Photo courtesy of Vivent Health
Vivent Health began in 1985 as the AIDS Resource Center of Wisconsin (ARCW), a small social service organization. Recently rebranded as Vivent Health, the new name emphasizes the medical aspect of their services and their expansion outside of Wisconsin to St. Louis and Denver. According to Vivent’s CEO Michael Gifford, “We will do whatever we need to do to make sure our patients are well cared for, and that’s why we are expanding nationally.” He adds that Vivent Health is the only HIV medical home recognized by the federal government anywhere in the U.S.
The HIV medical home concept is meant to address the poverty, drug use, homelessness, hunger and mental health that have fueled the HIV/AIDS epidemic that has affected more than 1.1 million people in the U.S., according to the Centers for Disease Control and Prevention (CDC). With all these societal issues working against HIV/AIDS patients, it can become difficult to manage their health.
Vivent Health uses a medical home system to ensure patients living with HIV/AIDS get their medication, while also supporting all other needs in their lives. “Vivent is about strengthening our response to the epidemic here in Milwaukee and all over the country. ‘Thrive together’ is in the tag line. That’s really important, because it’s about our patients and our staff coming together to help our patients thrive,” says Gifford.
Funding sources include Medicaid, insurance and revenue generated at Vivent’s pharmacy and from government grants. Five-percent of Vivent’s revenue comes from donors and special events such as the annual AIDS Walk. Vivent Health has been able to expand its services and locations. “It’s great fun to be able to do this, because we know the outcomes will be there. We know more people are going to get care; we know they’re going to be healthier,” says Gifford.
Medical Home Helps Address Stigma, Discrimination
While HIV/AIDS diagnosis rates for people living in Milwaukee have steadily decreased over the last 10 years, “thriving” after a diagnosis can oftentimes be difficult. People living with HIV/AIDS struggle with stigmas and discrimination when seeking medical care. According to Gifford, for example, an orthopedic surgeon outside of Vivent Health refused to operate on a patient because they had HIV/AIDS a couple of years ago. Such discrimination definitely still exists.
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Photo courtesy of Vivent Health
People of color are statistically more likely to have HIV; they often face greater challenges in managing their health, with a greater probability of being unable to reach the undetectable viral load outcome than do Caucasian patients. In Denver, Vivent was able to equalize the outcome between people of color and Caucasians through one-on-one patient care in their home medical service.
Vivent Health designed its medical home to manage all aspects of care throughout a patient’s life. Services such as dental care, medical care, legal counseling, psychiatric care, food pantry and housing services are all centrally located at Vivent Health, so patients can access what they need immediately. Patients can sometimes struggle to find transportation to their medical appointments, don’t have proper housing or lacking food. The model of care at Vivent Health aims to remove those types of obstacles, according to Vivent Health’s vice president of operations, Kevin Roeder. “We try to provide as many services as possible in one location for the patient or client, and we do that for a variety of reasons, but I think the most noteworthy one is it really helps address social determinants of health that are getting in the way of people caring for themselves,” he says.
In Milwaukee and elsewhere, poverty, lack of education, limited access to health care, homelessness, the stigma of AIDS and racism all affect populations of color more than white populations when dealing with health inequity, according to the Wisconsin Department of Health Services (DHS). “HIV is, sadly, a poster child for racial inequity and outcomes for health care. I don’t know of another health care provider in any diseased area that could say they eliminated racial disparity outcome. That’s the power of the model,” says Gifford.
‘The Power of the Model’
Treatments for HIV/AIDS can include PREP, or Pre-exposure Prophylaxis, which is a daily medication that, if taken, can prevent the spread of HIV throughout the body, according to the CDC. Viral suppression can also reduce the viral load in the body, making the virus undetectable in testing. These treatments help patients and, if they’ve reached undetectable status, can help prevent the further spread of HIV/AIDS. At Vivent Health, patients are 95% undetectable.
Access to medical care for those living with HIV helps prevent further infection and promotes healthier lives, according to DHS. In 2018, about 87% of newly diagnosed cases for HIV/AIDS were linked to care in Milwaukee within three months of those diagnoses, according to DHS’s annual report.
Referencing a patient named Kathy, Gifford explains the treatment she received at Vivent Health went beyond taking medication. After Kathy became undetectable, she started volunteering and eventually met a person she considered her soulmate. The couple moved from Milwaukee to start a new life, but shortly afterward, Vivent Health had to retrieve Kathy after discovering the soulmate had abused her. Upon returning, Kathy recovered fully again to an undetectable status.
“You show me another health care organization anywhere in America that would do for this patient what Vivent did for them. It just doesn’t exist,” says Gifford.
