A Different Kind of Healing Sister Dulce

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1 MARCH / APRIL 2012 of Baton Rouge A Different Kind of Healing Sister Dulce One on One with Terrie Sterling COO, OLOL HIV/AIDS Mental Health Makeover $ 8 00 Healthcare Journal of Baton Rouge Highland Road, Suite G-137 Baton Rouge, LA PRSRT STD US POSTAGE PAID Smith Hartley Publishing, LLC

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4 Stay in the know with HJBR enews Receive weekly updates on healthcare news in the Greater Baton Rouge area. To become a subscriber simply navigate to our website and sign up! of Baton Rouge smith W. HARtley Chief Editor KARen Stassi Managing Editor Philip Gatto Editor/Writer aimee swartz Contributing Writer Bruce D. Greenstein Secretary s Corner Rep. Bill Cassidy, MD Legislative Correspondent Cindy Munn Quality Correspondent david hood Policy Correspondent Jodi m. wilder Managing Director Liz Smith Art Director Dianne HARtley Sponsorship Director March / april 2012 HJBR Advisory BoARd Coletta BARRett, RN, MHA Vice President of Mission Our Lady of the Lake Regional Medical Center MiCHAel Bertaut Senior Healthcare Intelligence Analyst Blue Cross & Blue Shield of Louisiana JeANNine Hinton, LCSW, MHA Principal Healthworks: A Management Service Group, LLC MiCHAel Kaiser, MD Chief Medical Officer LSU Health Care Services Division Kim MitCHell, RN Charge Nurse Baton Rouge General Medical Center Naomi Nelson Chief Operating Officer Vascular Specialty Center Sean PRAdos Executive Vice President Louisiana Hospital Association Kate RatHBun, MD Medical Director LWCC CONTACT INFORMAtioN Highland Road Suite G-137 Baton Rouge, LA To SubsCRibe JournalBR.com Copyright 2012 Healthcare Journal of Baton Rouge The information contained within has been obtained by Healthcare Journal of Baton Rouge from sources believed to be reliable. However, because of the possibility of human or mechanical error, Healthcare Journal of Baton Rouge does not guarantee the accuracy or completeness of any information and is not responsible for any errors or omissions or for the results obtained from use of such information. The editor reserves the right to censor, revise, edit, reject or cancel any materials not meeting the standards of Healthcare Journal of Baton Rouge. 4 Healthcare Journal of baton rouge MAR / APR 2012

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6 To find out what s happening in New Orleans healthcare industry check out... of Baton Rouge HJBR 2012 Sponsors 6 Sigma Tek, LLC Baton Rouge General Medical Center Baton Rouge International School Blue Cross & Blue Shield of Louisiana Calandro s Select Cellars Campus Federal Cardiovascular Institute of the South CenturyLink D.R. Horton Foot and Ankle Institute Howell Analytics, LLC Knobloch, Poché & Burns Wealth Management Group of Wells Fargo Advisors, LLC LHA Physicians Trust Louisiana Health Care Quality Forum of New Orleans Louisiana Health Plan Louisiana State Medical Society Majestic Medical Solutions, Inc. Ochsner Medical Center-Baton Rouge Our Lady of the Lake Foundation Paretti Jaguar Peak Performance Physical Therapy JournalNO.com Personal Homecare Services Radiology Associates, LLC The Bone and Joint Clinic The Omni Group, LLC Walgreens 6 Healthcare Journal of baton rouge MAR / APR 2012

