Barrett Newkirk

The Desert Sun

When a group of people in the early 1980s felt compelled to respond to the lack of help available to those dying of AIDS in Palm Springs, they retreated into the mountains near Idyllwild to devise a plan. They decided a dedicated charitable organization was the answer and returned to the valley floor to make it happen.

Over the intervening three decades, that charity helped desert cities weather the AIDS epidemic while growing to become a national leader among HIV and AIDS groups with a budget of more than $20 million.

More recently, Desert AIDS Project, as the agency is now known, has expanded beyond HIV and AIDS care while staying close to its roots. DAP is now as much about giving patients access to primary health care as it is about HIV and sexual health, an evolution due in large part to advances in HIV treatment and broad changes in the U.S. health care market.

With more changes looming under President Trump, DAP leaders say they plan to continue to be part of the bumpy ride into the future.

"In recent months, one out of every two new patients who comes to us doesn't have HIV," CEO David Brinkman said in a recent interview. "They are people who are traditionally not served by the health-care industry. They're people who traditionally live on the margins, and they're people who traditionally need a full medical home."

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The flu is as likely to bring someone to DAP as an HIV scare. Patients may be looking for their first visit with a primary-care doctor in years or the piece of mind that comes with a full STD screening. They may want to see a mental health counselor, dentist or chiropractor. They may be seeking out some of the expanded care for transgender people DAP added under the umbrella of a new community health department.

Brinkman, who has led the agency since 2006, said all of the new offerings aren't meant to take away from DAP's core purpose.

"Desert AIDS Project's name will remain Desert AIDS Project and our primary focus will be HIV," he said. "Our commitment is to people living with HIV first and foremost. But we have a responsibility given the success of the model and health outcomes that we have and the programs that we have built."

In 2015, DAP became a federally qualified health center, a designation that requires it to target marginalized populations and offer general health services on a sliding pay scale in exchange for better federal health-care reimbursement rates.

Brinkman said he hopes to announce plans before the end of the year for a major fundraising campaign to expand the facilities at DAP's campus at Sunrise Way and Vista Chino. DAP is already working to eventually add to its affordable housing program with new structures built on vacant land near the campus on Sunrise. The wait for an apartment in the 80-unit Vista Sunrise apartments on Vista China, which DAP already operates, can last between 1.5 years and more than three years. More heavily subsidized apartments require longer waits.

DAP's fundraising operation will be on full display Saturday when hundreds of supporters gather for the annual Steve Chase Humanitarian Awards. This year the fundraiser, which has a reputation for bringing in celebrity speakers and entertainment, will include performances by The Pointer Sisters and 90s dance hit-makers La Bouche. The dinner's theme is 90-90-90 for the international plan to end AIDS by 2020 by making sure 90 percent of people with HIV know their status, 90 percent of those diagnosed are on treatment, and 90 percent of those on treatment have suppressed their virus levels.

Steve Chase was a well-known interior designer and early supporter of DAP who died of complications from AIDS in 1994.

"The gala is an important statement every year to help people remember that HIV is not over, that there are a lot of people through the world and the United States living with HIV, and DAP and other organizations need to continue serving those individuals," said DAP board chairman Steve Kaufer, a Chase friend and another early volunteer with DAP.

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More than 1.2 million people in the U.S. have HIV and an additional 40,000 people become infected each year. New infections combined with the fact that positive men and woman are living longer mean the number of people living with the HIV virus is growing. In California, for example, the number of people with HIV grew by about 10,500 from 2010 to 2014, according to state data. More than 6,000 people in Riverside County are HIV positive, the state said.

HIV is less scary than it once was, allowing DAP to shift attention to new medical advances and new threats. Through its sexual health clinic The Dock, DAP provides testing for HIV and other sexually transmitted diseases as well as medications available to prevent infection, known as PrEP and PEP.

Targeting new diseases

DAP is making two other infectious diseases a large focus of its education and testing efforts. Since the 1990s, syphilis has seen a resurgence in the U.S., particularly among gay and bisexual men. Communities with large gay populations, including Palm Springs, have grappled with syphilis rates far above those seen nationally.

Hepatitis C, a viral infection that gradually wrecks the liver, is typically spread through shared needles although sexual transmission is also possible. Last year, DAP opened a new hepatitis C clinic with the goal of upping the numbers of people being tested.

"Everyone probably should be screened for hepatitis C at least once in their lifetime," said Dr. Shubha Kerkar, an infectious disease specialist at DAP. She added that the two highest risk groups are baby boomers (people born between the mid 1940s and mid 1960s) and intravenous drug users.

Brinkman said educating people about the need to be tested for hepatitis C and syphilis was an easy extension of DAP's Get Tested Coachella Valley campaign, which has sought to make sure every valley resident knows his or her HIV status. Brinkman has traveled to Washington to speak about the program so that it might be replicated in other parts of the country.

The Affordable Care Act and its provision to add more low-income people to Medicaid have been a driving force behind DAP's growth into more general care. In California, where Medicaid is known as Med-Cal, the ACA expansion has led to one third of the state being enrolled in the government health coverage. A repeal of the law, like the one vowed by Trump and Republicans in Congress, puts all that growth into question.

"There's been no talk of rolling back services at this point," Kaufer said. If changes approved in Washington do cut into the reimbursements going to DAP, then leaders will decide how to respond, he added.

Trump has said little about HIV and AIDS, but advocates see no reason to be optimistic about the future funding or a continuation of the Obama administration committed to work with international health groups to fight HIV. Language about the nation's HIV strategy, along with other discussion of LGBT issues, was scrapped from the White House website immediately after Trump assumed office.

Shortly before the inauguration, 113 U.S. AIDS groups signed on to a nine-page letter to Trump urging him to continue the work already underway to completely stop HIV. So far, the administration has not responded.

Brinkman credited the Affordable Care Act with linking an enormous number of HIV patients to treatment for the first time. Any repeal puts that progress at risk, but he said he's hearing there is no reason yet for Desert AIDS Project to retreat on its plans.

"DAP's been doing this work for three decades, much much longer than we had Medicaid expansion" Brinkman said. "It's not going to stop its work."

Barrett Newkirk covers health care. Reach him at (760)778-4767, barrett.newkirk@desertsun.com or on Twitter @barrettnewkirk.