MY TOUGHEST CASE
Assisting Young HIV Patients
Although listing Dr. Wilcox’s accomplishments would require several pages and extensive explanation, describing what’s most important to him and at the heart of his career path is succinct and straightforward: helping others take control of their HIV status. As he says, “People shouldn’t be hesitant to be tested; everyone should be aware of his or her own status because knowing one’s own status is the only way to gain control.” This message is often easier heard than adhered to, as the population Wilcox focuses on includes those from birth to age 25, a group that due to development or immaturity often fails to take control of prescribed treatment plans.
After graduating from the University of Kansas School of Medicine, Wilcox completed a dual residency in Internal Medicine and Pediatrics at the LSU Health Sciences Center. Though in medical school he didn’t anticipate working with individuals with HIV, during his rotation with Charity Hospital’s HIV patients, he discovered his calling: “I found it to be a very interesting disease, but I also realized that I felt for the people who were struggling with the disease,” he says. In particular he remembers treating a 3-year-old who was HIV positive and who had a series of strokes. “I really felt for her; I found it very rewarding to care for her and those like her, and I knew that I definitely wanted to do that for a living.” Thereafter, he focused on treatment of HIV patients from birth to young adulthood, the population about which he’s most passionate. Building upon this seminal moment, Wilcox eventually opened an HIV clinic at Children’s Hospital.
Wilcox says that his toughest cases are treating young patients that won’t or cannot adhere to their prescribed treatment plans. The failure to adhere arises from various reasons, including immaturity and life circumstances. As he tells his residents, “HIV care is 10 percent prescriptive care and 90 percent psychosocial care.” Though prescriptions are critical, “one of your main jobs as a physician is helping your patients care for themselves wholly,” he says. Problems beyond the disease frustrate proper treatment and/or maintenance of the disease.
Patients invariably have mental problems, social problems, housing issues or generally have difficulty living with HIV, and these peripheral problems can be barriers to the treatment itself. For example, Wilcox recalls the loss of a young patient whom he had treated from her mid-teens, through pregnancy and until her untimely death. Due to numerous factors including age of disease onset and the responsibility of motherhood, the patient was never able to mature to the point that she could take control of her treatment and her HIV advanced. The loss was particularly difficult for Wilcox, who cared for her for so many years and sees this problem too often.
Another overarching battle he faces is the lack of preventative measures. He cites legislative defeat of efforts to include comprehensive sex education in public schools as a disservice to youth and the community. He is frustrated by the fact that 25 percent of those newly-diagnosed with HIV in Louisiana in 2011 were 25 years of age or younger, especially when his profession estimates that only 30 to 40 percent of people in the age group are tested. He says that young women usually learn of infection when they’re screened for pregnancy, while young men learn of infection after they become symptomatic or learn second-hand that a partner has been infected. Wilcox wants to change the community’s perception of HIV and AIDS. “AIDS isn’t a ‘gay disease’ or a ‘disease infecting only IV drug users;’ AIDS touches everyone’s life in one way or another,” he says. To that end, as Chief Medical Officer for the NO/AIDS Task Force, Wilcox has led the development of a Pre-Exposure Prophylaxis clinic and integration of behavioral health screening in the HIV primary care clinic, and he’s developing teams to educate the community about Hepatitis C.
To say Wilcox is busy is an understatement. In addition to his post at NO/AIDS Task Force, he’s the principal investigator for a grant to the LSU School of Public Health, the Delta Region AIDS Education & Training Center, an agency that educates health care professionals throughout Mississippi, Louisiana and Arkansas on treatment of patients with HIV/AIDS. Additionally, he sits on the Board of Directors as representative-at-large for the Communities Advocating for Emergency AIDS Relief Coalition. He is also the founding president for the National Alliance for HIV Education and Workforce Development.
He continues to be an advocate for his patients and the community in the battle against a disease that affects everyone’s lives.