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8 Are HCAHPS/Value Based Purchasing, Operational Efficiency, Market Share, & Team Member/Physician Engagement, keeping you up at night? Our Business Partners Our Lady of Lourdes Hospital Our Lady of the Lake Regional Medical Center St. Francis Hospital St. Elizabeth Hospital St. Elizabeth Physicians Practice Our Lady of Lourdes Physicians Group PACE - Program of All Inclusive Care for the Elderly Homer Memorial Hospital With the onset of Health Care Reform which includes initiatives such as VBP, Meaningful Use, and Accountable Care Organizations, hospital processes have to be repeatable, consistent, and safe. Voice of the Customer and Transparency are the new NormaI imperatives. Now more than ever before it is the minimum responsibility and duty to be reliable, consistent, and provide safe processes through flawless execution for patients. We at 6SigmaTek look at processes, One patient at a time. It doesn t matter if you are a 10 bed hospital or a 1000 bed hospital, that one patient could be our/your loved one. Our passion is that the patient comes first. Our Offerings Lean Certification and Training Lean Deployment 6Sigma Certification and Training Strategic Planning Performance Metric Creation Baldrige Training Baldrige Assessment Process/Facility Simulation Modeling Kaizen Event Training Kaizen Event Facilitation Kaizen Facilitator Training Energy Audits Our Results* CHF Discharge - Reduced CHF discharge by 30 minutes per patient. Diabetes Meal Insulin Coordination - Reduced LOS for Diabetic patients by 17% (1 day). Blood Culture Rework - Reduced rework rate by 72%. Physician Clinic Messaging - Reduced time for MD to return patient calls by 58%. Physician Clinic Workflow - Improved Press Ganey scores by 83%. Decreased total visit time by 20 minutes. Main ER Throughput - Reduced LWBS by half and also realized a $273,186 positive financial impact. ER Admission Process - Reduced non-value added charting time by 80 minutes and reduced LWBS by half. Reduced vaccine inventory by more than 50% to reduce waste and enhance cash flow. Contact 6SigmaTek today for a complimentary analysis of your hospital Improving Healthcare processes one patient at a time *These results represent a portion of more than $1.8 million in financial benefits/savings from April 2010 through February 2011 across the following facilities: Our Lady of the Lake RMC, St. Elizabeth Hospital, Our Lady of Lourdes RMC, and St. Francis Medical Center. (Results may vary.)

9 Table of Contents MARCH / APRIL 2012 Features 20 home front Baton Rouge struggles with a staggering rate of HIV infections, AIDS diagnoses 28 ONE on one with terrie sterling, COO, OLOL Terrie Sterling discusses current projects and past lessons learned at OLOL Cover Story A TOUCH 12 OF healing An exploration of the gift of healing, a reluctant missionary, and why she is the talk of the town. 38 LOUISIANA s mental HEALTH makeover Transforming Louisiana s behavioral health delivery system Departments 10 Editor s Desk 50 Healthcare Briefs 70 Hospital Rounds 80 Book Corner 82 Advertiser Index Correspondents 60 Legislative 62 Quality 66 Policy 78 Secretary s Corner MAR / APR 2012 Healthcare Journal of baton rouge 9

10 EDITOR S DESK The doctor of the future will give no medicine, but will interest her or his patients in the care of the human frame, in a proper diet, and in the cause and prevention of disease. thomas a. edison ( ) Something to consider... Number of Deaths by Leading Causes (CDC 2010 preliminary data) Heart disease: 595,444 Cancer: 573,855 Chronic lower respiratory diseases: 137,789 Stroke (cerebrovascular diseases): 129,180 Accidents (unintentional injuries): 118,043 Alzheimer s disease: 82,962 Diabetes: 68,905 Nephritis, nephrotic syndrome, and nephrosis: 50,472 Influenza and Pneumonia: 50,003 Intentional self-harm (suicide): 37,793 Are any of the deaths preventable? Probably most of them could have been avoided, or at least significantly delayed. Perhaps our greatest gains could come from our simplest efforts. Sometimes simple reminders help me to focus. letters & comments subscription help Smith W. Hartley Chief Editor 10 HealtHCARe JouRNAl of baton rouge MAR / APR 2012

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12 healing touch Touch A of Healing Exploring a Different Approach by karen stassi 12 Healthcare Journal of Baton ROUGE MAR / APR 2012

