Martine Etienne

Day-to-day responsibilities:
"A lot of what I do includes screening patients for the JACQUES Initiative and administering the Barrier to Adherence questionnaire which assesses patients and their adherence to taking their medication.

I do one-on-one HIV education workshops with those who might not want to come to a group workshop. These individuals tend to be newly diagnosed and more private about their HIV status."

On the success of the program:
The JACQUES Initiative is more than telling patients about HIV drugs and how to take their medication.

"It's about showing people how to live again, giving hope to those less hopeful. We conduct Life Skills workshops, which provide assistance with health insurance, substance abuse counseling and barriers to transportation. The JACQUES Initiative is really a holistic approach to treating patients living with HIV."

The biggest challenge:
Substance abuse is a huge barrier to success in Baltimore City and many of the patients who come into the JACQUES Initiative are dealing with some form of substance abuse, whether it's past or present. "Our job is to get them on the right track, to get their lives back and to help them be successful with their HIV regimen."

The greatest reward:
Patients are really rebuilding their lives. "We first meet them at an educational workshop and some are downtrodden and hopeless. After weeks of interaction, you can literally see the transformation that takes place in their life. Patients are grateful for the JACQUES Initiative, they come back to other educational workshops and share their stories about how much the Initiative has helped them."

"One of the things that drew me to the program was the direct contact we have with patients and seeing the difference in their lives," says Martine Etienne. "The JACQUES Initiative is more than telling people to take a pill. It's showing people how to live again."

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Kathy Bennett
Treatment Coach

Day-to-day responsibilities:
"I make sure client charts are in order, make weekly progress notes, note situations they might have encountered, get updated on anything new in their lives. I help them with housing, insurance, make sure they keep their doctors appointments. Sometimes they just need someone to talk to."

What spurred her interest and involvement:
"The name Joe Jacques. Joe Jacques was my mentor. All that I know I learned from Joe." A patient who has struggled with drug adherence and side effects herself, Bennett learned about the JACQUES Initiative at a community planning retreat. "I was real excited about a program to do direct observation therapy. And to know that they were naming a program after Joe, it was an honor. To carry out his legacy is a blessing."

The success of the program:
"The majority of my patients are doing extremely well. They haven't missed a day. They love us. They love the JACQUES Initiative. They say it's like a breath of fresh air, to see that genuine concern."

The biggest challenge:
"To see how many people need assistance with meds and are coming into the Institute seven days a week."

The greatest reward:
"No matter where you go now, people know about the JACQUES Initiative. People are sending patients here and coming to workshops. And we're not turning anyone away,"

"To see a client when they first come in and then months later, they just feel really good about themselves. They're real fragile at the workshop," says Kathy Bennett. "They don't know what to expect and when you really see them take charge of their life and blossom. That's the reward."

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Gene Chance
Community Outreach Coordinator

Day-to-day responsibilities:
Helped develop the operational phase of the JACQUES Initiative protocol, create standardized forms, secure educational materials. Coordinates events, plans educational workshops, schedules guest speakers, visits hospitalized patients in acute care at UMMS, as well as other prospective clients at community events.

What spurred his interest and involvement:
"The educational component." As a peer advocate with another local employer, Chance was involved with intensive case management. "I collected educational materials and distributed that information in class. Unfortunately, there was not a lot of patient education going on."

The success of the program:
Patients taking charge. "I think there's a great desire for the clients to learn more about this disease and in a format they can understand. I think that craving for knowledge is what truly helped fuel this."

The biggest challenge:
"In the beginning, seeing all the potential and wanting to make sure it was fulfilled. It's been amazing that it has been and so quickly."

The greatest reward:
"Just seeing patients do well." A friend and professional colleague who works with HIV teens was hospitalized for the third time this year when Chance talked her into giving the JACQUES Initiative a try. "I really doubted whether she would live out the rest of the year. All she was talking about was death. The reality was that she was great at telling everybody else what to do, but wasn't doing it itself. This program really jumped in and helped save her life. She hasn't been in the hospital since and her health has improved dramatically. To see something like this, the turn-around, is just amazing."

