By Jack Bunting

It’s getting easier for people to find the important care they need in 2021 through DAP Health Center (DAP). Top barriers people face are sheltering-in-place fatigue and lack of insurance with no idea where to turn. DAP has been paying attention to what patients say it takes for them to stay engaged in healthcare, which experts warn must not be overlooked during this pandemic.

Patient volume has steadily increased throughout the crisis, with about five new patients enrolling per day for ongoing primary care.

“People are answering the call to support each other and do their best to care for themselves and the greater public,” says David Brinkman, CEO. “As 2021 unfolds, DAP Health will continue to promote the wellbeing of individuals by creating solutions to reduce or eliminate disparities in underserved populations, including people of color.”

Keep Staying Home

Services at DAP Health are expanding in 2021, but patients won’t necessarily have to leave home in order to receive them.

Telehealth and Virtual Visits were immediately put into use last Spring at DAP, and patients were quick to embrace them. DAP says it will continue using the technology, and it will increase ways the platforms can be utilized by patients and doctors.

Health and income disparities for many in the Coachella Valley were already severe before COVID, and they have become much worse. DAP is addressing digital divide challenges by helping patients who have lost phone and Internet access.

Without Internet access, people are unable to communicate freely with their physicians, to access electronic medical records, to research health conditions and treatment, or find resources for healthy behaviors and lifestyle changes.

The Federal Communications Commission (FCC) and national organizations such as the American Public Health Association (APHA) have called reliable Internet access as a “super–determinant” of health because it affects numerous other social determinants of health, such as education, employment, and healthcare access.

With stay-at-home becoming a way of life, reliable phones and Internet have become vital for social and community context, an important part of staying healthy for anyone.

“We used to tell people to get off of their devices,” says Dr. Jill Gover, DAP behavioral health manager. “But during COVID, what’s important is that we maintain contact, communication and connection with each other.”

More Help with Wraparound Services

DAP opened one of California’s first COVID Clinics with a hotline, and at least 4,000 patients have been seen or tested for symptoms. These services will continue, but in 2021 DAP is also addressing some of the social determinants of health that are causing negative health outcomes during this pandemic.

Food and housing insecurity, joblessness, isolation, and access to healthcare can have a considerable effect on COVID outcomes, compounded by factors like race, ethnicity, and LGBTQ status. (CDC)

“Throughout 2020, we saw public health on center stage,” says David Brinkman, CEO. “And just as the AIDS pandemic of our founding taught us, it is apparent the critical role that health equity plays in the lives and wellbeing of humanity.”

With the coronavirus sure to continue on its destructive path well into 2021, DAP Health will expand its array of services even further.

Mobile testing and linkage to ongoing medical care in communities of color will greatly increase this year, and DAP is supporting programs to train medical clinicians in cultural competence.

New HIV Testing Set-Up at Revivals in 2021

Palm Springs Revivals, a location steeped in DAP history, will once again serve as the backdrop for bringing people closer to their health. The community will start noticing DAP’s Mobile Testing Van, with staff dispensing anonymous HIV tests that are self-administered at home. Follow up and linkage to care is always offered with testing from DAP, and we are answering our patients calls for additional ways of HIV testing, accessible in more places. 

HIV testing at DAP remains completely safe and open during this health crisis. But self-HIV testing is also available by mail. Anyone interested in finding out more should call April Cruz, diagnostic testing and outreach manager at (760) 656-8425.

Decades ago in the same complex, a group of off-duty medical professionals would meet AIDS patients at night to administer treatments in an era when HIV was still a mystery and conventional healthcare providers in the area were forbidden from treating people with AIDS. This was the beginning of Desert AIDS Project.

DAP is providing continuous access to HIV, HCV and STI testing and treatment, plus access to PrEP and PEP.

