Rick Cofer on the KIND Clinic’s Initiatives in Austin

The KIND Clinic in Austin, Texas offers healthcare services with a focus on sexual wellness in order to improve public health in the State. It continues to expand its services and experience measurable success with a goal of eliminating the risk of HIV infection to the greater Austin population.

Since it opened in 2015, the KIND Clinic has offered care to under-served members of the Austin community. What began as a volunteer effort now is a full-service sexual health and wellness clinic with patients from all walks of life and all sexual orientations. Its judgment-free zone enables its staff to deliver a high standard of care to those who need it most, particularly individuals without insurance and those who may avoid medical care as a result of stigmatization.

HIV As A Matter Of Public Health

The HIV and AIDS epidemic is an obvious yet underreported matter of public health in Austin and the world at large. According to UNAIDS, approximately 36.9 million people worldwide were living with HIV/AIDS in 2017. UNAIDS is an organization leading the global fight against this serious disease.

The World Health Organization considers Acute HIV Infection (AHI) an important issue facing the health of the global population today. It has stated that HIV/AIDS infection is one of the 10 greatest threats to global health in 2019.

[T]he epidemic continues to rage with nearly a million people every year dying of HIV/AIDS. Since the beginning of the epidemic, more than 70 million people have acquired the infection, and about 35 million people have died. Today, around 37 million worldwide live with HIV. Reaching people like sex workers, people in prison, men who have sex with men, or transgender people is hugely challenging. Often these groups are excluded from health services. A group increasingly affected by HIV are young girls and women (aged 15–24), who are particularly at high risk and account for 1 in 4 HIV infections in sub-Saharan Africa despite being only 10% of the population.

This year, WHO will work with countries to support the introduction of self-testing so that more people living with HIV know their status and can receive treatment (or preventive measures in the case of a negative test result). One activity will be to act on new guidance announced In December 2018, by WHO and the International Labour Organization to support companies and organizations to offer HIV self-tests in the workplace. – WHO

In 2017, the organization performed a research review to identify the cause of unidentified people with acute HIV infection and what could be done to resolve this serious matter.

There are undeniable clinical and public health benefits to AHI detection and treatment, but also substantial diagnostic and logistical barriers to implementation and scale-up. Effective early ART [antiretroviral therapy] initiation may be critical for HIV eradication efforts …. – The World Health Organization

After its review, the WHO identified issues in low and middle-income countries, but the level of undiagnosed and untreated infection in the underserved communities in America is also a huge obstacle to effective HIV management.

Clinics like Kind are working tirelessly to bridge the gap between the people who need care the most and are the least likely to find it and the services they need to live and prosper. When this population of Americans living with HIV is addressed, the spread of the disease can be significantly reduced.

What Is The Kind Clinic

Fighting stigma through education and awareness is a crucial component of our mission. – The Kind Clinic

The Kind Clinic illustrates its focus and goals through its very name. KIND stands for Knowledge, Inclusion, Nurture, and Dedication. These are the qualities this organization shows tirelessly in their fight to eliminate the risk of HIV in the Austin area.

The clinic’s purpose is to deliver measurable impact to the Austin community by providing state-of-the-art sexual health and wellness services to all community members LGBTQ people and their allies. The clinic provides services to anyone in need, irrespective of race, creed, sexual orientation or gender.

Through the Kind Clinic, Texas Health Action offers a full-service sexual health and wellness clinic dedicated to the treatment and prevention of sexually transmitted infections, including access to the HIV prevention treatment, PrEP and PEP, as well as gender care services. With a name and brand that represents: Knowledge, Inclusion, Nurture and Dedication, the Kind Clinic strives to deliver measurable impact for its community by providing state-of-the-art sexual health services to all people, regardless of race, creed, gender, or sexual orientation, without judgment or stigma.  – Texas Health Action

Community Acknowledgment For Excellence

The Kind Clinic was awarded Most Innovative Medical Care by the Austin Chronicle in 2017. The publication issued the following statement:

Whether you’re seeking STI testing, access to PrEP – the little blue pill that basically stops the transmission of HIV when taken daily – or gender affirming care and hormones, Austin’s Kind Clinic is your one-stop shop. What started as an entirely volunteer-run clinic to help residents learn about and get on PrEP has transformed into a full service sexual health and wellness provider that’s also home to Travis County’s first-ever trans-specific health care clinic. Kind not only keeps Austin queer, it’s keeping the community (and all folks) healthy and thriving. – Austin Chronicle

While The Kind Clinic is one of the only health care clinics in the area that focuses on LGBTQ+ issues, it takes a similar interest in all members of the community who need sexual health services. If there were two words to describe this healthcare clinic, they would be passionate and inclusive.

