Community in a Time of Crisis: Yale, New Haven, and HIV/AIDS, 1981-1996

AIDS in the Clinic

Article about pediatric AIDS, highlighting Leetha (Fraulino) Filderman, from Fairpress, December 10, 1986.

In the months following the infamous CDC report, unusual pathology results from Yale  New Haven Hospital’s (YNHH) laboratories made it clear that New Haven would not remain unscathed. In 1983, the Section of Clinical Immunology established a role for a single nurse practitioner to serve as an AIDS coordinator with broad responsibilities, including managing physicians’ meetings and clinical services for people with AIDS at the hospital while also providing direct nursing care for people with AIDS at the immunology clinic. 
 
For the first few years of the epidemic, this single AIDS Coordinator attempted to support both the patients and the health care providers connected to the disease. In 1985, Leetha (Fraulino) Filderman, APRN, assumed that role, and under her fierce and protective leadership, the AIDS Care Program began to take shape. She struggled to staff the overflowing outpatient AIDS clinic, which was not a required rotation for resident physicians at YNHH. Many health care providers refused to care for people with AIDS, and at times, the stigma faced by those patients extended to the doctors and nurses who devoted themselves to working with people with AIDS. After several months, pediatric resident Warren Andiman, MD, became the first physician to take on a formal role at the clinic, even though the vast majority of clinic patients were adults. They were also joined by social worker June Holmes, MSW, who served as a crucial link between the program and the city of New Haven. This collaborative approach, which was championed by YNHH Chief of Staff John Fenn, MD, became a defining feature of AIDS work at Yale.

Newsweek magazine, July 21, 1986.

In 1991, YSM recruited Gerald Friedland, MD, to join the faculty. He received funding for the creation of the first AIDS fellowship in the nation, which radically altered the landscape of HIV/AIDS research and clinical care at YSM. Yale developed strong links between a dedicated inpatient AIDS ward (now called the Donaldson Ward), the outpatient Nathan Smith Clinic, and the mobile health care van, emphasizing the importance of continuity of care. In addition, Frederick Altice, MD, began the groundbreaking HIV in Prisons Program, and the broader research program continued to expand as Yale became a National Institutes of Health (NIH) Adult AIDS Clinical Trial Unit, with a focus on recruiting diverse populations for drug trials.

The AIDS Care Program also built upon the existing strengths of community organizations. In the early 1990s, a Yale study revealed that people with AIDS had unnecessarily long hospital stays, caused by the limitations of existing outpatient services. Rather than duplicating efforts, the AIDS Care Program mobilized its resources to expand the highly successful programs offered by such organizations as APNH, AIN, and Hispanos Unidos, which were already active across the city. In 1997, this innovative collaboration was honored with an American Hospital Association NOVA award.

Article from Yale Medicine (alumni bulletin of Yale School of Medicine), summer 1991.

Article from Yale Medicine (alumni bulletin of Yale School of Medicine), summer 1991.

Poster advertising the interdisciplinary Yale AIDS Colloquium Series (YACS), 1991.