July 2003
As a Physician’s Assistant (P.A.) working in a women’s clinic, Tonia provides primary care to women living with AIDS. The women’s clinic is one part of a comprehensive Infectious Disease Program for a large health care system in the Southeast; Tonia has been working here for nearly two years. The entire clinic cares for over 4,000 people living with AIDS – attending to each individual’s needs, whether that is medical care, treatment education, mental health care, housing assistance or legal aid. As a P.A., Tonia juggles several different environments in any given week. Three to four days per week Tonia sees patient in the women’s clinic. In addition to performing routine medical exams, Tonia talks with patients about adherence, the side effects of ARVs, and writes prescription refills. Once a week Tonia cares for patients in the HIV and Hepatitis C co-infection clinic. Besides her clinic work, twice per month Tonia teaches an introductory class to patients who are living with Hepatitis C and AIDS. Mostly, Tonia and the class participants talk about the details of co-infection, treatment options, and possible side effects of the medications.
Tonia began working with the HIV community in 1987 as a volunteer for an ASO in New Haven, CT. She got involved with the AIDS community because “fighting AIDS is also about fighting homophobia, racism, and classism: all the social ills.” Tonia managed a group of volunteers for an AIDS hotline and Project Open Hand, a program that delivers meals to people living with AIDS. But she wasn’t entirely fulfilled; she wanted to make a more lasting and personal connection with people living with AIDS. This realization led her to become a PA, a career choice that has fulfilled her desire to work more closely with the AIDS community.
In Tonia’s eyes, one of the biggest challenges facing AIDS care providers is a vast misallocation of resources: “If we can come up with $70 billion to go to war with Iraq, why can’t we find the money to help people in this country dying of AIDS?” She also feels like more needs to be done to address substance abuse and it’s relation to the AIDS pandemic. There are personal challenges, too. “It can feel very isolating sometimes” – Tonia watched six of her patients die in the past two months.
This work isn’t easy. “But it’s incredibly rewarding, even when it’s really, really tough.” One of Tonia’s patients, who recently relapsed on drugs and went off her antiretrovirals, is now back on her meds and managing her disease, her life, and her garden! At a recent appointment, she brought in a bunch of ripe peppers from her garden for Tonia. At the end of the day, Tonia enjoys her work because she has a chance to learn about other people’s life experiences and believes these stories aid in her own personal growth. In addition to learning to work through her own feelings of isolation, Tonia has learned to honor her patients’ choices, cherish what hey have brought to her, and then let them go.
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