13 v In the heart of Baton Rouge something amazing is happening. Maybe you ve heard the rumors. Perhaps you ve caught the name. A story passed between friends or shared between colleagues. Not always a happy ending, but sometimes a miraculous one. The source of the hum? Sister Dulce Maria. A diminutive, plump nun with a sparkle in her eye and a mischievous grin who can apparently heal the sick through the mere touch of her hands. You don t have to believe it. You have the right to question it. You can argue against it. But for the thousands whose lives have been touched by Sr. Dulce, and for Sr. Dulce herself, it doesn t really matter what you think. What matters is that these people and their families believe they have been healed physically, emotionally, and spiritually by the prayers and the touch of this self-effacing nun. I am just a normal human being that God has chosen to use in a very special way, says Sr. Dulce, who does not think of herself as a healer, just an instrument through which God, or as she calls him, Papa, heals. While your own personal spirituality may allow you to believe this without question, as a physician, nurse or other healthcare professional you have been trained in the sciences, in the importance of empirical evidence. You have witnessed the seemingly miraculous results achieved by ever more sophisticated and successful technology and pharmaceuticals and have come to rely on them as your tools in saving lives. So, it is no surprise that some may be doubtful, uncomfortable, perhaps downright skeptical of the idea of illness being healed through prayer and the laying on of hands. However, it is also hard to ignore the evidence of countless local residents who swear it is true. Is it really that much of a stretch? It has been proven that compassion, contact, and touch can help people to heal. Why else do we encourage family members to talk to those in a coma, urge parents to touch a premature infant, reach out our hand to someone else s to calm them? It is also no secret that patients who are positive and hopeful thrive, while those who give up can fail despite all medical intervention. Despite the drive toward evidence-based medicine, we can all attest to the usefulness of anecdotal data even when it s hard to explain. I would even wager that we have all witnessed recoveries that seemed impossible; recoveries we might casually dub a miracle without necessarily ascribing credit to a higher power. MAR / APR 2012 Healthcare Journal of Baton ROUGE 13

14 healing touch That s something Sr. Dulce will never do. All I ask is that you give the credit to Papa, she insists. I am just a creature. He is working through me. Those gifts are not human. They come from Papa. I ve got to give him all the credit. Sr. Dulce s healing gift was not something she sought out. Her religious order, the Mercedarian Sisters of the Blessed Sacrament is a teaching community and Sr. Dulce is an educator. She loves that calling, but apparently it wasn t what God had planned for her. We all want to be comfortable, we want the normal life. I want to teach, be a normal nun, say my prayers, have a schedule, continue my education, says Sr. Dulce. It s not going to happen when Papa says, I ve got something I want you to do for me. My life belongs to him in every way. A Call to Healing Born in Corpus Christi, Texas, Sr. Dulce joined the Mercedarian Sisters as a teenager. She went on to earn a Bachelor s, Master s, and a Doctorate in education and administration. Assigned to California, Sr. Dulce planned to attend the master educator program at San Diego University, but the program fell through. About that time the priest at St. Leo s Mission in Solana Beach died. Sister received a call asking her to come help coordinate the mission programs, which catered to undocumented immigrants. She resisted. It was not her normal work, it would require her living away from her Order, and there was no salary offered. I took a vow of poverty, not starvation, she jokes, explaining the need to provide for the other nuns in the Order. I said, Papa this isn t my job, this isn t my work. My work is teaching children. But when Papa speaks you learn to listen. A few days later a group expressed a desire to rent part of the mission to open a Head Start program. Sister was asked if she would reconsider the rent could be her salary. Papa that was sneaky, thought Sr. Dulce, but she reluctantly agreed to work at the mission for the summer. That summer position turned into a five year assignment caring for those who had no jobs, nowhere to live, and inadequate food and clothing. She rose to the occasion, finding housing, jobs, free medical and dental visits, and donations to help care for her people. As Mama to her flock, she ran herself ragged. One day, exhausted, she knelt down before the Blessed Sacrament and said, Papa, I m so tired, just let me kneel here a little while before you. She believes she must have fallen asleep and describes what happened next as a dream where she was in horrible pain. Papa asked me, What s wrong? and I said, I m in pain. And He said, Show me your hands. I showed Him my hands and in my hands, were His hands, wounds and all. She said that God told her to lay her hands where it hurt and the pain disappeared. I thought, that was a strange dream, a lovely dream, but I only thought it was a dream, said Sr. Dulce. 14 Healthcare Journal of Baton ROUGE MAR / APR 2012

