Outreach and treatment of HIV/AIDS has long Nashville history

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by Brad Beasley
Inside Out Nashville Contributor

Twenty-five plus years ago, the staff in the Lentz STD clinic was faced with a problem.

There were rising rates of STD’s in Nashville’s gay community, and no effective way to access the folks that needed help.

Gay men were hesitant or just plain afraid to come into the clinic, and few private providers were asking if their patients were at risk from having sex with other men.

Enter into the picture two STD clinic staffers: Bob Keller, PA and Becky Green, RN, FNC. Together, Bob and Becky came up with the idea of providing some kind of outreach specific to the gay community. Pooling their own private (and other) resources, as well as getting approval from the State Health Department, the off-site clinic known as Lifestyles was born.

Lifestyles was located on Church Street in the small shopping area next to what was then The World’s End, and is now Blu and Blue Gene’s. The clinic provided Hepatitis B testing, standard STD testing and treatment, and was promoted as a gay friendly place where men and women could come without being judged or preached to.

In 1982, patients started presenting with symptoms that were not associated with the usual STDs. What we now know as HIV symptoms were occurring at an alarming rate, and the staff was unsure how to proceed.

In the United States, the agent that had been identified as possibly causing these problems was called HTLV-III. In France, the Pasteur clinic had isolated a virus they called LAV. In 1983, Bob Keller enrolled Lifestyles in an international study to determine if HTLV-III and LAV was the same virus. After two years of study and analysis, Becky and Bob co-authored a paper titled IgG anti-HTLV-III Sero from Male Homosexuals Cross Reacts with LAV.

These findings were presented in a poster session in April 1985 in Atlanta, GA at the International Conference on AIDS. While Lifestyles provided the blood samples for the study, the only true option for treatment at that time was counseling.

In the early 80’s, the first two physicians in Nashville to see these patients were Dr. Stanley Bodner and Dr. Stephen Hines. Both physicians were active in the medical community and with the Health Department in providing direction for the emerging problems and health issues of the men becoming increasingly sicker.

By the late 1980’s, the landscape was very different.

“It was a horrific time”, Becky states. “There was a big drop in STD’s because people were afraid to have sex, and the patient base for Lifestyles dropped quickly”.

“Medically, all that could be done was a CD4 count, a basic physical, and treat the visible symptoms as best we could.”

With such a drastic decline in patients and such a dramatic shift to an unknown disease, Lifestyles could not support itself and was shut down. While Lifestyles was gone, the idea was not. Bob and Becky brought the model back to the STD clinic at Lentz and started what was called the HIV Plus Program. This program was aimed solely at those folks living with HIV/AIDS, and was the beginning of what is today the Comprehensive Care Center.

The Plus clinic, as it was known, drew from resources all over the city. Several private providers volunteered their knowledge and experience in dealing with HIV, and through Dr. Stephen Raffanti involvement with Vanderbilt came into existence. Dr. Raffanti was on staff at both Vanderbilt and the Health Department, and was instrumental in recognizing the need for the entire community to come together to fight HIV/AIDS.

Because CD4 testing was not covered by the Health Department or private insurance, funding came from different resources as well. Many local bars would host drag shows to raise money for the clinic; money that was used to pay for the serologic tests needed for proper assessments. Probably the two bars that raised the most money for the clinic were The Cabaret, formerly located on Hayes Street, and the Warehouse 28, formerly on Franklin Road. The entertainment staff of these two bars, as well as many others along the way, took the community by the hand and helped to raise the needed dollars for the clinic to operate.

The Plus Clinic quickly became a regional venue, strategically located between the NIH in Washington D.C., and the CDC in Atlanta. Patients came from not only Middle Tennessee, but from all over the Southeast for treatment and care. In 1994 the Plus clinic moved from the Health Department and became the Comprehensive Care Center.

The CCC has become a nationally recognized treatment center for HIV/AIDS.

In 1985, the Health Department started its own HIV testing program. Terry Davidson, FNC (currently providing care at CCC) started doing some testing in June of ’85, and a formal program started in September of that year. Dan McEachern was hired to be the one and only HIV counselor for the program at that time. In October of 1985, Rock Hudson made is now-famous announcement, and Dan was overwhelmed with people wanting to be tested. Other community folks that collaborated with the Health Department were Paul Tucker, pastor at MCC, Janet Pierce, then the Executive Director of Nashville CARES, and Dr.’s Bodner and Hines.

It was during the fall of 1985 that I had my first HIV test and met Dan, and in 1986 became a volunteer with Nashville CARES. The testing and counseling staff grew with the addition of Dederick Yeargin in 1989. Dederick had started with the State Health Department HIV Program in 1985, and came to Nashville as a state assignee. Together, Dan and Dederick made their presence in the clinic known as a gay friendly and safe place to come for testing. In September 1991, I joined Dan and Dederick as an HIV counselor. In the early months of 1992, Dan and Dederick took their expertise out into the community in a nontraditional way.

I had arranged for them to set up a testing table in the former

Pink Triangle; a gay gift shop that used to be where the Silver Stirrup currently resides inside The Chute. When the Pink Triangle closed the tables were moved into The Chute, and having completed my training I joined Dan and Dederick on the outreach team, and became the liaison between the Health Department and the gay community. From this point on, our bar testing efforts grew until we were scheduling sometimes two bars a month in the middle of the night.

Pam Pitts, currently with the State Health Department STD Program, joined us in 1994, and together the four of us would set up shop in a bar in the middle of the night to do HIV testing. Dan and Pam would do the paper work; Dederick and I would draw the blood samples. In 2000 we added Hepatitis vaccinations, and in 2004 reached our goal of zero new cases of Hepatitis A in the gay community here in Nashville. We have testing tables set up at the annual Gay pride event in Centennial Park, and try to have a presence at many events around town during the year.

This outreach effort continues today. We go to Outloud the third Thursday of each month, and to a different bar each month to test. We typically set up in the bars between 10 p.m. and 1 a.m., and are at OutLoud! Books & Gifts from 7 p.m. until 8:30 p.m. In acknowledging the many folks who have contributed to public health efforts in dealing with HIV/AIDS, I have to recognize the medical foresight of Bob Keller, Becky Green, and Dr. Stephen Raffanti for putting Nashville on the international map of HIV/AIDS treatment.

I also want to recognize Dan McEachern for his unending community involvement and guidance throughout the last two decades, both in testing and counseling and with Ryan White activities. He has been an inspiration to many, especially to this writer.

I would also like to recognize the support of the Health Department administration in allowing us to think outside the box and explore new ways to improve the public health regarding HIV/AIDS education and support. Our ability to connect with our patients has been a hallmark of our continued presence within the gay community. The staff of the STD Clinic is grateful to be a part of this effort, and looks forward to continued collaboration with the gay community. For more information, or questions about STD/HIV, please call me (Brad Beasley) at 340-5676, or email me at brad.beasley@nashville.gov.