HIV/AIDS Programs

How Do I Apply?

Individuals who meet the criteria may apply by completing and submitting the Program Application form and Release of Information  to the Part C Program. Income verification is required for this program.

Acceptable means of income verification are:

• Federal Tax Return
• W-2 Form
• 1040 Form
• 1040A Form
• Paycheck Stubs
• Medicare/Disability Payment Stubs
• Benefits Verification Letter

It is the responsibility of the applicant to provide information pertinent to the Part C Program. All information is confidential. It is also the responsibility of the applicant to notify the program manager of any changes in address, phone number, and income status.

Your Rights as a Patient

• You have the right to receive services regardless of sex, age, marital status, race, national origin, religion, creed, handicap, or physical disability; and no service shall be denied because of inability to pay.
• You have the right to an explanation, in the language you can understand, of your health status, or the care you will receive and of your right to refuse service.
• You have the right to the information necessary to enable you to give informed consent before your care begins.
• You have the right to be treated with courtesy and respect.
• You have the right to privacy.
• You have a right to expect that your health care will be handled confidentially.

Medication and Adherence

Starting to take HIV medicines is a big decision, and it’s natural to have some concerns. Like every big decision, you want to look at all your options and have all your questions answered. Fortunately, today there are several HIV medicines available, and the goal is to find the combination that is right for you.

You should make the decision to start therapy by working closely with your health care professional. Try to learn all you can about HIV medicines.

With so much information to take in, knowing when and how to start therapy can be confusing. This is especially true when you hear different things about HIV from different people.

Because starting therapy is such an important decision, case management services are available to help you answer some of your questions about starting therapy. Case managers will help support your decision and help you schedule your medications so that they work for you and your life-style.

AIDSinfo
The HIV/AIDS Clinical Trials Information Service (ACTIS) and its sister service, the HIV/AIDS Treatment Information Service (ATIS), have merged into AIDSinfo. Brochures, fact sheets, drug information, and clinical trial updates are all available, and may be accessed in English or in Spanish. 

American Social Health Association
The mission of this organization founded in 1914, is to develop and disseminate accurate, medically reliable information on sexually transmitted diseases to the general public. Visitors to the Association website can find updates on its current/upcoming activities. Accurate facts- with emphasis on dispelling common misconceptions- are also provided for each of 14 different sexually transmitted diseases.

The Body: An AIDS and HIV Information Resource
The resources offered by this site may be characterized in one of two ways. First, the site offers basic reference information in 550 specific topic areas. Second, the Body connects patients with healthcare professionals (a regular "Ask the Expert" section), professional assistance of other types (contact information for the top AIDS support organizations), and one another (flourishing bulletin boards on a variety of topics).

Clinical Trial Data
patients can gain immediate access to information about ongoing clinical trials

GMHC (Gay Men's Health Crisis)
GMHC is a "not-for-profit, volunteer-supported and community-based organization committed to national leadership in the fight against AIDS." Highlights of the organization's website include an impressive section dedicated to nutrition, complete with healthy recipes, legal brochures covering debt management, disability, employee rights, and the like, and a helpful, common-sense article describing "Ten Ways to take Care of Yourself When You Have HIV Disease."

Join United Nations Program on AIDS (UNAIDS)
For a more global perspective on the epidemic, visit this site, which offers a good deal of information on the disease itself, human rights and legal concerns, the epidemiology of HIV infection, and more. Click on "Publications" to open a huge archive of articles ranging from journalism to scholarship, where nearly any question you may have about the international effects of this pernicious condition is likely to be answered many times over.

National HIV Testing Resources
This site has resources on HIV testing including a national database of HIV testing sites and answers to many questions about HIV/AIDS and testing. This site can help people locate an HIV testing site in their area.

Pediatric AIDS Foundation
In 1988, wife and mother Elizabeth Glazer discovered that she, along with her children Ariel and Jake, was HIV-positive. In an effort to ameliorate the plight of the many thousands of families affected by the disease, Glazer co-founded the Pediatric AIDS Foundation and worked tirelessly on behalf of AIDS victims until her death in 1994. The Foundation offers fact sheets on pediatric AIDS, news reports, and information about events aimed at raising both money and awareness, at its home site.

POZ
Poz magazine tells the ongoing story of the AIDS epidemic; selected content, as well as the ability to subscribe to the print journal, is available here. Poz's editorial focus is mostly nonclinical, with topics such as "The 99 Greatest [AIDS-related] Moments of the 90s," but occasional articles do examine the drug pipeline and related matters. The journal is available in Spanish as well as English.

