As she trained for her career as an infectious disease specialist, Dr. Mary Louise Decker, medical director of The Wright Center for Community Health’s Ryan White HIV/AIDS Clinic, worked with people dying of AIDS at the Gift of Peace AIDS Hospice in Washington, D.C.

More than 20 years later, half of the patients she treats at the Ryan White Clinic are over 55 and living healthy, everyday lives, thanks to decades of medical advances and the comprehensive care she and her team of dedicated and compassionate healers provide.

“The advances in treatment have been remarkable,” she said about the virus, which was once a death sentence. “Now, HIV is a chronic disease, similar to diabetes or hypertension.”

Dr. Decker and other staff members reflected on the advances made since the first World AIDS Day was observed on Dec. 1, 1988. Today, more than 70 million people have been infected with HIV, and about 35 million have died from AIDS since the pandemic’s start, according to the World Health Organization (WHO).

The Ryan White clinic, based at The Wright Center for Community Health Scranton Practice, 501 S. Washington Ave., treats more than 450 patients aged 18 to 84 from 14 counties across Northeast and Central Pennsylvania annually. It offers comprehensive services for people living with or at risk of acquiring HIV/AIDS, including prevention, testing, and treatment.

The Ryan White Clinic offers a whole-person approach to patient care, allowing patients to visit a single site for a full spectrum of health services. In addition to medical care management, staff at the clinic offer behavioral health, dental care, and addiction and recovery services. Ancillary services include housing assistance, medical nutrition therapy, emergency financial assistance, and more.

“A patient might come for a general medical visit, but during that time, they will have their immunizations updated and their labs drawn and have the opportunity to talk to their case manager or with a behavioral health counselor. They’ll often meet with our nutritionist and maybe visit our food pantry,” said Dr. Decker. “We refer patients to specialists when appropriate. Many of these patients have not had access to these services before. It’s satisfying to see our patients looking and feeling well and caring for their health.”

Dr. Decker said the most significant change in HIV and AIDS treatment since the late 1980s has been the advances in medication. Azidothymidine, commonly called AZT, became available in 1987 to help people with HIV live longer. But it was expensive, and because the virus continued to mutate, it often stopped working. As scientists learned more about the virus, better drugs were developed during the 1990s.

It meant, however, that people living with HIV had to take “a handful of pills” every day, according to Dr. Decker. Today, people can take just one pill to lower the amount of HIV in their blood to undetectable levels, ensuring they will not develop AIDS. There’s also an injectable medication available to patients at the Ryan White HIV/AIDS Clinic and medication to reduce the risk of the patients’ partners becoming infected with HIV. 

Because of the effectiveness of new medications and the staff’s focus on making sure patients can obtain medication and take it as prescribed, most of the clinic’s HIV patients have virtually undetectable viral rates. That ensures the patient will not develop AIDS, allowing them to live long, healthy lives. It also means they cannot pass HIV to anyone else. 

“The overall goal of the Centers for Disease Control is at least 95% of the people diagnosed with HIV have virtually undetectable viral rates by 2025,” said Melissa Bonnerwith, grants administrator for the Ryan White Clinic. “Our viral load suppression at the Ryan White Clinic sits at 96.31%, so we’re already at the national goal.”

Despite the advances, the stigma surrounding HIV and AIDS remains, according to clinic leaders.

Sister Ruth Neely, CRNP, a Religious Sister of Mercy, began offering HIV outreach services in 1997, three years before The Wright Center’s Ryan White HIV/AIDS Clinic was formally established. She said many patients she works with still struggle with acceptance from family, friends, and society.

“I talked to one of my patients; he’s 80 years old,” she said. “And he said the stigma is still out there. It’s something he’s always dealt with.”

Dr. Decker said HIV and AIDS are discussed more freely than in the past. “We’re doing a  better job of getting the message out there,” she said. “The more we can normalize getting tested, the less stigma will exist.” 

WHO IS RYAN WHITE?

Ryan White was 13 when he was diagnosed with AIDS after a blood transfusion in December 1984. When the Kokomo, Indiana, teen tried to return to school, he faced AIDS-related discrimination in his community. Along with his mother, Jeanne White Ginder, he rallied for his right to attend school and became the face of public education about the disease. On Aug. 18, 1990, Congress enacted the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act — the legislation that created the Ryan White HIV/AIDS Program — to improve the quality and availability of HIV care and treatment for low-income people with HIV. Today, the Health Resources and Services Administration’s Ryan White HIV/AIDS Program provides HIV care and treatment services to more than half a million people with HIV.

The Wright Center received its federal Ryan White designation in 2003. Since then, the clinic has provided comprehensive HIV primary medical care, essential support services, and medications for those living with HIV, including the uninsured and underserved, throughout 14 counties in Northeast and Central Pennsylvania, including Lackawanna, Luzerne, Wyoming, Wayne, Pike, Monroe, and Susquehanna counties.