15 As many as God has targeted for me to work with, that s how many I will work with. That works out to be approximately 500 people a month. She was not thinking about the dream when, the next day, she returned home to find her little pug dog, Georgie, in pain. The dog had apparently eaten some poisonous fish and was covered in welts. Sr. Dulce prayed, Papa please don t take my pug she can t give you any glory, she s just a dog. In that instant she felt a hand take hers and place it on Georgie s head. As she moved her hand over the dog, the welts disappeared and Georgie sat up and licked her hand. I thought it was just Papa hearing my prayers and I thanked him and she was fine, said Sr. Dulce. It wasn t until she was called to the bedside of a woman with pancreatic cancer that it began to dawn on Sister that perhaps God had other plans for her. The woman was in terrible pain and, similar to the experience with Georgie, Sr. Dulce felt her hands drawn to the woman s abdomen. She describes feeling terrible burning pain in her own hands, but she could not pull away. When the pain finally subsided, the woman had fallen asleep. I took my hand off and wondered, What was that? said Sr. Dulce. I went to Papa and I said, Okay What? What? What? The woman s daughter called the next day to ask what she had given her mother because she had woken up with no pain, sat outside, and was able to get some sunshine. The daughter asked Sr. Dulce to come lay hands on her again. But when I went, she was dying, she said. He took away the pain, but it was her time and I told her, You are going to be okay. I am going to help you. And I lay my hands on her so she could die in peace. A Complex Gift Those who are slow to accept Sr. Dulce s gift question why she cannot save everybody. Some of the patients she sees experience miraculous cures, yet others still succumb to their illness. Sister is quick to explain that she does not choose whom she heals, that she is simply doing what God tells her. Sometimes it is just a person s time to die, but her touch may relieve their pain or anxiety or her counseling may relieve a family s grief. She is confident that she is providing whatever form of healing God wishes for that person and that He will put those who need her in her path. You might think that with her gift, Sr. Dulce might be tempted to frequent the hospitals healing everyone she sees. But quite apart from the fact that she is so busy with her own schedule at the prayer center, and her desire to help as many people as she can, she acknowledges that her work would never be complete. If I could maneuver my gift I d heal everybody and my neighbor, she says. However, on occasion, God will send her to the hospital specifically to see one person. If I show up at the hospital you are very lucky, she jokes. Because Papa has sent me to heal you. When I go to a hospital I am sent. I don t go by my own design. I ve got enough patients here. Although she devotes the early hours of her days to personal prayer, scripture study, and communion with God, Sr. Dulce claims to have an ongoing dialogue with God throughout the day. Sometimes there MAR / APR 2012 Healthcare Journal of Baton ROUGE 15

16 healing touch Due to the nature of her work, Sister loves to be surrounded by bright colors. are no words, but He makes His wishes known to her. She admits that she often resists or bargains with Him, but it is that unspoken communication that allows her to know when someone needs her help even before they have contacted her, or to communicate with people despite barriers of language or silence due to illness. Sr. Dulce says she can also heal through other people s hands when she cannot physically visit the person. Talking to a family member on the phone, she will have them lay their hands on the patient while she prays. Because she physically feels the pain and illness as she heals, this can be problematic. Sometimes the person laying on hands also requires healing and she can distinguish between the different types of pain. That doesn t work, she said, because she can only heal one at time. I can t heal through the other person s disease. It may all sound a little supernatural, but to her it is perfectly normal because she believes God is aware of what is going on with each of us and through her connection with Him, she is also aware. I m nobody special. I m very normal. What you see is what you get. No secret lives or mystical running off into the stars. Complimenting Medicine Sr. Dulce stresses that there are different types of healing. A patient may succumb to cancer, but their healing may have been in their soul or in a family relationship so they could have peace before they died. Sometimes a healing is immediate and unexpected. At other times, it is a gradual process that may require some spiritual healing first. When it takes a while, God is working something in their lives, said Sister. Or they may just not be ready yet. If a person doesn t heal, they didn t heal. I don t take responsibility for that. Without God s power I can do nothing. I leave it up to Him. I lay hands and while He s healing I pray and wait on His word to be fulfilled. Sometimes, said Sr. Dulce, a person s physical ailment is healed, but it is clear they still have healing to do. If I want a straight back and I didn t have any faith, I could go to a doctor, have surgery, and he ll get it done. The difference between the kind of healing God does and the kind of healing doctors do is they heal the body momentarily, until you die. But God heals you body, mind, and soul. He heals the inner person along with the body and that s the difference. That is not to say that Sr. Dulce does not respect and encourage the work of doctors. She believes that, like her, they have been given their healing skills, their ability to care for others as a gift from God. When a patient complains of a pain or a problem she will ask them if they have seen their doctor or if they have taken their medicine. I work with doctors. I like for the doctors to take care of them, because that s their gift. They need to go see their doctor, they need to take their medication, they need to be helped by medicine, said Sr. Dulce. However, she believes that a doctor who practices prayer before he goes to work and who trusts in God and who practices his faith, whatever that faith might be, is more likely to have a higher percentage of healed patients than a doctor who doesn t. I advise you to get yourself a doctor who believes in God and believes in prayer, says Sr. Dulce. The Reluctant Nun Despite her ability to heal others, Sister cannot heal herself unless God wills it. In fact, it was while she was recovering from an illness of her own, that God chose her for a new mission. While recuperating in San Antonio, she began to see visions of trees and the place 16 Healthcare Journal of Baton ROUGE MAR / APR 2012

