Dawn Jenkins, HIV/AIDS healthcare warrior: 'Know your status'
AIDS activists protest in New York's Grand Central Terminal on Sept. 2, 2004. AP Photo/Stuart Ramson.

Houston transplant Dawn Jenkins is nationally revered for her work as director of Thomas Street Health Center and HIV Services for Harris Health System. This September, Jenkins celebrated her fifth-year anniversary of leading the largest HIV/AIDS service in Harris County. During her leadership, she’s maintained services and care for 5,700 HIV/AIDS patients annually while navigating historic hardships including the recovery of Hurricane Harvey, the ongoing COVID-19 pandemic and the emergence of Monkeypox.

Dawn Jenkins

Before coming to Houston, Jenkins, a licensed clinical social worker with more than 30 years of experience, also worked in the state of New York, a bulk of it (16 years) for the New York City Health and Hospitals Corporation, the nation’s largest public healthcare system. As a pioneer in social advocacy and HIV/AIDS services, she was directly involved with the implementation of Intensive HIV Case Management Services with the AIDS Institute of New York State.

In Houston and Harris County, Jenkins keeps a pulse on the HIV/AIDS community’s healthcare needs through her work as an appointed member of the Ryan White Planning Council for the Houston Extended Metropolitan Area.

Jenkins realizes AIDS has faded from the national conversation, but hopes to put it back on people’s minds because of the treatment successes that need to be celebrated, and because of the continued prevalent health threat HIV/AIDS poses, especially for the Black and Latinx communities. And though Blacks make up only 13% of the US population, according to the Centers for Disease Control (CDC), Blacks are disproportionately impacted by HIV, making up 40% of those with HIV in this country in 2019. Thus, Jenkins gladly spoke with the Defender about the topic and her role in providing service to those with HIV/AIDS.

But first, some statistics to consider.

The World Health Organization still classifies HIV as a global epidemic, with “epidemic” defined by WHO as “an unexpected increase in the number of disease cases in a specific geographical area.” So, even though COVID, Ebola, bird flu and others have during various moments have taken center stage in the American consciousness, HIV/AIDS is still doing damage.

For example, according the WHO statistics from July 2022, in 2021, 38.4 million people were living with HIV, which is roughly the population of the country of Iraq or the state of California. That number is more people than the combined populations of Sweden, the United Arab Emirates, Austria and Israel.

Of those 38.4 million individuals with HIV in 2021, the vast majority were adults (36.7 million), with women (19.7 million) living with the disease in greater numbers than men (16.9 million). But an astounding 1.7 million of those with HIV were children 15 years old or younger.

And though there were more women than men living with HIV in 2021, more men contracted the disease that year (680K compared to women at 640K) and more men died of HIV-related causes (320K compared to women at 240K).

Blacks are 13% of the US population but 40% of the people in the US HIV

CDC, 2019

In 2021, 1.5 million people acquired HIV, while 650,000 died from HIV-related causes.

Still, the medical community is encouraged by current trends. The global HIV epidemic claimed 68% fewer lives in 2021 since its peak in 2004. And fewer people became newly infected with HIV than in any year since 1990. Moreover, between 2000 and 2021, new HIV infections fell by 49%, HIV-related deaths fell by 61% with some 18.6 million lives saved due to individuals receiving antiretroviral therapy (ART) in the same period. This achievement, the WHO report says, was the result of “great efforts by national HIV programs supported by civil society and a range of development partners.”

Currently, 85% of the 38.4 million people with HIV (roughly 32.6 million) know their status. That means 5.75 million people are currently living and interacting out in the world as if they do not have the disease. The WHO’s target of having 95% of those with HIV being knowledgable of their status requires that at least 4 million of that 5.75 million group be made aware that they are infected with HIV.

In the Americas (North, Central and South America), an estimated 3.8 million people were living with HIV in 2021, of which 85% knew their status, 74% were on treatment, and 66% were virally suppressed. An estimated 2.8 million people were on ART. Also, an estimated 110K people became newly infected with HIV, while 86K deaths were attributed to HIV-related causes.

