DESPITE IMPROVEMENTS in the rate of infection for injecting drug users and heterosexuals, the gay and bisexual men are still acquiring HIV/AIDS at significant rates, according to the executive director of AIDS Project Rhode Island.
Thomas Bertrand, the executive director of AIDS Project Rhode Island, chairs the Rhode Island HIV Prevention Coalition and is a member of the Rhode Island Board of Dentistry.
Bertrand earned a bachelor’s degree in biology and psychology from Vassar College in 1984, a master’s degree in organizational psychology from Columbia University in 1986 and a Masters in Public Health in epidemiology 1992 from the State University of New York at Albany. He has 20 years of public health experience in Massachusetts and Rhode Island, where he was the director of communicable disease programs.
An avid biker, he has completed two Outward Bound courses in winter mountaineering and white water rafting and spends most weekends exploring old country roads and bike paths throughout Rhode Island.
PBN: HIV/AIDS is no longer the public health crisis it once was. How many people suffer from this disease in Rhode Island today and how does your organization address the need for intervention?
BERTRAND: While we have witnessed tremendous advances in medical treatment for people living with HIV/AIDS since the start of the epidemic, I believe that HIV/AIDS is still an important public health issue for Rhode Islanders and that at least one risk group, gay/bisexual men, is in crisis. HIV/AIDS has remained a persistent public health problem since 2005, with 97 to 125 new HIV infections reported each year. Dr. Michael Fine, director of the R.I. Department of Health, has made “getting to zero” cases of HIV one of his top priorities.
Behind the overall numbers is good news for injecting drug users and heterosexuals, who have seen very encouraging drops in new HIV infections. In stark contrast, however, rates of new HIV infections among gay/bisexual men have been on the rise, with just 31 new HIV infections in 2000 and 62 in 2011, a 100 percent increase.
There are approximately 4,000 people living with HIV in Rhode Island. I estimate that this number grows by about 60-80 per year. It costs about $380,000 per person for a lifetime of HIV/AIDS medical treatment and care. So, while HIV has not been in the public eye in recent years, I consider it a major public health concern in Rhode Island.
As executive director, my goal has been to build comprehensive community-based programs and form partnerships to support HIV prevention, testing, and case management.
PBN: What is the most common misconception about AIDS today, now that the public is better educated, and how do you deal with that?
BERTRAND: While the powerful image of Magic Johnson, who has lived with HIV/AIDS for more than 20 years, has raised public awareness of the disease, that same image can overshadow its seriousness and potentially poor health outcomes, especially for those who can’t afford health care. While giving a talk to 200 students at Woonsocket High School this past spring, all of them recognized a picture of Magic Johnson, but not a single one of them recognized a picture of Rock Hudson when he was dying from HIV/AIDS in the late 1990s. The message that HIV/AIDS is a manageable yet still very serious disease seems contradictory. The realities of living with HIV/AIDS include a lifetime of medication, doctor visits, and confronting potentially profound social/personal issues regarding physical intimacy and relationships, stigma, and discrimination. From an economic standpoint, the lifetime costs for a single case of HIV are estimated at $380,000 – a tremendous cost to our health care system.
PBN: What does “living with HIV/AIDS” mean today and what helps sufferers cope best?
BERTRAND: People living with HIV/AIDS can lead full and long lives as long as they remain in medical care. In addition, our society has moved in a positive direction of being more open, accepting, and supportive of people living with HIV. I know of a person who, wanting to avoid the stigma of having HIV/AIDS, told his friends and family that he had cancer. How surprised was he when he eventually told them the truth and they were relieved! Coping with having HIV requires two things: getting appropriate health care, and finding support from friends and family who will provide love and acceptance. The website, www.thebody.com, has great information for those living with HIV.
PBN: How exactly does Family Service of RI help you accomplish your mission?
BERTRAND: About four years ago, APRI merged with Family Service of Rhode Island, one of the largest social service agencies in Rhode Island. A decision was made to make APRI a division of FSRI and keep its name and brand. The merger has allowed us to capitalize on FSRI's existing systems and programs to expand and strengthen APRI'S. For example, many of APRI clients now have real-time access to FSRI's programs related to mental health, trauma, and parenting. APRI views our clients from a holistic perspective, so being part of the expanded FSRI family has strengthened our ability to meet the needs of our clients.
PBN: As an avid biker and white-water rafting aficionado, you clearly have a passion for maintaining a healthy lifestyle. Is that a message you impart to those coming to you for help and if so, how do you communicate that?
BERTRAND: Yes, exercise as part of a healthy lifestyle is a very big part of my life, and this certainly is a priority for APRI and our clients. It is critically important for people living with HIV to eat nutritious meals and exercise. This helps many of them maintain body mass, improve metabolism, and absorb HIV medications. APRI administers programs that help people access dental care, free hot meals and groceries, and dental products like toothpaste and toothbrushes. We also formed a partnership with the YMCA of Greater Providence that offers group exercise classes for HIV+ people over the age of 50. Another important component of a healthy lifestyle for people living with HIV is having friends and social supports. Many of our clients are socially isolated, with few close friends and/or family members. APRI runs a drop-in center in downtown Providence two days a week where clients can meet, have lunch, and enjoy each other’s company while playing bingo, learning how to sew, or baking apple pies for Thanksgiving, to name a few activities. I often believe that helping our clients feel connected to a community (and having a little fun sometimes) is one of the most important things we can do for their good health and well-being.
If you want to help APRI and further our cause, I hope you will consider supporting me in the AIDS Walk for Life 2013: http://www.firstgiving.com/
Five Questions With: Thomas Bertrand,
executive director of AIDS Project Rhode Island