17 Their care has allowed Vicki to maintain her dignity and self esteem... Vicki raised her three daughters as a stay at home mom. Upon re-entering the work place she was employed by cardiology groups, Ocshner Health Plan and Humana Health Plan. She worked as an Office Manager, Provider Relations Representative and Contract Specialist. She was diagnosed with Alzheimer s at the age of 56. She has accepted her diagnosis with tremendous grace. The caregivers from PHS have provided a much needed and welcome relief for her family and have shown great compassion and patience. She has accepted them as her good friends and they have cared for Vicki with that level of love and attention. Their care has allowed her to maintain her dignity and self esteem. Vicki continues her battle today with a smile and the help and support of her PHS friends. When faced with choosing care for your aging loved one, consider a different option... Our Family s Option. Personal Homecare Services provides 24/7, in-home companion care. Your family member will remain in the comfort of their own home, with their personal memories and possessions. PHS is one of the first non-medical services specializing in live-in care and working in conjunction with doctors, healthcare providers, and hospices to provide continuous around-the-clock care without the hassle and expense of hourly services. All of our clients called us because someone they trusted told them about PHS. PHS is now helping families throughout Louisiana, Mississippi, and Texas. Meal preparation assistance with personal hygiene Medicinal reminders Light housekeeping Transportation to/from appointments Companionship PHS Personal Homecare Services Call today for more information.

18 healing touch chapel, and a convent sits on a lake surrounded by woods right in the heart of Baton Rouge. When you are there however, the city slips away and wildlife roam the grounds in peace and near silence. The center is dedicated to those who are seeking healing from Sister as well as regular spirituality groups for men, women, and youth seeking a closer communion with God. Additional public space and trails for meditation are being developed. that would be her new home. She was not particularly receptive to this new plan. When Papa said I was coming here, I said, Oh give me a break. I want to stay and be a regular nun. I just want to teach and work with my people. Where are you taking me now? She was told that God would send her a priest after His own heart and that priest would tell her where she was going next. One day a call came from Father Jeff Bayhi of Baton Rouge. His mother was ill and he had heard of Sr. Dulce s gift. He wanted to come see her. Confident that her Mother Superior who had been urging her to rest would turn him away, Sr. Dulce was somewhat surprised when not only did she allow him to come, but ultimately granted his request that Sr. Dulce come to Baton Rouge. Irritated by this priest who had managed to convince Mother Superior to let her leave despite Sr. Dulce s desire to await a new teaching position, she was determined not to like him. I said, Papa is this the priest? and He said, That s the one. Everything was arranged and before I knew it I was here. The Source of the Hum Sister s beginnings in Baton Rouge in 2001 were humble, initially operating out of a home near LSU. As her ministry grew, St. Agnes Catholic Church offered her space in the school gym. In 2009 the Cypress Springs Mercedarian Prayer Center was constructed at the end of George O Neal Lane through funding from the Sister Dulce Foundation. The complex of three buildings the ministry office, a Today, most of Sr. Dulce s days are spent with cancer patients or those struggling with a terminal illness, pain, loss, or grief. I work with those who have cancer and other terminal diseases, those who are dying, so I can walk them past their fears, their anxieties, and maybe sometimes past their disease, to God, she explains. She also works with grieving family members. Despite her busy schedule, she remains on call for those in crisis and responds to hundreds of prayer requests during the early morning hours she spends talking and praying to God. As many as God has targeted for me to work with, that s how many I will work with. That works out to be approximately 500 people a month, according to her assistant, Kim Johnson. Sr. Dulce has been loath to publicize her gift, but of course word spreads so her work continues and grows. She is confident it will continue for as long as God wills it, but also knows that this is the end of her journey, that she is where God wants her to stay. Healing is God s presence on this earth. Disease and sickness comes with our nature, our fallen nature, says Sr. Dulce. God has brought me here to heal people and teach them to live in His presence and to do their part to grow in their relationship to Him so that they, on their own part can heal others. Sr. Dulce s absolute belief is contagious. It is easy to approach her and the stories that surround her armed with questions and healthy skepticism. She understands that. Perhaps even welcomes it. But it is hard to look into those eyes and question anything she is saying, to avoid feeling she is getting a little insight into your soul, to not hope she might just get the word from Papa to heal you, too. To find out more about Sister Dulce you can visit the center s website at 18 Healthcare Journal of Baton ROUGE MAR / APR 2012