According to HIV.gov (updated Oct. 27, 2022) HIV stats in the US look like this:

  • Approximately 1.2 million people in the U.S. have HIV. About 13% of them (156K people) don’t know it and need testing.
  • HIV continues to have a disproportionate impact on certain populations, particularly racial and ethnic minorities and gay, bisexual and other men who have sex with men.
  • In 2019, an estimated 34,800 new HIV infections occurred in the U.S.
  • New HIV infections declined 8% from 37,800 in 2015 to 34,800 in 2019, after a period of general stability.
  • In 2020, 30,635 people age 13 and older received an HIV diagnosis in the U.S. and six dependent areas—a 17% decrease from the prior year, likely due to the impact of the COVID-19 pandemic on HIV prevention, testing, and care-related services.
  • HIV diagnoses are not evenly distributed across states and regions. The highest rates of new diagnoses continue to occur in the South.

It is the US population that garners most of Jenkins’ attention, especially those in the South. And more specifically, those in Houston/Harris County.

DEFENDER: Was a career in social work and healthcare your dream job as a child?

DAWN JENKINS: Well, when I was five, I always said, “I wanna be a superstar,” whatever that means, and “I wanna help people.” So, there’s a little artist side of me and I have been a part of an African dance troop. I took tap and ballet and jazz. I’ve performed on ABC, The View, a little show in Carnegie Hall, and a couple of smaller venues in New York City. And the helping part has always, always just been a part of who I am, and who I was from Girl Scouts. Did you ever know anybody being in Girl Scouts from elementary school all the way to college? That was me. Girl Scouts, all the way through. And I tell people, my career or interest in the arts, Broadway don’t take me. I take Broadway wherever I go, whether it’s in healthcare or social work. If you ask anybody that I work with, team, colleagues, peers, patients, they’re like, “She’s animated.” There is joy inside of me that I have to bring.

Even when I worked with the elderly, several nursing homes here, when I came to Houston. It was a show we sang. We did lots of old tunes to take people down that nostalgic lane. So, I take it with me.

DEFENDER: So, tell us about how you’ve done that with Thomas Street. And what is Thomas Street?

JENKINS: Okay, so Thomas Street or “The Street” is a health center within Harris Health System. And one of the goals that I’m trying to do is connect those dots because Thomas Street has a very robust, important history in the field of HIV and it’s a part of Harris Health. But most often, if you say, I represent Harris Health, HIV services, people go, “Okay. That’s nice.” And when I say “At Thomas Street,” they go, “Oh, like, wow. Thomas Street.”

I heard about Thomas Street, even when I was in New York City. Thomas Street is the first freestanding HIV dedicated clinic in the United States. So, in the very beginning of the HIV/AIDS epidemic, where it was just a tough time—people didn’t know what it was, a lot of stigma, a lot of discrimination—Thomas Street was that place where you could go and not just get the healthcare services that you needed, but you got a sense of belonging. Like, we’re not afraid of you. And we just broke through those stigmas.

A lot of great research, a lot of awesome physicians that are written and published in the field of HIV came out of Thomas Street. And again, like I said, we knew about Thomas Street in New York City. And New York City is on and poppin’ and progressive. We hit everything hard and fast. So, for a clinic in the south to be that progressive was amazing.

My education is a bachelor’s in social science with a minor in psychology from Hofstra University in Long Island. After that, I went to Hunter College School of Social Work as part of the CUNY system in New York. I worked at New York City Health and Hospitals Corporation, the Queens Hospital division. It’s kind of like Harris Health on a very broad scale, about two hospitals in each borough and a hundred clinics all over the place. And there, I was really raised professionally to work with a population of people that might have a little bit less resources than others, but it doesn’t mean that they cannot get the best services.

Fast-forward to Thomas Street Health Center, part of Harris Health, I walk them floors every morning when I come in and I tell people, “Hey, how are you doing this morning? Did you know that your doctors are a part of research known all over the world?” Some have contributed to that one pill a day, and now we’re getting ready to go to the injection every other month where HIV, in the very beginning, I’m telling you, it was if AIDS didn’t kill you, that medication did. It was just so much; so complicated back then. Just too much for a person to handle. And now we’re one pill a day. So, when people say they come to Harris Health, like the county hospital, I’m like, “Your doctors are Baylor doctors, they’re UT doctors. We’ve got all kinds research and I guarantee you and put some money on it that the cure will probably come out of Thomas Street. How about that.

DEFENDER: Were you born in New York?

