What drove you or inspired you to go into medicine?
As a kid I loved science. Science fairs, physics class, volunteering in a lab on the Texas A&M campus, even science fiction, were all things I enjoyed. When I went to college, I was sure I would get a Ph.D. and become a laboratory scientist, but two things happened to change that. First, I was studying molecular biology and took a virology course. It was 1993, and our understanding of HIV changed monthly. There was no treatment, and the virus mutated so rapidly that the human immune system and vaccines couldn’t keep up with it. I remember sitting on my dorm room floor reading about it and feeling overwhelmed, but so impressed by the scientists who were working to stop the epidemic. The second game changer was that I went to Mexico to study indoor air pollution and fuel-efficient stoves as a part of my senior thesis project. That project then became a Fulbright Scholarship. I came back from Mexico fluent in Spanish and committed to working with underserved populations. It clarified that for me, my passion was to practice medicine and serve, rather than work in a lab.
What is your area of expertise? What drove you into this specific area?
I’m an infectious diseases physician, and the focus of my clinical practice and research is the care of people living with HIV. I started learning about HIV in college, and when I started medical school in 1996, there was still no effective treatment, but that changed quickly. In 1996, the physician who would become my mentor at Columbia University, Scott Hammer, and others working with the AIDS Clinical Trials Group, discovered a combination of antiretroviral medications that would suppress the virus. This transformed HIV from a deadly infection to a chronic one. During residency, it was clear to me that HIV clinical care and research would allow me to pursue a field that challenged me intellectually while also allowing me to work with underserved populations on the social justice issues that were most important to me.
What professional accomplishment are you most proud of?
In clinical work and research, there are never any individual accomplishments—everything is a part of work with a team. I am very proud of the work that we’ve done in the Dominican Republic, helping to understand the challenges people with HIV face there and the results of antiretroviral treatment expansion in the country.
Right now, I’m incredibly proud to be a part of the End Stigma End HIV Alliance here in San Antonio. We’re a diverse group of people living with HIV, activists, social workers, nurses, physicians and public health professionals who came together last year in response to rising rates of HIV in young people in San Antonio—a trend that unfortunately is occurring across the Southern U.S. and Texas. San Antonio Mayor Ron Nirenberg and Bexar County Judge Nelson W. Wolff support our efforts, and on Nov. 30, 2017, San Antonio became the first “Fast Track City” in Texas, a part of an international effort to end the HIV epidemic. The mayor committed to specific goals for the epidemic in San Antonio by 2030: 90 percent of people in San Antonio with HIV should know their diagnosis, 90 percent of those should be on treatment and 90 percent of those should be virologically suppressed. We’re working with every HIV service organization in the community to help reach these goals, and in the past few months, we’ve set metrics and targets for 2018. It is exciting to be a part of such a dynamic and passionate group. I believe we can end the HIV epidemic in our community.
What do you want patients to know about you?
That I care about them as human beings and will listen.
What makes UT Health San Antonio a special place to practice?
Everyone is incredibly collaborative. I can pick up the phone and speak with surgeons, dentists or cardiologists about my patients and they all want the best for my patients.
What is special about practicing in Bexar County?
In talking to my colleagues in other places, it is unusual for an entire community to be willing to collaborate to end the HIV epidemic, which gives us the tools to make a difference. Working with the community here is one of the most rewarding things that I do.
What do you do to relax outside of the office, lab or clinic?
I still read a lot of science fiction. I have two daughters, so I spend time watching them do the things they love: soccer, ballet folklorico, track and piano. Finding time for fitness is important to me. I do CrossFit, run on the southern reach of the River Walk near my home and do yoga.
What unique challenges or opportunities do you have as a physician in San Antonio?
There are so many opportunities. The entire community has come together to end the HIV epidemic, giving us an amazing opportunity to have an impact. The challenges are the things we all know as physicians: San Antonio has high levels of income disparities and many people are uninsured. Transportation is difficult for many of our patients. Unfortunately, in my field, people with HIV still face a lot of stigma. I have patients whose friends are afraid to hug them or share dinner plates with them. Even some providers still think of HIV like we did two decades ago. They don’t realize that, with treatment, people with HIV can live long and healthy lives and do not pass the virus on to others. This is a challenge, but one we’re all working hard to overcome.