Internist Speaks Volumes for Those Suffering in Silence

MAY 19, 2015
Ed Rabinowitz
Judith FeinberEveryone needs an advocate, a champion. Someone taking up the fight on their behalf to correct an injustice that occurred or an imbalance that exists.
 
Where HIV, AIDS, and women are concerned, that champion is Judith Feinberg, MD, a professor of internal medicine at the University of Cincinnati College of Medicine.
 
Feinberg is nationally renowned for her work on HIV and AIDS, and his contributed significantly to their effect on women. She has also brought to light the importance of working harder to include women of color in clinical drug trials designed to broaden the medical community’s knowledge about AIDS.
 
“Women are kind of the forgotten part of HIV,” Feinberg explains. “They don’t get very much attention. It’s not like they can go to a gay bar. There’s no sort of natural community for women who have HIV. Most of them end up bearing that in silence.”
 
So Feinberg speaks for all of them.
 
Shunned and Overlooked
 
Feinberg says one of the challenges facing women with HIV and AIDS is one of access and attention. Many of them have no one they can turn to because they don’t feel that their families will accept them.
 
“About 30 percent of the people that we’re seeing in our clinic are women,” she says. “That’s a significant amount of the population. That’s why I’m drawn to it.”
 
But there are other issues. Feinberg says that women have been excluded from studies in this area, so there is a paucity of information available to clinicians for guidance. What has come to light from studies comparing women and men is that women respond with much more nausea than men across a range of medications. That’s an education problem.
 
“I think because being gay got so much press early on that many people are just not aware of [women and HIV/AIDS],” Feinberg says. “Everything about being a female and having this disease tends to isolate women. And often the only time they can be open about it is when they see their doctor.”
 
Hepatitis C Challenge
 
Feinberg’s work as a researcher and caring clinician is not limited to patients battling HIV. She’s also heavily involved in the area of substance abuse. She created a syringe exchange program in Cincinnati designed to address heroin addiction and to cut infection rates of HIV and Hepatitis C.
 
“That’s a big tragedy,” says Feinberg, referring to the substance abuse issue. “In this county, Hamilton County, Ohio, which encompasses the Cincinnati and close suburbs, we had 250 who died of a narcotic overdose in 2014. That’s five a week. It destroys families. If that isn’t a tragedy then I don’t know what is.”
 
The syringe exchange program, however, has had a host of hurdles to overcome, not the least of which is the conservative nature of the Cincinnati populace.
 
“This end is the red end, Cleveland is the blue end,” Feinberg says. “You know, John Boehner comes from a Cincinnati suburb.”
 
But the challenges go deeper than simply political ties. Feinberg says that people—even sympathetic, educated people—don’t truly understand the meaning of harm reduction, which is a very important public health principle. The tendency is to equate the syringe exchange program to aiding and abetting—even enabling in many respects.
 
“But that’s like saying if you have glasses in your house you’re enabling people who come to visit who are alcoholics,” Feinberg says. “People don’t start shooting up because they have clean needles. They shoot up because they’re addicted to drugs. People will shoot up whether they have clean needles or not. The idea of harm reduction is to keep people alive and healthy until they get with the drug treatment program.”
 


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