JENKINS: I was born and raised in Queens. And, I say that just with such pride. I ran in so many circles, with LL COOL J and Curtis [50 Cent] Jackson, who’s now in Houston. And he’s doing some good things with children, young entrepreneurship and business in the Houston schools. So, I’m proud of that.

I had been in Queens, born and raised in Queens, and then married, three children. We kind of moved a little north to Westchester County, which is north of the Bronx. And then made this transfer here to Houston in 2008. My husband’s job brought us out here and I was like, “Where can I get a good pizza? Where’s the subway? We gotta drive everywhere.” But it’s beautiful.

Fast-forward, I have adjusted. Like, I’m driving down a major highway and I see cows. So, I used to stop at the light and take a picture with my cell phone that you can use while you’re driving. In New York, as soon as cell phones came out, the law—a $150 ticket if caught doing that. rally probably the second week. So we couldn’t use them. We couldn’t use them at all. But just loving the slower pace, the ability to see an open sky, just absolutely beautiful. But since 2008 to 2022, I’m like, I could have stayed home for this. Y’all are booming, growing, traffic. I’m like, “Where did the cows go?” Now, there are tall buildings and stuff. I’m just glad that I got to experience the beautiful, beautiful country part of Texas before y’all turn into New York tomorrow.

DEFENDER: What led you to specialize in care for HIV/AIDS patients,

JENKINS: At Queens Hospital I started out as a social worker with the at-risk youth population: sexual active, parenting, pregnant teens in the hood. And, being so young myself then, because I think when I got my master’s I might have been 21. And to be close to that adolescent population where you could be this role model, this strong young woman of color that might be four years older than [many of the youth I worked with] in this role of mentoring. And in that particular practice, HIV became a new thing. And it was like, okay, “We now are offering testing.”

And I remember a young couple getting ready to go to college and they just wanted to be monogamous, saying “We just want to make sure everything is all good.” To tell somebody 18 years old on their way to college, that your HIV test is positive, that was devastating. And, things have changed so much, but I could remember, one of the more seasoned social workers would be the one to get this list every week. And every test that went out, we had to code it with name and number, and she would get the paper back and we’d go, “Bernice, is anybody positive?” And we would just exhale. And then it’s like, “Oh my gosh, Dawn, you have one.”

So, I had to get myself together to be able to share that diagnosis and figure out how am I gonna do this and provide some hope and not have these young people feel like their life is over, their dreams are crushed; “We’re on the way to college now. We’re getting out of the hood, and now this.” That opened up that door. And then from there, there was a little position of growth to be a coordinating manager for an HIV program that they had at the main hospital.

So I took that particular position and then from there, landed with one of the best HIV teams in the country. Particularly, this doctor went on to do some work with Magic Johnson and other people. And it led me to stay in that field, because you have to. I’m very animated and upbeat. You gotta bring the hope, you gotta have some life. You gotta laugh because you’d be crying every single day: “Who died today?”

And now fast-forward, ain’t nobody dying. You know what they’re dying from? Uncontrolled hypertension, diabetes, ain’t eating right. HIV—that’s controlled. That’s what our doctors say. I could see them twice a year. But if they keep eating the way they’re eating, there’s gonna be a problem. Isn’t that something. [HIV/AIDS] is now a chronically managed, if you do well, chronically managed illness.

DEFENDER: What does the public need to know about HIV/AIDS right now, especially since it’s rarely even discussed anymore?

JENKINS: What you need to know is, you need to know. People need to get tested because the more you know, the quicker you can take those antiretroviral phenomenal medicines and then you could be virally suppressed. So, the more you know, the chances of transmission are significantly decreased if you get on treatment. But for a lot of people, there’s still that fear of “I don’t wanna know.” And you should, because here’s the deal. If you’re negative and you can take that PrEP medication, if you fall into the category of, and I don’t like to use like judge terms, but if whatever you’re doing puts you at a higher risk for potentially contracting HIV, you can get on the PrEP medications. It’s another one pill a day that will prevent you from getting it.

And, one of the things is, “Hey, everybody deserves relationships and love. And what if somebody is in love with somebody who’s positive and maybe they want a baby, or maybe they want safe intimacy? There are protocols now that not even the [HIV] negative mom, if it’s an [HIV] positive dad, the negative mom should not produce a positive child if they follow the proper protocol. And it doesn’t have to be through artificial insemination, et cetera. This is how advanced we have become. So, this is why I scratch my head, like, “Somebody is positive? Why are we getting more positive people? What’s is going on?” So, it’s all about knowing your status and getting information to protect yourself from transmissions.

