Health Department clinics that serve patients with HIV and other sexually transmitted diseases face a difficult situation as a result of a budget cut rendered them unable to test for HIV since last August
The Department of Health laboratory system is not testing HIV viral load or other studies that help monitor the patient's health. This prevents to measure the amount of virus in blood as well as it affects to detect is a patient faces complications due to certain medicine.
El Nuevo Día found out about this through several sources, who asked to remain anonymous for fear of reprisals. The information was then confirmed by Dr. José Vargas Vidot, an independent senator, and Rosa Rivera, an HIV-positive patient.
"Right now the Puerto Rico Public Health Laboratory, which is the state laboratory, has more than 2,000 tests delayed," said one of the sources and added that patients are recommended to go to private clinics or laboratories to get their tests, which results may take up to more than a month thus delaying treatments and endagering their health.
According to these sources, there were large budget cuts to the Centers for Prevention and Treatment of Transmissible Diseases (CPTET, Spanish acronym). In addition to the Latin American Center for Sexually Transmitted Diseases (CLETS, Spanish acronym) that operates at the Medical Center, the Health Department has CPTETs in Bayamón, Arecibo, Caguas, Carolina, Mayagüez, Ponce, Fajardo and a satellite clinic in Humacao.
"Without reagents we can not charge for the tests, that is we can´t meet the goal to be sustainable. It is a way of driving the service into a corner. It's like the ( Dr. Guillermo) Arbona system, which was destroyed," said another source.
"We had never faced such a situation before. You are caught in the dilemma of deciding whether you treat the patient (under these conditions) or not," noted another source.
To questions from El Nuevo Día, Vargas Vidot said he knew about the current situation of HIV patients that are treated in Health Department clinics.
He said that limiting funds for reagents of the Health Department laboratory started months ago and that he believes it should be the reference laboratory. If a protocol is followed (regarding the HIV program) then laboratories usually can report in a similar way, he added.
He said that many doctors had to stop treatment protocols to patients because they depend on a series of laboratory tests.
Vargas Vidot also said he thinks that Health authorities have not been very proactive in the fight with the Board because there are already some buyers from large corporations (for Health facilities).
He also highlighted the expertise of the staff at the Health Department laboratory, while lamenting that many HIV patients remain in uncertainty because they do not know the serological status of the virus and others cannot start their treatment because doctors need some tests to determine the best medications for them.
Meanwhile, Rivera stressed that it´s urgent for the government to intervene in this situation, particularly to avoiding breaching quality protocols.
“I am concerned about how a doctor can make decisions without (a patient´s) laboratory test results, how will he know if medications are working," Rivera said, noting that when patients get their tests at private laboratories tested, they also reveal they have HIV.
For several sources, there is a plan to close down or privatize CPTETs. In fact, they said that recently, Health Department employees visited some clinics with representatives from a U.S .company allegedly interested in buying those clinics.
"Right now, 85 percent of HIV patients are treated in the public health care system. There were 8,000 patients, however there may be less patients now since many left the island after Hurricane María., but now they must be less because after Hurricane Maria many left the island. The important thing is that with the treatment they receive, 92 percent (of the patients) maintain viral suppression due to a decrease in the level of detection that results in maintaining the disease as non-transmissible," said another source.
Meanwhile, on Tuesday, President Donald Trump announced a plan to “defeat AIDS in America and beyond,” eliminating 90 percent of new infections within 10 years.
Data from the US Department of Health warned that in Puerto Rico, Washington D.C. and another 48 US counties more than 50 percent new HIV diagnoses were identified between 2016 and 2017.
Dr. Robert Redfield, director of the Centers for Disease Control and Prevention (CDC), announced that Trump´s initiative is based on four strategic points: diagnosis of new cases, rapid and effective treatment, protection to avoid infections and rapid response to stop new outbreaks.
Rafael Rodríguez Mercado, Puerto Rico Health Secretary, said yesterday in written statements that he welcomed all federal plans that represent benefits to Puerto Ricans, specifically in the area of health.