Megan, RN, BSN 
Nurse Case Management

Duties: Nurse Case Management through the Part C program offers assistance with medication adherence, side effect management, nutritional services, specialty referrals (i.e. ophthalmology, dental, psychological), etc. as well as education regarding HIV and the disease process. I attend physician appointments and assist with referrals, follow up care, appointment reminders, etc. I spend a lot of time going through lab results in relation to medication adherence. I teach those I work with about their disease, medications, and offer support in whatever area is needed.

Teagan

Case Management

Duties: Case Management through the Part C program by offering an assessment of client needs, especially focused on the most basic needs of food, shelter, transportation to medical appointments, etc. I make referrals to other agencies based on the individual needs of each client. I work closely with nurse case management to ensure the patient is receiving cost effective health care and support services.

Tammi, BSW
Health Program Manager

Duties: A portion of my time is dedicated to working with the Part C Program as the program coordinator. It is my job to make sure the program is delivered effectively and within the requirements outlined by the funder (HRSA).  I write the annual grant proposal and work closely with our staff and stakeholders to ensure we are providing care that is evidence-based and person-centered, as well as within the scope of the grant.

Case Management

Case management services are available for all clients applying to the Part C EIS Program. Case management can help clients access available services from such programs as Medicare, Medicaid, Ryan White Part B Program, drug manufacturer patient assistance programs, outpatient mental health and chemical dependency programs, outpatient nutritional services and translator services. Case managers are also available to help with adherence education for clients on HAART therapy and patients who are considering beginning therapy.

The Part C Program is only able to pay for outpatient primary medical services that may qualify for assistance. These services include disease related physicians visits, some laboratory services, dental services (please discuss with the dentist and the Part C program manager before services are administered as pre-authorization is required), case management, access to outpatient substance abuse, mental health therapy, and outpatient nutritional services. Please contact the Part C Early Intervention Services Program with any questions regarding services not specifically listed in this section.

FREE HIV/STI Walk-In Clinic Hours at Falls Community Health

Mondays: 8 a.m. to 12 p.m.
Tuesdays: 8 a.m. to 12 p.m.
Thursdays: 12 p.m. to 4 p.m.

521 N Main Ave. Sioux Falls, SD 57104. Call 605-367-8793.

Testing includes: HIV A/B Rapid Screening, Syphilis, Gonorrhea and Chlamydia. Treatment will be based on test results, client history, exposure, and type of infection.

Confidential risk reduction counseling prior to and after testing. Clients are highly encouraged to see a healthcare provider if symptomatic. Preliminary positive results are laboratory confirmed; Clients who test positive are referred to additional services and treatment as needed

The South Dakota Department of Health in Sioux Falls provides FREE testing at their location, at 4101 W. 38th Street Suite 102, Sioux Falls SD. 57106. Their office is located next to the Savers Store (to the west). Call 1-866-315-9214.

OR

You can be scheduled with a provider at Falls Community Health (there may be a cost for this visit). Call 605-367-8793

Mission

The Falls Community Health HIV/AIDS Prevention Program is committed to achieving the goals of the National HIV/AIDS Strategy.

• Reduce the number of people who become infected with HIV
• Increase access to care and improve health outcomes for people living with HIV
• Reduce HIV-related health disparities

550 people are estimated to be living with HIV/AIDS in South Dakota. Our goal is to ensure every HIV positive person is aware of their status, linked to quality medical care, and provided the support they need to lead a long, healthy life.

Services provided

• HIV/STI education
• Risk reduction counseling
• Free condom distribution (see map below)
• Ryan White Part C
• HIV medical care and treatment
• Pharmacist consultation
• Referrals

How Do You Get HIV?

HIV is spread through blood, semen, vaginal fluids, and breast milk. It can be passed from one person to another:

• During oral, vaginal, or anal sex without a condom or without being on medicines that prevent or treat HIV
• While sharing needles or equipment used to inject drugs or give tattoos or piercings;
• From a mother to her baby during pregnancy, childbirth, or breastfeeding.

HIV is NOT spread by:

• Air or water;
• Insects, including mosquitoes or ticks;
• Saliva, tears, or sweat;
• Casual contact, like shaking hands or hugging;
• Using public drinking fountains or restrooms.

Who should get tested?