"We all knew we would save lives," says Gene Chance. "But sometimes you don't know how far you'll be reaching."

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Harriet Kapilikisha

Day-to-day responsibilities:
Meets one-on-one with clients, assists with medication and other day-to-day concerns. If someone misses an appointment or experiences side effects, she follows up to address issues.

What spurred her interest and involvement:
Originally from Africa, she has spent more than a decade in the pharmaceutical industry and the field of HIV/AIDS. In Africa, Kapilikisha had seen the false claims of drugs that could "cure" AIDS.

"For them, an HIV diagnosis is like a death sentence. The difference is that here when you're told you're HIV positive, you go on, it's a lifelong disease. I know drug adherence is difficult and it's a lifelong process. I wanted to offer support as much as possible and help where I can."

The success of the program:
Individualized attention. One patient, for example, reported that his drugs prevented him from sleeping. A simple adjustment was made so that he takes his pills earlier in the day. "He is reporting that he is feeling fine now. He works seven days a week and comes in after hours for directly observed therapy. We try to make it as convenient for them as possible."

The biggest challenge:
The difference in cultures. "In Africa, the problem is not adherence, but availability of meds. Here, it's substance abuse. As a result, adherence to the medication becomes a problem, resistance to drugs develops or there can be debilitating side effects."

The greatest reward:
"Seeing the patients come in every day and looking better. Some will tell you, you're a godsend. This program is something we've needed for so long. It makes me want to go on to do more."

"I think the educational workshops are really great," says Harriet Kapilikisha "People assume they know so much and come to find out that there are so many misconceptions."

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Valerie Coles
Community & Education Coordinator

Day-to-day responsibilities:
Meets with practitioners, community based organizations, AIDS service organizations and patients to introduce the JACQUES Initiative program, serves as liaison between the JACQUES Initiative and clients, manages program data, registration and screening process for workshops and study entry.

What spurred her interest and involvement:
Coles has spent her career affiliated with social work organizations, addressing community needs. "This position was appealing because it allows me the opportunity to advocate and help educate patients."

The success of the program:
The patient who comes away from the workshops, the screening & initiation to therapy visits feeling empowered. The patient who, after three to five months, receives lab results that indicate they are successful in managing their HIV medications.

The biggest challenge:
Keeping up the pace. "There are a number of people in Baltimore City who need this program, and we're up for the challenge."

The greatest reward:
When clients successfully take their medications, truly realize that who they are is not a CD4 count or a viral load number, and you see this reality in their smiles, in their walk, in their talk and most of all in their lab results.

"There is still a stigma to being HIV-positive and the average HIV persons thinks, "I'm about to die." It's when we remove that stigma and they can see that they have a chronic illness, that others won't reject them, and that they have a future that the patient will become engaged in their care."

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Lisa Langer
Pharmacist

Day-to-day responsibilities:
"I dispense medications to the patients. Some come everyday; others come weekly. And that's for HIV and any other medications needed. We call it one-stop shopping, to make it easier and more convenient for them to manage their care."

What spurred her interest and involvement:
A pharmacist for 13 years, Langer had been working part-time for the IHV, when she was approached about the opportunity to participate in the launch of the JACQUES Initiative. "It seemed like a natural solution."

On the success of the program:
Langer believes it begins with the patient's introduction to the educational component of the program, then frequent follow-up with clinical staff. "Derek's workshop is just wonderful, how he explains drug resistance and the importance of medications and how they're taken; how an HIV diagnosis is not the death sentence it was 10 years ago but it a chronic disease, much like diabetes."

The biggest challenge:
"There are few negatives. The patients are very appreciative. We've had some patients," she says, "who've done everything they were supposed to, but then have trouble following through. But that's the exception. The secret is finding the right words that will turn on the light bulb for them."

The greatest reward:
Personal contact. "As a hospital pharmacist, 90 percent of the drugs you dispense are to a nurse. You never get to know patients or know if what you do is helping them. Here, I see day-to-day that what I do is helping them."