Jennifer Janelle, M.D., is an assistant professor of medicine in the UF College of Medicine’s division of infectious diseases. She is the infectious diseases fellowship program director and also principal investigator of the North Florida AIDS Education and Training Center, or AETC, a partner in the Southeast AETC network. Janelle has more than 20 years of experience providing clinical care to people living with HIV infection. Currently, she provides patient care at the UF Infectious Diseases Clinic as well as at several Ryan White-funded HIV clinics in rural areas of North Florida.
On Nov. 6, 2019, Janelle was the UF College of Pharmacy’s LGBTQ+ invited speaker and presented on “Living and Loving with HIV.” Second-year pharmacy student Alex Duarte interviewed Janelle about living with HIV and the importance of patient education. A transcript of the interview is provided below:
In regards to infection prevention, what are the major hurdles for minority populations to receive proper education and prevention?
Minority populations are stigmatized both from outside as well as from within their communities. To address stigma from within, community leaders need to be a voice of reason, embrace people, and be open. Talking about prevention and protection against HIV may be a challenge, but I do feel that this will be most effective for individuals when it comes from within their own community.
As HIV+ people are aging, how are minorities disproportionately impacted by the condition?
We already know that minority populations have higher incidences of hypertension, obesity, diabetes, cardiovascular complications. Managing these comorbidities in addition to HIV can be very challenging. It would be ideal to have an integrated system where patients get their HIV and primary care at the same time, but affordability of medical care remains a major hurdle for many patients.
What steps can pharmacists take to assist minorities, and minorities in particular, who live with HIV/AIDS?
I really think that having a welcoming, non-discriminatory space and to avoid challenging patients at the register are essential. I would like to encourage pharmacists to watch what is going on in the environment in front of the pharmacy. If you see someone looking at condoms and you can tell that they may not be comfortable, go and help them so as to normalize the situation. I think that there is going to be a new model in how pharmacists deliver HIV care. An example of this is linking patients to PrEP (Pre-exposure prophylaxis) and potentially HIV treatment. Another thing that pharmacists should be aware of is that some patients may fear picking up their prescriptions because of the possibility that their information regarding HIV status could be overheard by other customers during counseling. So, it is important that pharmacists counsel patients in a proper setting such as a consultation room and not by the counter. Making the person in front of you a priority is a key.
The stigma of HIV/AIDS still burdens many. How can we help to educate the general public and also create a sex-positive environment that is engaging for minorities to welcome their HIV+ peers?
I think that we have to work on letting people be who they are. Understanding and using proper pronouns and addressing people in the manner they prefer is important. Showing cultural humility and some knowledge helps people feel understood. It is important to treat everybody with respect and help them to know that you care about them. One of the things that a lot of people are not aware of are the many resources for HIV patients. Some patients lacking health literacy to explore these resources should contact knowledgeable healthcare providers or pharmacists to obtain access to these resources.
How did you get to where you are now in your career?
I attended the University of Tennessee in Memphis where I did a rotation at a children’s hospital called Le Bonheur in the early 1990s where we were beginning to recognize HIV. At the time, my attending was an Infectious Disease specialist and he really fostered that interest in me. During my residency I was looking towards next steps, a fellowship in infectious diseases just followed along.