The CDC recommends everyone age 13-64 be tested at least once as part of their routine health care. If you answer “yes” to any of the following questions, you are at increased risk for HIV infection and should get an HIV test:

• Have you had sex with someone who is HIV positive or whose HIV status you didn’t know?
• Have you injected drugs (including steroids, hormones, or silicone) and shared equipment with others?
• Have you exchanged sex for food, shelter, drugs, or money?
• Have you been diagnosed or sought treatment for an STD?
• Have you been diagnosed or sought treatment for hepatitis or tuberculosis?
• Have you had sex with anyone who has any of the risk factors listed above or whose history you don’t know?

You should also get tested if:

• You have been sexually assaulted;
• You are a woman who is planning to get pregnant or is pregnant.

About the Rapid HIV Test

The rapid HIV test looks for antibodies to HIV. If a person was infected with HIV, the body can take 3-6 months to make the antibodies. At 3 months, an HIV test has an accuracy of 97% and is the recommended guideline by the CDC for getting tested after a risk for HIV. The full 99.7% accuracy is achieved at 6 months. When it’s time to take the test, a clinician will ask you general health questions and discuss risk factors. A small sample of blood will be taken from your finger. The rapid HIV test takes 15 minutes for results.

What if my test is negative (nonreactive)?

If your last risk for HIV was less than 3 months ago, it is uncertain whether you have HIV. Another test would be recommended after the 3 month time frame has passed. If your last risk for HIV was more than 3 months ago, you can be confident you are not infected with HIV. If there is a known risk for HIV and you test negative at 3 months, it is recommended to get a follow up test at 6 months.

What if my test is reactive?

If a rapid test is reactive, a confirmatory blood draw will be taken and a recommendation to do full STD testing will be made. Early intervention services and HIV medical care services are available for people who are HIV positive. This service is funded by the Ryan White Care Act. There is currently no cure for HIV, but there are treatments that help keep the infection under control and programs to pay for these treatments. Many people with HIV live long and healthy lives.

We are required by law to report all positive test results to the South Dakota Department of Health (SD DOH). Your information will not be released outside of SD DOH (and even within SD DOH very few people have access to the information).

You can lower your risk of getting HIV by

• Choosing less risky sexual behaviors;
• Using condoms consistently and correctly;
• Reducing your number of sex partners;
• Using HIV medication to reduce your risk;
• Getting tested and treated for other STDs;
• Not having sex if drunk or high;
• Not sharing needles if injecting drugs.

Location of Free Condoms

Condoms are available at several locations in Sioux Falls and its surrounding communities. Condoms are provided free of charge to help prevent the spread of HIV and other sexually transmitted infections.

Learn more about condom distribution sites at livewellsiouxfalls.org.

Resources: 

• CDC
• AIDS.gov
• TheBody.com
• POZ Magazine
• Get Yourself Tested (GYT)
• SD DOH
• Heartland Health

Bills related to HIV/AIDS care need to be submitted to the Part C social worker after they have been submitted to other appropriate compensation programs (Medicare, Medicaid, and/or private health insurance). The Part C Early Intervention Services program cannot provide assistance if coverage is available through other compensation programs. The Part C Program may be able to help with charges that are not covered by other compensation programs. It is the responsibility of the client to forward HIV/AIDS health related bills to the Part C Program social worker.

A non-symptomatic HIV-infected individual usually does not require any special consideration when they are planning, or are in the provisions of, dental treatment. However, good oral hygiene is a must for the infected patient. Oral health should be established early in the disease process. Daily brushing and flossing and regular professional care are all important aspects of routine oral hygiene. Individuals should be seeing their dentist at least two times a year for oral examinations and evaluation. If oral lesions or other complications arise, call your dentist.

Dental treatment modifications for patients with HIV are based on the patient’s medical status, and not on HIV status. Complications reported to be associated with dental treatment of patients with HIV infections and AIDS have been rare.

Medications may interfere with dental treatment and cause adverse effects, such as decreased salivary flow. Interactions between some medications may occur. Please make sure that your doctor and your dentist know all the medications you are taking.

A diagnosis of HIV can be overwhelming; fear is a reasonable and expected reaction. The infected individual fears the disease’s progression- and fears rejection from friends, co-workers, and family members.

No matter how or why an individual starts using drugs, over time, repeated drug use causes significant, long-lasting changes in brain structure and function that lead to addiction. Today, addiction* is defined as compulsive drug seeking and using, even in the face of terrible personal and social consequences. It’s a chronic, complex brain disease. For many people, addiction takes over their lives, destroying their ability to function in family, workplace, and community. Use of alcohol or other drugs can further suppress the HIV-positive individual’s immune system.

