54 percent
are receiving medical care. “What’s
evident in the data over the last 20
years is that HIV has a dispropor-
tionate impact on people with low
access to socioeconomic resources,
and what then overlies that pop-
ulation is inconsistent or lack of
access to health care,” Brown says.
EFA already offers free HIV and STI testing
four days a week, plus 20 case managers, seven
exam rooms, and an onsite lab. Brown leads a
tour of the sunny building on Locust, her tone
light as she shows off the condom supply room
(“Every size, flavor, and color”) and more seri-
ous when she explains the wraparound services
that will soon be rolled out. A mental health
suite, dental office, and food pantry will open,
allowing EFA to address not only a patient’s
most direct medical needs but also factors
that make it difficult for someone to live with
HIV. Most people with the disease whom Brown
serves don’t have access to dental insurance,
which is important because there are connec-
tions between oral health and overall health—
and HIV can have manifestations in a patient’s
mouth. And food? Another basic that patients
sometimes don’t have.

Good Script

Live near EFA, at 2653

Locust? Use its on-site

pharmacy to fill a pre-

scription, and the funds

feed directly into its

care program.

GATEWAY TOPIC A

Photography by Matt Marcinkowski

ĖěĒēĐ

PEOPLE LIVING WITH

HIV IN THE ST. LOUIS

HIV CARE REGION

SEX

5,1210HQ



1,109:RPHQ

AGE

3,595SOXV

2,327

292 

16 8QNQRZQ

RACE

3,505%ODFN$IULFDQ

$PHULFDQ

2,426:KLWH

176 +LVSDQLF

123 8QNQRZQ

TRANSMISSION

4,0080DOHWRPDOH

LQWHUFRXUVH

1,048+HWHURVH[XDO

FRQWDFW

963 8QNQRZQ

211 ,QMHFWLRQGUXJXVH

ACCORDING TO THE

MISSOURI DEPARTMENT OF

HEALTH & SENIOR SERVICES

HIV STATS

Mitchell Ballesteros-

Lynch (left) and

Tawnya Brown