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The Sweet spot: Access to care

It was 30 years ago, during the worst part of the HIV/AIDS epidemic, when the Sweet Emergency Fund came into being.

Dr. Donna Sweet talks to staff in her clinic
Since joining the KU School of Medicine-Wichita faculty in 1982, Dr. Donna Sweet has led the treatment of HIV/AIDS in much of Kansas.

It was 30 years ago, during the worst part of the HIV/AIDS epidemic, when the Sweet Emergency Fund came into being.

"We were working with a lot of very sick and dying people, and we didn't have the resources we have now in terms of case management and other things that built up through the years," the fund's founder and namesake, Donna Sweet, M.D., recalled. "We were desperately short of funds for paying for things back in the day."

The needs ranged from prescription drugs to a house for patients "with nowhere else to go." The idea of a fundraiser sprang up, and Sweet - a professor of internal medicine at KU School of Medicine-Wichita - volunteered to host. It's been in her backyard every year since then.

Sweet became known as "the AIDS doctor," though not because of the fundraiser. A former farm girl and the first member of her family to attend college, she first became interested in the disease because of her work in immunology and microbiology, her profession before she graduated from KU School of Medicine; her late husband was a Ph.D. immunologist. Since joining the KU faculty in 1982, Sweet has led the treatment of HIV/AIDS in much of Kansas while advocating for anything that can help prevent its spread.

In addition to a large general practice, Sweet and her team - which includes two nurse practitioners, a physician assistant, another internist and a family physician - care for about 1,300 HIV/AIDS patients, or just about all who live outside the northeast corner of the state.

"We're all credentialed HIV specialists," she said of her team. "This is the only place in the state where you can say that."

To reach rural patients, Sweet and her team drive to Salina and fly to Garden City and Pittsburg on a regular basis. In the past, KU was able to help cover flight costs, but that ended amid budget cuts in the last few years. Now, they must charter flights utilizing support through the state HIV program to continue those clinics.

Sweet has also conducted research and lectured around the world. In the United States, federal funds are now available for many aspects of treatment, in part because of lobbying by people such as Sweet. But her emergency fund is still needed to cover things such as eyeglasses and physical therapy to help newly diagnosed patients.

"We use it on an almost daily basis for somebody new to care who doesn't have their benefits in place," Sweet said.

Implementing what's known as "rapid-start HIV therapy," Sweet said, "We draw blood and get things going. The idea is to send them home with a prescription they can start that day." Patients "tend to take it more seriously" when that happens, she added.

New drugs and treatment mean that most HIV/AIDS patients can lead normal lives, as long as they follow their physician's guidelines.

"If you can get your patients on the drugs, they truly don't transmit it," she said. "There's a new movement called ‘U equals U.' Undetectable equals untransmittable."

But that doesn't mean the disease isn't a threat, Sweet says.

"It's still a public health issue. People often ask why we should treat HIV any differently than diabetes or hypertension. Well, diabetes and hypertension are not transmitted sexually."

That's why she's against a recent proposal requiring Medicare patients - about 25 percent of all HIV patients - to try cheaper, less-effective drugs before qualifying for more expensive treatment options, known as "step therapy."

"Why should you wait for someone to get sick?" Sweet said. "It seems like there's always an issue somewhere. We try to be on the right side of taking care of HIV patients."

Few would dispute that she's done that, around Kansas and in her clinic at KU School of Medicine-Wichita.

"She clearly wants anyone who's HIV-positive to be given expert care regardless of their ability to pay, whether they're homeless living under a bridge or a professional in the community," said Michael Madecky, who is HIV program coordinator for the clinic.

There are no plans to end the annual fall backyard picnic fundraiser with its fried chicken, homemade cookies, cold beverages, and live and silent auctions. Although Sweet describes most of her work matter-of-factly, she takes pride in the fact that "very little" of the fund's money is put into raising more of it. An annual humanitarian award and dinner established by Sweet in 2005 also raises money for the fund. Local broadcasting legend Larry Hatteberg was the 2019 honoree.

This article was first published in KU School of Medicine-Wichita's Embark Magazine.


KU School of Medicine-Wichita