Since May, Dr. Robert Bolan has been trying to hire a physician who knows how to treat HIV patients. One of the doctors at the Los Angeles LGBT Center, where Bolan is the medical director, moved away last year.
"I just haven't been able to land somebody and put them in a clinic," he said. "There really is a shortage of primary care physicians, and particularly primary care physicians who want to go into HIV care."
Experts say that the first generation of doctors trained in HIV medicine is beginning to retire, and not enough physicians are entering the field to replace them.
To address that problem, L.A. County health officials announced Tuesday that they are launching a fellowship to train doctors in HIV-related medicine. Funded by a $7.5-million grant from pharmaceutical company ViiV Healthcare, the program will teach physicians how to care for HIV-infected patients at county facilities.
The fellows will be paid a salary during the two-year training and could receive student loan debt repayment assistance.
Dr. Mitchell Katz, the head of the county Department of Health Services, called the lack of physicians who specialize in HIV-related medicine an "alarming reality." L.A. County has more than 60,000 people estimated to be infected with HIV.
Katz trained as a physician at the height of the AIDS crisis, he said. Now, physicians are looking to enter specialties that pay better, he said.
"I didn't set out to be an HIV doctor either, but the emergence of the epidemic is what led us to do what we do," Katz said. "My concern is what does that look like into the future."
Advocates agree that the new initiative is good news for HIV-prevention efforts, but also note that ViiV Healthcare manufactures and sells HIV medications.
"To be clear, this is not charity on the part of ViiV," said AIDS Healthcare Foundation President Michael Weinstein.
Weinstein said he didn't see any problems with the county accepting the money, but that it should be viewed as a way for the company to increase sales.
Katz said ViiV Healthcare will have no influence over the prescribing practices of doctors.
Katz acknowledged that the grant comes at a time when drugmakers are being lambasted for reaping huge profits, "but I don't think we want people's skepticism to prevent pharmaceutical companies from doing the right thing."
According to county documents, ViiV Healthcare officials approached the county last year about the project.
Katz said the money that would help fellows pay off loans was a major part of the appeal in ViiV Healthcare's proposal. If fellows who have completed the program work in underserved areas anywhere in the country, they can get up to $50,000 a year toward paying off their medical debt.
"If people come out of residency with crushing debt, you can hardly blame them for looking for the most lucrative careers," he said.
The grant is expected to last five years and will be used to train 10 to 18 physicians. Doctors who apply must have completed a clinical residency.
Dr. Andrew Zolopa, the company's global medical director, called the program the first of its kind and said he hopes it becomes a national model for HIV training. It has the potential to benefit the county, doctors, patients and the company, he said.
"In the end it's a win-win-win-win, all the way around," he said.