Guyanese Physicians Visit UM’s Pediatric and Adolescent HIV Clinics

A delegation of Guyanese public health physicians toured the Miller School of Medicine’s pediatric and adolescent HIV clinics on August 4.

The four Guyanese physicians visited the Pediatric Care Clinic and Special Adolescent Medicine Clinic, where they engaged in observational sessions with the school’s renowned HIV pediatric specialists Gwendolyn B. Scott, M.D., professor of pediatrics and Director of the Division of Pediatric Infectious Disease and Immunology, and Lawrence B. Friedman, M.D., professor of pediatrics and Director of the Division of Adolescent Medicine — both of whom have been on the frontlines of Miami’s HIV epidemic since the disease surfaced in the early 1980s.

The group’s visit was part of a multicity peer study tour sponsored by the Centers for Disease Control and Prevention to provide Guyana’s Ministry of Health with knowledge of specialty health models that could benefit populations in Guyana. In addition to meeting with Scott and Friedman, the visitors heard ideas from a Miller School pediatric nurse practitioner and outreach and case workers who provide care and support to children and adolescents with HIV and their families. Two Miller School residents in Pediatrics from Guyana also gave the group a warm welcome.

“The reason we sought the support of the CDC for this peer study was primarily because we felt that we needed more experience in dealing with the HIV-positive teenage and adolescent population,” said Shanti Singh, M.D., M.P.H., program manager of the National AIDS Program Secretariat of Guyana’s Ministry of Public Health.

The English-speaking South American nation has one of the highest HIV and AIDS prevalence rates in Latin America and the Caribbean and receives assistance from the CDC Guyana country program and the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR). With a reported 250 HIV-positive minors currently in treatment in Guyana, the group was specifically interested in effective methods of diagnosing and providing comprehensive care to infants and young children and transitioning them into adolescent care.

At the pediatric care clinic, the group learned about effective HIV diagnosis, treatment and care for children, as well clinic organization, nutritional assessment and depression screening tools.

“These types of exchanges are very important, and we are happy to share our expertise,” said Scott. “We always learn from one another, and the challenges we face are very similar.”

They also spoke with young adults who had started care in the pediatric care clinic as young children and shared their experiences with being diagnosed with HIV at an early age, the associated stigma and transitioning into adolescent and adult care.

“What really impacted us is how well they knew of their disease,” said Singh. “They were very educated with what HIV is about and what it means to be living with HIV. They spoke well in terms of opportunistic infections, complications of ARVs (antiretroviral drugs), being on treatment and so forth, and for me personally I think that’s one of the things that I’ll go back home and try to move our adolescents along a continuum so that they can reach that level.”

At Friedman’s clinic, the group learned about the Miller School’s successful and innovative outreach methods that target adolescents for prevention, testing and treatment, and provide continuous support.
The Guyanese doctors expressed their challenges of getting youth in Guyana tested and screened. Friedman provided a history of UM’s long term, extensive research of children and adolescents with HIV and said that having improved drug therapy, a diverse team and capacity in outreach and support services has been key to UM’s success.

“We’re a diverse group racially, ethnically and linguistically,” said Friedman. “Because of this we’re not only able to attract at-risk and infected members of the adolescent population for testing and treatment, but also since 1994 we’ve been part of a research consortium to maintain an adolescent cohort with different protocols and studies that help us meet the needs, and observe how people with HIV of this age group behave.”

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