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HIV and Illicit Drug Users: Part II
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Case Study for HIV and Illicit Drug Users: Part II - eRounds:
This case is by: Dr Marci Drees of the Christiana Care Health Systems in DE. Marci Drees, M.D., MS, FACP, DTMH, is the infection prevention officer and hospital epidemiologist for Christiana Care Health System. She is also an active researcher on the causes and prevention of diseases through her work as clinical investigator with the Center for Outcomes Research and co-director of Resident Research for the Department of Medicine.
The patient (JL) is a 62 yo man with HIV/AIDS initially diagnosed in 2002. He also has diabetes and chronic hepatitis C. He quit drinking alcohol in 2002 but continued to smoke tobacco and use crack cocaine intermittently. He returned into care in October 2013 after receiving no HIV or primary care for 2-3 years. At this point, his CD4 count was 293 and viral load was about 75,000 copies/ml. He had last used cocaine 3-4 days previously but stated “I can quit anytime.” He returned for a follow-up visit 1 month later, anxious to resume antiretroviral medication.
He had not used cocaine in approximately 3 weeks, and denied any anxiety about his ability to remain clean – “I’m in a really good place right now.” He was given new prescriptions and instructions to obtain labs in 3 weeks and return to clinic in one month. He has not followed up with obtaining labs, and has missed this and another subsequent visit. His phone number is now disconnected and so the clinic is unable to reach out to him to return to care.
About the Speaker. I. Jean Davis, Ph.D., P.A., AAHIVS, is an HIV Specialist at Desert AIDS Project Team. She has decades of HIV Education and Clinical Care. She became a faculty member of the AIDS Education Training Centers in the early 90s. She became board certified nearly 10 years later as an HIV Specialist. She has trained 100s of provider in the area of HIV and related issues and provided care for 100s of persons with HIV and their families.
Dr. Davis received a Bachelor of Arts Degree in Psychobiology prior to pursing a professional career as a Physician Assistant. She was one the first 300 PAs to be licensed to practice medicine in the State of California. Dr. Davis continued her education and received a Bachelor of Science in Human Anatomy and a Doctoral in Chiropractic Medicine. She was the first person in California to have the dual licensing as a Chiropractor and a Physician Assistant. Dr. Davis returned to school and completed a PhD in Preventive Medicine. She also has a Master of Science Degree in Clinical Research.
Her faculty positions have included Chiropractic Colleges, Physician Assistant Programs and Medical Schools. She has held faculty positions at Cleveland Chiropractic College, Charles Drew University of Medicine and Science and UCLA, Geffen School of Medicine.