Listen with Care

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Natasha Travis, MD, helps shape the HIV learning curve for physicians and patients
by Chael Needle

Awarded a 2012 Minority Clinical Fellowship by the HIV Medicine Association, Natasha Travis, MD, is tackling head-on the disproportionate impact of HIV infection on minorities. She is currently completing her fellowship at Emory University, the Ponce de Leon Clinic at Grady Memorial Hospital, in Atlanta, Georgia, under the mentorship of David Malebranche, MD, and Wendy Armstrong, MD, but her interest in providing access to HIV screening and care to African-American communities and educating other African-American physicians, like herself, was forged in Milwaukee, Wisconsin. 

As a member of the Cream City Medical Society, an affiliate of the National Medical Association, the nation’s largest association for African-American physicians, Dr. Travis was made aware of one of its initiatives to increase HIV testing awareness among African-American physicians, and, consequently, as a majority of African Americans in Milwaukee see African-American physicians, among community members. The specialist in internal medicine helped to organize a screening event, now eight-years-strong, by collaborating with likeminded physicians and community-based organizations who were also interested in raising awareness about prevention and reducing HIV racial disparities related to testing and care for African Americans and others in underserved communities. The organizers took on the NAPWA mantra, “Take Control; Take the Test” and, by keeping their ear to the ground, they were able to tailor the outreach to the evolving needs of the communities. 

Thanks in part to her work on this screening outreach and her tenure as a member of the Wisconsin HIV Community Planning Network’s Statewide Action Planning Group, Dr. Travis became a firm believer in educating physicians outside of the HIV specialty about HIV screening and patient resources and, at the same time, allaying their fears about addressing HIV with their patients and linking patients to care if they are positive.

Asked if there are resources already in place in African-American communities that can be capitalized on in order to normalize HIV testing and care, Dr. Travis mentions some that have already been tapped—churches, community-based health fairs—but also highlights three groups that could vitally energize African-American care.

African-American physicians—of all specialties—are key. “I truly do believe in my heart, that when a doctor tells you to do something, you’re probably going to do it. So, the best influence that we have is for us as providers to encourage patients to take control of their own healthcare by getting the knowledge they need to take care of themselves,” says Dr. Travis. “If we can just get the doctors involved, not just [HIV specialists], but everybody, [then we can make a bigger difference].” HIV screening, for example, need not be the province of HIV specialists or HIV healthcare workers, she notes. Podiatrists, pharmacists, primary care workers, emergency room nurses—HIV screeners need to meet patients where they are and whenever they (often infrequently) seek care. All could be enlisted and further educated to improve linkages to screening and care. 

Indeed, Dr. Travis gravitated toward the fellowship, in part, as an opportunity to close her own knowledge gap about the ins and outs of HIV care when treating her own patients who are HIV-positive—dosing medications, monitoring resistance, managing side effects, and changing regimens, among others. In turn, she hopes to encourage other primary care doctors to enhance their own practice of medicine with knowledge about HIV screening and care.

Women can be a motivating force in prompting men to seek care. Notes Dr. Travis: “If you’re a man, who are you going to listen to? Moms, grandmothers, aunties, sisters—people who actually might really have a major influence in your life. We need to educate our women in African-American communities so that they can be the factor that causes somebody to do something!”

HIV-positive individuals already in care can guide and educate people based on their own expertise. “Someone who is already in care and already connected [may even be] a more powerful resource than your mother or your doctor—somebody who is living with HIV,” notes Dr. Travis.  “I wish I was talking only about HIV but I’m talking about African Disease Process. When it comes to diabetes, high blood pressure, people who are experiencing it are also the most knowledgable. Educators, researchers, and doctors—we don’t know half of what we could know if we just sat and listened to our patients who are actually going through it at this time.”

Stethoscope in hand, Dr. Natasha Travis is dedicated to making sure the heartbeat of HIV awareness among physicians, advocates, and patients is as strong as it can be.

Chael Needle wrote about the drug-drug interaction profile of pitavastatin, a drug used to manage dyslipidemia, in the August issue.

September 2012