“We are offering more ways of testing to fit our clients’ needs during COVID, whether it’s in the mobile clinic, our campus clinic, and for specifically HIV, a self-test,” said C.J. Tobe, director of Community Health. “We will do whatever it takes to offer HIV, STI and HCV testing, and then link anyone to treatment immediately if they need it.”

Living with HIV During COVID

Understanding COVID’s effect on people with HIV (PWH) is still developing among scientists, but DAP is acting now to boost resources for its HIV testing and treatment programs for people in the Coachella Valley.

Despite COVID, providing more HIV testing and better treatment for PWH remains essential to ending the HIV pandemic.

“If 90% of PWH begin antiretroviral treatment (ART) early enough, and they are consistently provided care, we will end HIV,” says David Brinkman, CEO.

HIV Medication & Care Quicker in 2021

DAP will cut the time between diagnoses of HIV and entry into care for patients in 2021, and will make medication available quicker, a move to prevent people from falling out of care. DAP believes this will also help decrease HIV transmission rates.

DAP Health offers services that PWH need to stay healthy and untransmittable to others. Patients become part of the DAP family beginning with testing, to linkage into care if testing positive, and then being enrolled in medical and mental healthcare, dentistry, social services, and prescriptions access. 

Documented viral suppression is usually possible when patients receive ongoing attention in these areas. DAP has the largest team of HIV-specialized doctors in this part of California experienced in aging with HIV and long-term survivors.

“We need to link investing in the wellbeing of people living with HIV to ending the epidemic,” says Bruce Richman, founder of the Undetectable=Untransmitable (U=U) movement. “Because when you invest in the wellbeing of people with HIV, you prevent new transmissions.”

DAP further helps patients thrive with HIV with access to social services they are eligible for, ensuring they receive needed food, housing, transportation, and home health care support if they need it.

Despite access to medication and care, people are still developing and even dying from AIDS in this community. Even before COVID, DAP’s early intervention program had 160 referrals for attempts to find patients who had stopped filling their ART prescriptions, ceasing their HIV treatment without explanation. (Based on calendar year 2019)

PWH will now receive antiretroviral therapy (ART) quicker after receiving an initial HIV diagnosis, or immediately after requesting it if they had stopped ART for any reason.

Failing with ART could result in catastrophe, especially with COVID’s compounded threat to PWH if they have compromised immune systems.

Falling through the cracks also could mean that some patients whose bodies had stabilized with life-saving HIV meds have stopped taking them, sometimes for five years or more. And for others, it means not starting therapy at all after receiving an HIV diagnosis.

Doubling Social Cohesion in 2021

Specialists say social isolation can be as harmful as smoking 15 cigarettes a day, but many are trapped with long-term social seclusion, worsened by this pandemic. In 2021, DAP Health will double access to specialized doctors and therapists whom patients can access from home, and a social services team to link them to programs and coverage.  

This includes one-on-one therapy and support groups focusing on mental health and substance abuse with emphasis on recovery and relapse prevention. Also offered are general wellness initiatives, socialization programs and activities to counter isolation.  

Danny Kopelson serves on DAP’s Client Advisory Board and considers himself as thriving with HIV, although living during a second major pandemic for him is full of reminders of the hardest days of HIV he survived.  

“When COVID was identified as a deadly virus, that immediately triggered a 40-year-old nightmare,” Danny says. “The bleak memories of AIDS in the 80s and 90s flooded into my head.” 

“Much of the language being used related to COVID is exactly the same as with AIDS,” says Danny.  

Familiar phrases and keywords can include testing positive or negative, antiretrovirals, antibody, resistance, and viral loads. 

“This is not an everyday conversation, so hearing it on the news immediately takes me back to the past.” 

As life during COVID becomes a reality, keeping Virtual Visits with doctors and using Zoom meetings for wellness services and groups are keeping life open for Danny and others.  “I’ve started to feel more hope,” he says. “I’ve gone back to doing yoga, meditating, volunteering and being in regular contact with family and friends; masked, distanced and with Zoom.”