Mildred Lewis has been living with HIV for 19 years.

She’s spent 17 of them in Point Breeze, and for 16 years she has been drug-free.

Today, Lewis is Philadelphia FIGHT’s lead HIV tester and counselor in the Point Breeze area, using her personal experience and trusted presence in the neighborhood to serve an at-risk community.

“We specifically target South Philly because especially in this [Point Breeze] section we have a lot of intravenous drug users, as well as a lot of poverty,” Lewis said.

Lewis considers it her duty to educate both peers and youth within the impoverished community about the importance of HIV testing. The 19145 and -46 zip codes, which span Point Breeze hold a poverty rate of 22 percent and is home to more than 1,100 individuals living with HIV/AIDS.

She considers targeted approaches in HIV and primary care to be the most effective, and works with high-risk populations in order to accurately address the highest needs in the neighborhood.

“Most people don’t want to talk about it,” Lewis said. “But if they don’t talk about it, they don’t know if they have it. We find that youth are contracting it, and they’re hiding it from their families because they don’t have that support. So we have to get out there and educate.”

FIGHT is a comprehensive health services organization providing education, testing and advocacy for people living with HIV/AIDS in Philadelphia. Often, their clients rely on subsidized health care access, including benefits from Pennsylvania’s expanded Medicaid provisionsfrom the Affordable Care Act.

The health center is working to bring treatment to what FIGHT Director of Education Juliet Fink Yates calls a “testing desert.”

“HIV is a disease that capitalizes on impoverished areas,” Yates said. “Point Breeze is a neighborhood that has historically been among the poorest in the city, and so it tends to have a higher rate of HIV because of that.”

FIGHT is one of the many HIV care organizations funded by Ryan White Care Funding. A branch of the U.S. Department of Health and Human Services, the fund offers medical care and support services for those who do not have access to healthcare.

Currently, FIGHT can only provide free testing for HIV in Point Breeze as their federally funded resources allow.

This restricts them in using a University of Pennsylvania testing van every Tuesday at Tasker

and Point Breeze Avenues from 3-6 p.m., and setting up in Zion AME Methodist Church from 9-3 p.m. every Wednesday.

Urban Solutions is a Primary Care Facility on Broad and Tasker streets that offers HIV testing and treatment and is also funded by the Afforable Care Act. Dr. Noble Jones, medical director and CEO of the office, thinks access to healthcare is a federal responsibility.

“We are fortunate enough to have Ryan funding which helps us with care for patients who have gaps in their insurance and medication coverage,” Jones said. “Philadelphia, in particular, has very good coverage for medications and for care. It would be impossible to treat them without the coverage because it’s just too expensive when the medications are inhibited by price.”

By funding programs like FIGHT and Urban Solutions, which directly serve an underrepresented community, the Ryan White Care funding is filling the gaps left by the Affordable Care Act.

Enacted by President Barack Obama in 2010, the Affordable Care Actmade strides in the HIV/AIDS community by expanding access to Medicaid, covering the cost of preventative services like HIV testing and lowering prescription drug costs for Medicare patients, among other measures.

“I think that increasing access to Medicaid was hugely important for many people we serve because it gives them availability to get covered for many conditions, HIV/AIDS
being one of them,” Yates said. “It’s really helped a lot of people that we’ve served being able to meet their healthcare needs.”

The contrasting platforms presented by major party nominees in the 2016 Presidential election raises the question for Point Breeze residents of the future of the healthcare system and its impact on HIV positive individuals.

The Clinton campaign released an extensive platform regarding HIV/AIDS treatment and prevention, and plans to expand the Affordable Care act.

The Trump campaign makes no mention of HIV or AIDS in theirHealthcare Reform proposal, or platform as a whole, and plans to repeal the Affordable Care act completely in favor of free-market healthcare reform.

“Trump doesn’t have much to say so it’s obviously not a big deal to him,” said Lynette Trawick, an advocate for the HIV-positive community whom has been living with her HIV diagnoses since 2008 at the age of 26. “If you’re not interested in HIV, you’re not for me.”

Trawick, a mother of 11, is covered under Medicaid, which subsidizes the cost of her HIV medication. For just one pill a day, the market price is $2,000 per month, and $24,000 per year.

Hillary Clinton has outlined an initiative that will cap monthly out-of-pocket costs at $250 for prescription drugs, in order to make access to medication possible for those who are uninsured, and has voted to defend the Ryan White Care Act.

The 2016 Presidential election and its effect on healthcare will certainly impact at-risk communities like Point Breeze, where Trawick says access to health insurance can mean life or death for someone living with HIV.

“A Clinton administration would be pro-HIV care, pro-medical care in general for the whole community,” Jones said.  “The republicans have showed very little support for that. I don’t think there’s any question about where they stand in that regard.”

- Photo and text by Brianna Spause, Video by Brianna Spause and Maggie Andresen for Philadelphia Neighborhoods