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20 hiv / aids Home Front Baton Rouge Struggles with Staggering Rate of HIV Infections, AIDS Diagnoses By Aimee Swartz 250 red balloons, floating high above the cityscape, were not only a vivid show of solidarity to commemorate World AIDS Day, but a somber reminder of the devastating impact the disease continues to have in communities throughout the greater Baton Rouge area. >> 20 Healthcare Journal of Baton ROUGE MAR / APR 2012

21 Photo courtesy of LSU HeALth Care SeRVIces DIVISIon Number of Persons In recognition of World AIDS Day 250 red balloons are released from LSU s Mid City Clinic. Source: Louisiana Office of PuBLic Health STD/HIV Program V.5/17/2011 MAR / APR 2012 Healthcare Journal of Baton ROUGE 21

22 hiv / aids...in Baton Rouge, almost a quarter of people diagnosed with HIV had AIDS at the time of their diagnosis and many convert to AIDS within 12 to 36 months of their initial HIV diagnosis much sooner than any other region in the U.S. According to a new surveillance report recently released by the Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia, the Baton Rouge area again has the second highest rate of new AIDS diagnoses in the United States. Miami tops the list, while neighboring New Orleans ranks third. These calculations are based on Metropolitan Statistical Areas as defined by the U.S. Census Bureau. In the case of Baton Rouge, this includes nine parishes East and West Baton Rouge, Ascension, Iberville, Pointe Coupee, East and West Feliciana, Livingston, and St. Helena that collectively are known as Region 2. Recent figures estimate that 30.6 persons per every 100,000 in Baton Rouge have AIDS a rate almost triple the national average of 11.2 per 100,000. Although this rate is down from 40.0 persons per every 100,000 in Baton Rouge from the prior year, the virus shows no signs of slowing down in the city where more than a quarter of the state s new HIV cases are diagnosed each year. When the pool of potential sexual partners has such high rates of HIV, the chance of acquiring the virus are greatly increased, said Timothy Young, executive director of the HIV/AIDS Alliance for Region Two (HAART), the area s largest provider of Ryan White funded services. As a result, Baton Rouge has become a hotbed for HIV. At an infection rate of 45.9 per 100,000 persons, it too looms large over the national average of 17.4 cases per 100,000. Neither Young nor Madeleine Heck, MD, Clinical Assistant Professor at Louisiana State University, are surprised by the numbers. This is not a problem unique or specific to Baton Rouge or even Louisiana. The high rate of HIV infections and AIDS diagnoses in Baton Rouge is consistent with the reality of the epidemic nationally and, in particular, in the southeastern states of the U.S., where the disease continues to spread at a rapid pace, particularly in African American communities, explained Dr. Heck. Their opinion is backed by strong surveillance data that show the southern United States bears a disproportionate burden of disease both in terms of the proportion of the population affected in the region as well as a disproportionate share of the overall number of individuals with HIV in the nation. Southern states continue to report the highest number of new AIDS cases, the highest newly reported HIV cases, and the smallest decrease in deaths due to AIDS. Sylvia Andrews, who administers the city s Ryan White Part A program, says there are a variety of reasons for these disparities, ranging from poverty to poor overall health, to lack of HIV/AIDS education. Given the region s culturally conservative climate, however, AIDS-related stigma frequently layered on top of stigma related to sexual orientation and drug use tops the list. The stigma is so great, she says, that it causes people to downplay or deny their risk for HIV infection. Based on the high rates of HIV/AIDS and other sexually transmitted infections in the south, there is a clear dissonance between our views and our behaviors, Andrews noted. 22 Healthcare Journal of Baton ROUGE MAR / APR 2012

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