IU Health’s LifeCare offers a team approach to patient’s living with HIV. A big part of that team is social work – finding solutions to individual needs.
By IU Health Senior Journalist, T.J. Banes, tfender1@iuhealth.org
She was just a kid when Shawn Delmolino first felt it. An acquaintance had been diagnosed with AIDS. He was married and Delmolino sensed the strain when people ‘whispered’ about the man. He later died of complications of the immunodeficiency virus.
“I didn’t know what stigma was at the time but I do now. I think about that family and how they had to manage to keep the situation a secret. When you are living with something alone, you are living without the support of others,” said Delmolino. She serves as a licensed social worker with IU Health LifeCare, a program offering various HIV services.
Those services include diagnosis and treatment, health assessments and medical exams, comprehensive treatment, access to lab work, immunizations and TB testing, education and counseling, and assistance with specialty and community referrals.
Delmolino is team lead for a group of eight social workers, managing a caseload of about 200 patients each.
Born in Dallas, Delmolino grew up in Anderson, Ind. and graduated from the former Highland High School. She went on to receive her master’s degree in social work. One of her early experiences working with patients living with HIV was at the city’s south side Concord Neighborhood Center, one of the state’s first community centers.
Working as an HIV care coordinator she referred patients to IU Health LifeCare.
“I came with a patient to an appointment at LifeCare and I thought how great it was that social work was integrated into the medical care,” said Delmolino. Later she had an opportunity to join the team.
“I’ve always wanted to combat that stigma of HIV with love and acceptance. I tell people that I want LifeCare to be a place where people want to be and don’t feel like they have to be here,” said Delmolino. She started her role with IU Health Methodist Hospital conducting HIV testing and education with patients in the ER. She also coordinates care for pediatric patients living with HIV at Riley Hospital for Children at IU Health. The Riley Hospital team sees anywhere from 65-70 patients – some as young as six months and some in their early 20s.
March is Social Work Month and this year’s theme is, “The Time is Right for Social Work.”
In Delmolino’s role she focuses on building a rapport with patients and helping them understand the role of social work. Team members stress more than one message: “You’re either a person living with HIV or a person affected by HIV;” “HIV does not discriminate at any time regardless of sexuality, circumstances, education, or wealth.”
Breaking barriers also means education: “If someone has had sex without using a condom, then that person is at risk of contracting a sexually transmitted disease.” LifeCare extends testing and education to persons living with HIV and their loved ones.
Working with a social worker, means receiving individualized care. That care could include assistance with insurance, transportation, housing, or other resources, said Delmolino.
Since she began working with people affected by HIV, Delmolino has witnessed some positive changes.
In early 2016, a health equity program called Prevention Access Campaign (PAC) launched “U=U” (undetectable=untransmittable). The action has united HIV advocates, activists, and researchers with the common message: People living with HIV who achieve and maintain an undetectable viral load – achieved by taking prescribed medication – cannot sexually transmit the virus to others. In 2017, the US Centers for Disease Control and Prevention officially supported the research that resulted in the widespread “U=U” campaign.
Language and phrases have also been modernized to help reduce stigma. Some of those terms offered by the National Institute of Allergy and Infectious Disease (NIAID) include use of: “People Living with HIV” rather than “HIV infected people,” and “Condomless sex” rather than “Unprotected or Unsafe Sex.”
Similarly, policies regarding disclosure by those testing positive for HIV are now referred to as “duty to inform” rather than “duty to warn.”
In terms of medical advancement, last year the FDA approved a monthly injectable drug, Cabenuva, to treat adults 18 and older. In February 2022, the FDA expanded the label for the medication to allow for bi-monthly administration. Patients now have an alternative option to daily antiretroviral therapy.
“Medicine to treat HIV is expensive. One of the roles of our social workers is making sure patients have access to health coverage and to help initiate applications for Medicaid and the Ryan White HIV/AIDS Program to secure funding,” said Delmolino.
“Our role is to assess and help patients with unmet needs,” she said. “We do our best to connect them to the resources they need and help break down barriers to treatment.”
Outside of work, Delmolino and her wife, Sara Minor, enjoy camping and canoeing with their dog, Frankie.