KIND Services

Patients at The Kind Clinic receive preventative care and treatment for many aspects of sexual health and general health. They are, however, perhaps best known for administering medications that block HIV infection.

These medications are known as PrEP and PEP. When taken correctly, they significantly reduce both exposure to others and presentation in infected individuals.

The Kind Clinic Provides PrEP

PrEP stands for pre-exposure prophylaxis. This medication prevents people at substantial risk of contracting HIV from infection. Patients take it orally once a day. In pill form, sold as Truvada, PrEP contains 2 medicines (tenofovir and emtricitabine) which work together to prevent HIV from establishing a permanent infection in people exposed to it through sex or IV drug use.

When taken regularly, PrEP has been proven to lessen the danger of HIV infection in individuals that are at risk by as much as 92%. The pill must be taken regularly to achieve this level of success, but the figure is substantial and encouraging.

PrEP is even more effective when combined with other preventative measures including condom use. The crucial part of the program, of course, is taking the medication every day. For members of the Austin population without healthcare or who are stigmatized by mainstream healthcare providers, Kind is a lifeline.

The Kind Clinic Also Provides PEP

PEP stands for post-exposure prophylaxis. The drug is a pill that contains antiretroviral medicines (ART) given to people who have potentially been exposed to HIV in order to prevent infection.

If an exposed person begins taking PEP within 72 hours of exposure and continues to take the medication for 28 days, it is an effective treatment. Again, because this type of medication requires continued use and continued monitoring by a healthcare professional, providing that level of care to exposed people is vital.

The Kind Clinic makes a genuine effort to reach people effectively by creating a judgment-free environment where they are affirmed regardless of gender, orientation or lifestyle. According to Board Member and local attorney, Rick Cofer, the clinic’s openness is part of its outreach efforts.

[For instance, in certain cultures] there are men who may not self-identify as gay but identify as men who have sex with men and there are certain cultural stereotypes and attitudes that come along with that perspective that can make identification of the disease and illness more difficult.  – Rick Cofer, Attorney, KIND Board Member

Therefore, the clinic strives to transcend these problems by being positive, proactive, and above all else, inclusive.

Kind Gives Gender Affirming Care

In an effort to further inclusivity, The Kind Clinic offers something called gender-affirming care to all of its patients at no cost to them. The clinic meets you where you are, in the skin you’re comfortable in, however you identify. The goal is to provide the care any given individual needs, not to reject how they identify or place any barrier at all between the person and the services they deserve.

The clinic uses an informed consent model providing patients with the most current information available about hormone replacement therapy. This enables patients to make informed choices about their own body. If patients choose to take hormones, the clinic assists them with referrals to qualified physicians and additional services, as needed.

Kind is working toward providing financial assistance for hormone replacement therapy (HRT) medication. In the meantime, it provides referrals to access medication at a reduced cost.

The TeleKIND Initiative

With TeleKind you can NOW connect with your Kind Clinic medical professional from the convenience of your mobile device or computer. Use TeleKind for follow-up appointments, prescription refills, and health care questions. The same Kind Clinic quality of health care, from the convenience of wherever your busy lifestyle takes you!  – Kind Clinic

Thanks to the new TeleKIND system, patients can access their services from almost anywhere. This program is Austin’s first telehealth service offering quality sexual healthcare to patients through confidential and convenient video chat.

The clinic is highly aware that nearly 2,000 of their patients make a significant commute to the clinic annually. They established the video chat system so these patients can contact their health care providers by phone or laptop.

We take pride in providing our patients with a safe, supportive and empowering environment to address their sexual health concerns. TeleKind will allow us to provide that same personalized care for our patients without the commute. – Dr. Cynthia Brinson, Chief Medical Officer for Texas Health Action and the Kind Clinic.