Treatment can help because it offers the medical, psychological, and behavioral support that individuals need to stop using drugs. Outpatient substance abuse treatment programs allow clients to maintain their daily routine while receiving substance abuse treatment. Treatment can also play a major role in helping individuals adhere to recommended services and medications.

Risk reductions: Due to decreased inhibitions while under the influence of drugs and/or alcohol, individuals may participate in unsafe sexual activities, use injection drugs, and put themselves and others at risk for HIV transmission.

*Addiction is not the result of character flaws or moral failings but of profound changes in the brain’s function.

Mental Health

People with good emotional health are in control of their thoughts, feelings, and behaviors. They feel good about themselves and have good relationships. They can keep problems in perspective.

It’s important to remember that even people with good emotional health sometimes have emotional problems or mental illness. Mental illness often has a physical cause, such as a chemical imbalance in the brain. Stress and problems with health, family or work can sometimes trigger mental illness or make it worse. However, people with good emotional health have learned ways to cope with stress and problems. They know when they need to seek help from their doctor or a counselor.

Sometimes You Need to Talk to Someone:

• When you feel like you can’t do it alone.
• When you feel trapped, like there’s nowhere to turn.
• When you worry all the time, and never seem to find the answers.
• When the way you feel is affecting your sleep, your eating habits, your job, your relationships, your everyday life.
• When it’s not getting any better.

When you need to talk to someone who can help, you need an experienced, trained professional.

Routine Lab Work

In order for you and your doctor to know how best to fight your HIV infection, you will need to have blood tests on a regular basis. This will help you closely monitor yourhealth and any possible damage that HIV or other drugs you are taking might cause. In addition to common blood tests- like a Complete Blood Count (CBC) and a Chemistry Screen- you will need to have two more tests that help measure the progression of HIV disease.

T-cell count: As HIV disease progresses, the T-cell count goes from a normal count of 500 to 1500 cells in a cubic millimeter of blood (a drop, more or less) down to a count as low as zero. When the T-cell count goes below 200, there is an increased risk of opportunistic infections. When the T-cell count drops below 50, the risk rises dramatically.

Remember: A high T-cell count is good, and a low T-cell count is bad.

Viral load count: A test known as a viral load count, a viral burden count, of an HIV RNA count, measures the amount of HIV in a drop of blood. If only a small amount of virus is present (say 50 to 200 copies, depending on the test), then not all tests can detect the virus. This is what is meant when a viral load count comes back with a result of “undetectable.” It does not mean there is no virus present; it means that the amount of virus is so low that the test cannot measure it. As HIV disease progresses, the viral load count tends to rise, so that someone who starts with a very low viral load count (for example, 5,000 copies per drop) may rise to a very high viral load count (for example, several hundred thousand to almost a million copies per drop).

Remember: A low viral load count is good, and a high viral load count is bad.

Generally, your doctor will order a routine set of blood tests every three or four months. It may be more or less frequent, depending upon how far your HIV disease has progressed and what medications you are taking.

Nutrition

Proper nutrition is a powerful tool for the successful management of HIV disease. Medical research confirms that weight loss- especially muscle tissue wasting- often leads to malnutrition. Malnutrition has been identified as a co-factor that contributes to HIV disease progression. Nourishing foods, medications, and nutritional supplements all work together to fight the immune suppression initiated by HIV.

5 Easy Things You can do to Boost Your Nutrition:

1. Drink plenty of water, juice, and decaffeinated beverages
2. Try to consume at least 100 grams of protein each day. Proteins help to keep your immune system and muscles strong.
3. Eat three times a day or more. People who eat more often per day usually have an easier time keeping their weight stable. Try adding snacks between meals, or even eat six small meals.
4. Eat a mixture of fruits and vegetables every day
5. Talk to your doctor or dietician about the benefits of vitamins and mineral supplements.

If Mouth Sores, Dry Mouth, or Swallowing Difficulties Make it Hard to Eat:

• Try soft foods that are of a smooth consistency. Cut your meats finely or use a blender on them. Add a liquid to foods or dunk foods in a liquid.
• Avoid spicy foods, extremely hot foods, or foods with a high acid content (such as orange juice or tomatoes).
• Rinse your mouth frequently and drink lost of fluids.

What About Fevers and Night Sweats?

Your needs for both fluids and calories are higher when you have a fever. Remember to increase your intake of fluids. Drinks containing caffeine and/or alcohol should be avoided because they cause further dehydration.

Eating healthy should be near the top of your treatment plan. Health care professionals such as your doctor, your case manager, and your dietician can help you make food choices that are right for you, and they can discuss nutrition options with you.