And for the folks out there that are positive, you can have a wonderful, healthy life. Stay on your meds. Make sure you check your labs. And then you could be virally suppressed to the point of being undetectable. And what undetectable means is that the tests are not strong enough to detect the level of HIV.

DEFENDER: What’s the most rewarding thing about your job?

JENKINS: Parking in that parking lot, when I go into the office, and getting out that car, looking at that beautiful orange building structure that used to be a hospital for people that worked for the railroad way, way back when. And just getting into, I’m even saying character. It’s like I get into gear of who am I going to cross paths with today? Who am I going to bring some joy to? What is my assignment? I know what my job is, but what is my assignment? So, as a Christian, that’s my faith. You walk by faith and you also were brought here to do great works in His name that He already prepared for you to do in advance. That’s what the word says. So, for people who don’t know their purpose, I go, “Wow, that’s a different kind of journey.” But when you know what your purpose is and you walk in it, that’s what makes life so beautiful when I go to work.

Whether it’s a crowded day, people are playing the lines that are long, or it’s an awesome day and everything just flows right, you go in there to bring some joy and to let people know that HIV is not a death sentence. So that’s what I enjoy. And you can ask my team. We have an awesome, awesome group of people who work at Thomas Street who also bring the joy. They say, “We can tell when you are in the building because we hear them heels clicking and you’re either singing… There’s a routine in the morning. I walk by people registering and it’s usually <starts singing> “It’s gonna be a lovely day.” And people just kind of start singing. We pick the song of the day. It’s just about joy. Bringing the joy to whatever you do, whether you’re part of our housekeeping team, whether you’re in the pharmacy, security, the doctors, we gotta bring it.

DEFENDER: What are the challenges in general with your job, and the challenges specifically in having to deal with things like Hurricane Harvey, the COVID pandemic, etc.?

JENKINS: So, the challenges in general, as you might have seen, we’re on the news about this budget Are we gonna pass the budget? Are we operating in a deficit? Finances for safety net hospitals are always an issue. We are blessed enough that I would say maybe 80% of our services may come from some kind of grant funding. So, that helps supplement the city funding. But again, we are a part of Harris Health System and we do rely on some of that revenue to support things like our operations and fill in the gaps where the grants don’t. So that’s always a challenge. And we just have to get creative in terms of how we continue to provide these needed services. Because Thomas Street is a one-stop shop.

You go in there to bring some joy and to let people know that HIV is not a death sentence.

Dawn Jenkins

You come into the building, you can go to social services, you can get behavioral health services, you can get specialty services. Because outside of just HIV care, they may need to see the endocrinologist or the rheumatologist. All of that is in the building. Working to sustain those services so that there are no gaps, including in pharmacy… finances, finances may be a challenge. But, at the end of the day, I don’t think we ever say no to a service.

The other piece is, we work with a community of providers. So, if we can’t meet that need at Thomas Street, we may send them to AIDS Foundation Houston, Legacy [Community Health]. We are all on the same playing field, just different jerseys. We all play football. We might play for the Giants or Kansas City or the Saints. So that’s one challenge.

COVID, we managed well. We were talking before this about jumping into telemedicine, which prior to COVID it was, “Well, we gotta see; there’s issues around compliance. It’s gonna take a lot. It’s gonna be a process.” And COVID was like, “Really”? And then that process moved quickly and we met every IT, every legal, every compliance need, and we made it happen. That was one of the positive things that came out of COVID. So right now, we’ve come a long way.

Just because we’re not dying like we used to, doesn’t mean we should fall off in terms of our education and advocacy.

Dawn Jenkins

The challenge really is to get that information out there to let people know, just because we’re not dying like we used to, doesn’t mean we should fall off in terms of our education and advocacy. Y’all need to know. We need to bring it. We need to bring it everywhere: to the schools, the colleges, the churches, the supermarket. Just let people know that HIV hasn’t gone anywhere. How we’re treating it and where it’s transitioned to as more manageable so people can have a good quality of life is there, but we still need to know how to reduce transmission.