Copyright 2000 / Los Angeles Times
Los Angeles
Times
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October 6, 2000, Friday, Valley Edition
SECTION: Metro; Part B; Page 1; Zones Desk
LENGTH: 767 words
HEADLINE:
TRANSIT STRIKE STRANDS HIV PATIENTS;
MISSED APPOINTMENTS, DRUG
TREATMENTS COULD HAVE DIRE CONSEQUENCES
BYLINE: RICHARD
FAUSSET, SPECIAL TO THE TIMES
BODY:
In
another example of the MTA strike's disproportionate effect on the most
vulnerable elements of society, HIV and AIDS clinics in Los Angeles County are
reporting missed appointment rates as high as 50% since bus drivers walked off
the job in mid-September.
Although health-care facilities are reporting
more missed patient appointments overall, some health officials are especially
concerned about the effect of the strike on the thousands of low-income
HIV-positive patients in the county--because consistent monitoring, dosages and
adjustments are crucial elements of the drug cocktail programs many patients use
to combat the virus.
"One of the really important things with the new
cocktail medications is adherence to both the medical appointments and the
therapies," said Mark Henrickson, director of the Northeast Valley Health
Corp.'s HIV services division in Van Nuys. "If people can't get to clinics for
monitoring of their blood levels, they're going to be hit with potential
long-term consequences."
Northeast Valley's HIV clinic is one of those
most seriously affected by the strike, with 70 no-shows--or half of the clinic's
total appointments missed--since Sept. 18, Henrickson said.
The L.A. Gay
& Lesbian Center's Lambda Medical Group, which operates a number of special
HIV programs in Los Angeles among its general health-care services for the gay
community, reports a no-show rate of 25%.
Last week, the AIDS Healthcare
Foundation, which operates seven clinics in Los Angeles County, saw 15% fewer
patients than normal. This week, those numbers improved when AHF-commissioned
vans were dispatched to pick up stranded patients. "But that was out of our own
pocket, and we'll only be able to do that for a short period of time," said
Cesar Portillo, a spokesman for the private nonprofit foundation.
Keith
Waterbrook, director of health services for the Gay & Lesbian Center, said
that with the strike only three weeks' old, its effects haven't been devastating
for bus-dependent HIV patients--yet.
"There's flexibility," Waterbrook
said. "If you miss an appointment this week it's not that horrible, but it means
you need to be seen within two to three weeks. But if the strike continues, the
impact will be very severe on our patients."
Neal McCarty, 46, of
Northridge, is on two AIDS cocktail treatments; he also suffers from emphysema.
Normally reliant on buses, McCarty has been using his bicycle for medical
appointments and grocery store trips. Worried about discolored phlegm he's
noticed recently, he made an appointment at the northeast Valley clinic
Tuesday--a 30-minute trip by bike--but missed it, he said, "because I didn't
have the strength to ride down there."
*
Byanka Uriarte,
32, of Reseda, who is HIV-positive, has missed three appointments for hormone
treatments and blood monitoring since the strike began. "Without the blood tests
I have no way of knowing whether the HIV medication is working," Uriarte said.
Missing a prescription dosage is also a problem, said Dr. Robert Bolan,
director of the Lambda Medical Group. "Brief periods off medication result in
the virus reactivating and being able to reproduce in the presence of some of
the remaining drug in the system," he said. "And that's the circumstance under
which the virus develops resistance."
Bolan and others are worried about
bus users getting to drugstores to have prescriptions filled. "When you're
talking about a medically indigent population, waiting until the last minute to
fill a prescription is not unusual," AHF spokesman Cesar Portillo said.
Each year, Los Angeles County receives approximately $ 37 million in
federal Ryan White CARE Act funds--the county's main source of
money for the HIV services that help 18,500 low-income patients with HIV and
their families, according to Gunther Freehill of the county's Office of AIDS
Programs and Policy. About 5% of the funding goes to subsidized transportation,
including bus and taxi vouchers and van services.
But bus vouchers
aren't much help these days, and established taxi and van services can help only
so much during normal weeks. The Gay & Lesbian Center's Waterbrook said the
center has about $ 150 in taxi vouchers to give out each week.
Northeast
Valley Health Corp., which has one van serving five Valley HIV clinics, now
turns down five to six people per day who need rides, Henrickson said.
"We're booked solid, and we're desperate," he said.
Meanwhile,
at the clinic, he added, "We've got doctors sitting around looking at each other
saying, 'Where are the clients?' "
GRAPHIC: PHOTO:
Byanka Uriarte of Reseda, who is HIV-positive, has missed three appointments for
blood monitoring because of the MTA strike. PHOTOGRAPHER: DAVID BOHRER / Los
Angeles Times
LOAD-DATE: October 6, 2000
