Nearly 6,500 Oregonians are living with HIV, according to the Oregon Health Authority—and half of them live in Multnomah County, Here’s what you should know about our local HIV clinic:
- Multnomah County’s clinic is the only comprehensive HIV clinic in the state.
Patients don’t just rely on the clinic for support with HIV-specific medical issues—the clinic also provides non-HIV primary care, mental health services, addiction counseling, nutrition help, and referrals to dental care. In addition to direct medical care, each patient also receives comprehensive case management, which can include financial assessment, benefits eligibility assistance, and crisis intervention.
- The clinic serves anyone living with HIV, regardless of ability to pay.
Though fewer than 10% of Oregonians today are without health insurance, thanks to the Affordable Care Act, cost can still be a barrier to getting treatment for HIV. “Part of our process is to link up everybody who’s eligible to insurance,” says Multnomah County Health Department pharmacist Debby Parrish. “We also have a sliding scale, as the whole health department does,” to cover any charges not covered by insurance.
This assistance can be lifesaving for the vulnerable populations that the HIV Health Services Center serves. Almost a quarter of clients are homeless or unstably housed, and 76% are low income. In addition, many patients struggle with substance abuse and mental illness, and 16% have limited English-language skills. And the population served by the county is substantial: a third of all HIV-positive Portlanders and a fifth of HIV-positive Oregonians receive care at the center—over a thousand people statewide.
- 2015 marked the clinic’s 25th anniversary.
In 1990, when the center opened, there was relatively little that could be done to treat HIV or AIDS. “In the early days,” says Parrish, “it was treating the infectious diseases, end-of-life planning, hospice, all of those awful things.” Early drugs had to be taken on a grueling schedule and often had debilitating side effects. (These days, treatments are far more effective, and one Portland researcher may be on the brink of a cure.)
- The HIV-positive population is getting older.
Almost half of clients are over 44 years old, a statistic that would have seemed unthinkable in the early days of the epidemic. As better drugs become available, people are living much longer with the virus, and that means a new set of health concerns. “We’re now dealing with aging,” says Parrish. “We’ve always done primary and preventative care,” but recent years have seen a shift toward treating issues like cardiac disease, diabetes, and osteoporosis.
- The health department’s approach is one of a kind.
Multnomah County has the distinction of having one of the few county health departments in the nation that offers not only screening and education, but full primary care for people living with HIV/AIDS. “It’s very unique,” Parrish explains. “There are some cities, like San Francisco and New York, that developed a clinic system, and a lot of HIV care clinics came out of university-based clinics, but as far as county health departments [that offers this range of services], they’re few and far between.”