Kind Clinic patients can use the system for follow up appointments, health care questions, and prescription refills.

Our mission through TeleKind is to ensure that sexual health is attainable for Central Texans, regardless of clinic proximity. TeleKind will allow our expert providers to support our patients’ sexual wellness goals through a convenient, user-friendly platform they can access from anywhere. – Christopher Hamilton, CEO of Texas Health Action

General Sexual Health Services And At Risk Outreach

In addition to PEP and PrEP administration, Kind patients can access sexual health services including general wellness treatment, STI testing and treatment, and HIV testing. Their belief in kindness for all extends to undocumented people living in the US, low income and uninsured community members, and members of the LGBTQ+ community.

Board member Rick Cofer also shared some interesting statistics, including that 12% of the people with HIV in Austin are women. In 2016, 18% of the Austin population with HIV were African Americans and 41% were Hispanic/Latinos. Both of these groups contract the disease at a statistically higher rate than their share of the population.

Kind makes an extra effort to do outreach to the most at-risk populations to make sure they get the services they need so that they can stay healthy.

To that end, The Kind Clinic has what they call a  90/90/90 initiative. That means that if 90% of the people who have the disease are diagnosed, 90% of the people who know they have it get the treatment that they need, and 90% are therefore fully virally suppressed, the community can be free from the risk of infection.

They also stress that undetectable means untransmittable. This is an effort to educate the population that HIV positive people who take medications and have an undetectable viral load in their system cannot infect other people with the virus. This makes detection, awareness, and treatment so much more important.

The Importance Of Sex Positivity To Outreach

Rick Cofer recently stressed the importance of the clinic’s sex-positive stance on a local Podcast. He sees this as a way to draw people in for the services they need and reach those who require help but may be reluctant to seek it.

The Kind Clinic is not just a typical health care or free clinic where people might go in, it’s a truly different model. The culture is truly different. In my view … and I think among our patients, it is a judgment-free zone. We all know people that do not feel comfortable going to their longtime general care practitioner or family physician and discussing sexually related matters. At the Kind Clinic, it’s not just that we’re invested in sexual health and wellness, we are pro-sex and we are sex positive and we think that sex should be fun and that it should be safe and that it should not be shameful. And we welcome all. – Rick Cofer, Civil Rights & Wrongs Podcast

This sex-positive approach helps break down stigmas that still affect the community at large and populations who need care the most.

The Kind Clinic Breaks Down Harmful Stigmas

Cofer recounted problems in the past regarding the rights of people living with HIV and why it’s important for activism to continue.

Rick Cofer
Rick Cofer and the board of directors of the KIND Clinic at a strategic planning meeting.

[T]here were bills filed by the legislature and given serious consideration and policies considered seriously by the Texas commission of insurance, for example, to require that an individual that is HIV positive or had AIDS and sold a home, that that must be disclosed at the sale of the home because you can get AIDS from a house.  The

re was a legislator from NE Texas who later went to Congress who tried to pass a bill in the legislation that tried to pass a bill that would prohibit individuals who are HIV positive from working in food service because you can get HIV if someone touches your food.  – Rick Cofer, Civil Rights & Wrongs Podcast

Activism and services like The Kind Clinic make a statement as much as they offer tangible help to the community. They stand as a representation that Austin does recognize its HIV positive population and cares about their wellbeing.

The past wasn’t always that way, but the days to come can be different.

The Kind Clinic Moves Into The Future

The Kind Clinic has come a long way from operating evenings and weekends out of a local Austin Doctor’s clinic. They have provided access to sexual health services for the past three years and describe themselves as ‘bursting at the seams’ but ready, willing and able to accommodate everyone.

In fact, they’re hungry to help. It’s their passion.

Their message for the community? HIV is no longer a death sentence. If infected people find out their status early enough and they get on the right medication, there is a really good chance of medicated individuals completely repressing the virus. That’s not just good for them, but for the entire population of Austin.

To support The Kind Clinic, visit www.kindclinic.org.

Read about attorney, Rick Cofer:

https://www.avvo.com/attorneys/78701-tx-rick-cofer-1802667.html

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