District of Columbia: Rapid, Discreet Care for Those at Risk of HIV

Rapid-enrollment HIV/AIDS programs such as the one provided by the District's Whitman-Walker Clinic (WWC) are linked to more voluntary HIV testing, early diagnosis, and earlier start of care -- key targets in the fight against HIV/AIDS.

WWC launched its program in 2008. "We built from scratch. We basically flipped everything on its head in an effort to really try to ensure that there weren't barriers to care," said Erin Loubier, WWC's director of public benefits. "This is rolling out the red carpet. We want you to seamlessly move through because we want you in care."

In 2009, the D.C. Department of Health took note of WWC's program and began urging other clinics to adopt a similar approach targeting anyone in danger of becoming infected or spreading the virus: victims of rape or sexual assault, newly diagnosed patients, patients transferring to/from other providers, and those who have stopped receiving treatment.

This spring, the health department established a set of criteria for the programs, such as offering primary care within 24 hours of first contact and access to a case manager. And, because of HIV/AIDS stigma, the clinics must provide a codeword for new clients to use when they arrive for an appointment. Thus, "red carpet" at WWC, "youth connections" at Children's National Medical Center, and "Dr. White" at the Carl Vogel Center. "Everybody knows what you're talking about and you've never mentioned HIV," said Loubier.

The programs considerably reduce a process that used to involve hours of paperwork and separate appointments with a social worker, mental health specialist, nurse, and physician over a period of several weeks. "Now it's a bundled service as soon as they come in," said Katrina Jones of the Vogel Center.

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