Research is not always in the test tube or laboratory bench. Nor are advances in patient care achieved only through tightly controlled clinical studies, in university medical centers and major teaching hospitals. Funding is not always available from national foundations or the federal government, especially when the modality is new, unusual or deals with a less than popular disease or segment of the population.
Today, the importance of nutrition in HIV is recognized and attended to by health care professionals treating the disease. This, however, was not always the case. It is possible to trace the history of the nutritional aspect of the treatment of the disease in Chicago.
The idea for a nutritional aspect of HIV treatment came from a meeting which occurred at Howard Brown Health Center Clinic in 1988 between Bob Rybicki (former Director of Social Services at Howard Brown) and Kathleen Pietschmann, N.D. The clinic staff were reviewing the services that could be provided which would impact the disease. Nutritional assessment and intervention using a registered dietician seemed needed and feasible. Funding would have to be secured for this project and in Chicago, at that time, there were few sources for direct services for HIV. Washington Square Health Foundation had been identified by the AIDS Foundation of Chicago as the foundation that was providing funds for direct HIV services. Washington Square had decided that it would fund projects for this unpopular and stigmatized disease. Dr. Pietschmann (then Ms. Pietschmann, RN, MS) was, at the time, both a volunteer to Howard Brown and a volunteer consultant to Washington Square. She was asked by Washington Square to assist with the program development. Bob Rybicki knew that the individual selected for the position would have to be knowledgeable, willing to learn, and be accepting of different lifestyles. Interviews were conducted by the Howard Brown staff, with the technical assistance of Dr. Pietschmann, and concluded by the Howard Brown staff, with the technical assistance of Dr. Pietschmann, and concluded with the hiring of the first dietician for HIV in Chicago, Annette Smerko-Henry, RD, LD.
Patient response was overwhelmingly positive, but health care professionals were slow to acknowledge the potential contribution. Ms. Henry did outreach and remembers a presentation to one of the major HIV treatment centers receiving little interest, “It was as if they thought I was making a case to have them hire me”. As time went on, with the work of Dr. Kotler and wasting syndrome identified as AIDS defining, nutritional assessment and interventions became a part of the standard of care. Today, diet, supplements and hormonal assessment and replacement are utilized to correct the deficiency.
Most recently, Washington Square has continued its support of the nutritional aspect of AIDS care by funding an expansion of the Open Hands, meals on wheels program to the South Side of Chicago.