HIV Specialist - March 2021 - 8

AT THE

FOREFRONT
Q&A with Dr. Michael Stefanowicz
Assistant Professor at the University of Texas Austin and a
Member of the HIV Clinical Leadership Fellowship Program
class of 2018-2020
Why did you choose to pursue a career
in HIV Primary Care?

I chose a career in HIV primary care for a few reasons. One, I was already
very passionate about the primary care movement in general, even before I
had an interest in HIV medicine. I chose family medicine because it has long
held a historically special place in advocating for whole person care. Many
people may not know this but family medicine as a distinct specialty was in
many ways born out of the counterculture movements of the 1960s. Family
Medicine was a direct response to the trend towards partitioned specialty
care. It focused not only on the individual but their family unit, their broader
ecosystem, and the psychosocial influences unique to each person. If this all
sounds rather mainstream these days it's probably because it is.
In part, we have Family Medicine to thank for bringing the concepts
of whole person primary care to the forefront. HIV primary care is now
coming into its own as well and builds on these principles. With people
with HIV (PWH) living longer the trend has been away from strictly
HIV-centric care and more towards a focus on the traditional elements
of primary care: chronic disease management, primary and secondary
prevention, wellness, and aging in a healthy way. The HIV practitioner is
both primary care doctor and specialist. I think HIV care has also informed
primary care in so many ways. Primary care is now focusing more on teambased care, which is something that practitioners of HIV medicine have
appreciated for decades.

What brought you to the HIV Clinical Leadership
Fellowship Program in particular?

I had a fair amount of experience caring for PWH in my training at UT
Austin Dell Medical School's Family Medicine Residency. However, I knew
that I wanted to be more than a medical practitioner alone. I wanted to
accrue foundational skills that would empower me to be a change agent
for the healthcare system at large. The HIV Clinical Leadership Program,
in partnership with the Pacific AIDS Education and Training Center at
the University of Southern California, exposes fellows to a myriad of care
models around Los Angeles County, while at the same time housed within
a training ground with academic bonafides. It offered a unique clinical
training experience but also access to many excellent mentors who helped
me discern the right career path for myself.

What did you particularly enjoy about the HIV Clinical
Leadership Fellowship Program?
The breadth of clinical experiences is one of the biggest strengths of the
program. In HIV medicine we talk a lot about the " HIV Care Continuum "

8 

MARCH 2021   HIVSPECIALIST  WWW.AAHIVM.ORG

in terms of testing, linkage, rapid initiation
of ART, retention, and viral suppression. The
fellowship ensures that all fellows participate in every single-entry point on that care
continuum. Fellowship training requires all
fellows take call at the LAC+USC County
hospital emergency department to facilitate
face to face linkage for new HIV diagnoses
and to interface with patients who have not
been retained in care. We talk to patients
about their diagnosis and then arrange a
prompt follow up appointment at our continuity clinic, the Rand Schrader clinic. We
also see patients experiencing homelessness
at our EIS clinic in Skid Row and at the LA
County Jail. A few other training sites include the Maternal and Child Clinic (MCA),
Homeless Healthcare LA needle exchange
and harm reduction program, and the inpatient infectious disease consult service at
LAC+USC. It's an incredible strength of the
program that fellows can insert themselves
anywhere on the care continuum and so it
really offers patients flexibility in seeing their
same provider if life's circumstances change,
guaranteeing a level of care continuity that
few other clinical systems can offer.

What was your favorite
clinical experience and why?

I valued every clinical experience I was afforded but my time with our street medicine
team was my favorite. For those who may not
know, street medicine is an emerging model
of care focused on delivering medical care to
some of the most marginalized groups of men
and women in the U.S. living on the streets.
Keck Medicine of USC has a robust street
medicine program charged with delivering
care to persons living on the streets and
scaling up the pipeline of competent street


http://WWW.AAHIVM.ORG

HIV Specialist - March 2021

Table of Contents for the Digital Edition of HIV Specialist - March 2021

HIV Specialist - March 2021 - Cover1
HIV Specialist - March 2021 - Cover2
HIV Specialist - March 2021 - 1
HIV Specialist - March 2021 - 2
HIV Specialist - March 2021 - 3
HIV Specialist - March 2021 - 4
HIV Specialist - March 2021 - 5
HIV Specialist - March 2021 - 6
HIV Specialist - March 2021 - 7
HIV Specialist - March 2021 - 8
HIV Specialist - March 2021 - 9
HIV Specialist - March 2021 - 10
HIV Specialist - March 2021 - 11
HIV Specialist - March 2021 - 12
HIV Specialist - March 2021 - 13
HIV Specialist - March 2021 - 14
HIV Specialist - March 2021 - 15
HIV Specialist - March 2021 - 16
HIV Specialist - March 2021 - 17
HIV Specialist - March 2021 - 18
HIV Specialist - March 2021 - 19
HIV Specialist - March 2021 - 20
HIV Specialist - March 2021 - 21
HIV Specialist - March 2021 - 22
HIV Specialist - March 2021 - 23
HIV Specialist - March 2021 - 24
HIV Specialist - March 2021 - 25
HIV Specialist - March 2021 - 26
HIV Specialist - March 2021 - 27
HIV Specialist - March 2021 - 28
HIV Specialist - March 2021 - 29
HIV Specialist - March 2021 - 30
HIV Specialist - March 2021 - 31
HIV Specialist - March 2021 - 32
HIV Specialist - March 2021 - 33
HIV Specialist - March 2021 - 34
HIV Specialist - March 2021 - 35
HIV Specialist - March 2021 - 36
HIV Specialist - March 2021 - 37
HIV Specialist - March 2021 - 38
HIV Specialist - March 2021 - 39
HIV Specialist - March 2021 - 40
HIV Specialist - March 2021 - 41
HIV Specialist - March 2021 - 42
HIV Specialist - March 2021 - 43
HIV Specialist - March 2021 - 44
HIV Specialist - March 2021 - 45
HIV Specialist - March 2021 - 46
HIV Specialist - March 2021 - 47
HIV Specialist - March 2021 - 48
HIV Specialist - March 2021 - 49
HIV Specialist - March 2021 - 50
HIV Specialist - March 2021 - 51
HIV Specialist - March 2021 - 52
HIV Specialist - March 2021 - Cover3
HIV Specialist - March 2021 - Cover4
https://www.nxtbook.com/ygsreprints/AAHIVM/hiv-specialist-march-2021
https://www.nxtbook.com/ygsreprints/AAHIVM/G121337_AAHIV_122020
https://www.nxtbook.com/ygsreprints/AAHIVM/G119632_AAHIV_092020
https://www.nxtbook.com/ygsreprints/AAHIVM/G118334_AAHIV_062020
https://www.nxtbook.com/ygsreprints/AAHIVM/G116663_AAHIVM_032020
https://www.nxtbookmedia.com