AIDS Clinic in Van Nuys Closing

The largest AIDS clinic in the San Fernando Valley is closing, its officials said Thursday, in part because it’s caught in an ironic trap: New drug therapies that offer the best hope yet of beating the disease are too expensive for its budget.

The AIDS Healthcare Foundation’s clinic in Van Nuys will cease operations in September, said foundation president Michael Weinstein, sending its nearly 500 uninsured or Medi-Cal patients to seek care elsewhere.

Weinstein said the nonprofit foundation, which operates three other clinics in the Los Angeles area, had applied to Los Angeles County health officials for an additional $1 million to meet the cost of the new drugs and other expenses.

At a news conference in front of the Van Nuys clinic, he angrily said the county had turned the request down. “It’s a cruel act in the wake of Vancouver,” he said, referring to the site of the recent AIDS conference at which promising results of the new drug therapies were hailed.

Weinstein said that when word of the funding denial came Wednesday, it was decided to close the Van Nuys clinic because it is the foundation’s smallest.

The decision was particularly difficult, Weinstein said, because it leaves the Valley without a full-time AIDS/HIV clinic for uninsured patients.

The closing of the clinic is likely to fuel local activists’ contention that the Valley does not get its fair share of AIDS/HIV health care facilities.

“We had to make a cut,” Weinstein said in an interview. “And if it’s a choice of cutting the care for 500 people in one clinic or 1,000 in another, you have to go with the smallest.”

The foundation, which has a $30-million annual budget--the largest in the country for a community-based AIDS care organization--was granted $5.6 million from the county this year, the same amount it received last year.

County AIDS coordinator John Schunhoff acknowledged that costs had risen since then, but he said it was a struggle just to keep the funding at last year’s level.

“Every other year we were able to increase their budget, but this year we actually got a reduction in federal funds,” he said.

The recently announced advances in drug therapy involve giving patients a combination of three medicines, including one from a new class of drugs called protease inhibitors. The mixture was shown in several studies to greatly reduce levels of HIV, the virus that causes AIDS, to an undetectable level in some patients.

“A protease inhibitor for one month for one patient can cost $600,” Weinstein said. Scientists at the Vancouver conference said the combination drug therapy could cost as much as $16,000 a year per patient.

Because AIDS Healthcare Foundation mostly serves patients who have no private insurance and are not eligible for Medi-Cal or Medicare, it has to pay the cost of those therapies, Weinstein said.

Patients will either have to seek care at other Valley facilities--Olive View Hospital, a county facility, takes uninsured patients, as do a few other community-based clinics--or travel into Los Angeles for health care.