The Infectious Diseases and Immunology Center is a 16,600-square foot facility which provides care to a large and diverse patient population from across the state. The Ryan White HIV Care program offers comprehensive HIV primary care to over 2,000 PWH, which is over 90% of PWH who are in care in the state of Rhode Island. Our site has over 20 active clinical HIV faculty, 5 specialist APP’s, and 3 dedicated HIV clinical pharmacists. Clinical care is provided in a multidisciplinary environment that also includes six social workers, three medical case management nurses, a clinical ID nursing team, a nutritionist, and a behavioral medicine team. The Center is an active HIV research and training site. It is the primary site of the Providence/Boston Center for AIDS Research (https://cfar.med.brown.edu/) and the Miriam Hospital Clinical Trials research unit, serving as an active site for HIV-focused studies.

Additionally, our program will provide clinical training in the diagnosis and management of active tuberculous infections and treatment of latent tuberculous. Fellows will rotate at the RISE Tuberculosis Clinic. The RISE TB Clinic provides care for most Rhode Island residents with active tuberculosis and latent TB infection. The clinic cares for both adult and pediatric patients. The clinic is partially funded by the RI Department of Health and works closely with the RIDOH team to support active TB patients through treatment with directly observed therapy., The TB Clinic cooperates closely with the DOH to support contact investigations for patients with active TB and screen exposed patients. RISE Clinic staff meet weekly with the RI DOH TB teams and quarterly to conduct cohort reviews of active TB patient cases to address programmatic issues and processes. The RISE TB clinic also plays a critical role in evaluation and management of newly arrived refugees and TB Class B1 immigrants. The TB clinic providers serve as TB medical consultants to community providers.

Consistent with the majority of HIV care provided today in the US, this training program is primarily an outpatient-focused year. Key components of the clinical curriculum are listed here:

• Longitudinal HIV care. Fellows maintain an HIV primary care panel. Fellows follow their own panel of PWH, whom they see in 3 HIV clinic sessions per week. Fellows hand off a core panel of patients year-to-year, and also see other patients (all living with HIV) for urgent care visits and new patient intakes., including participation in our rapid ART initiation protocol. Fellows also care for patients for PrEP and hepatitis C during these clinic sessions.
• Elective clinics. Fellows will choose among a number of internal and external elective clinics. Options include:
  • Perinatal HIV care at Women & Infants Hospital
  • HIV management of incarcerated individuals at the Rhode Island Adult Correctional Institution
  • Tuberculosis care at the RISE Tuberculosis Clinic
  • Pediatric HIV care at the Pediatric HIV Clinic at Hasbro
  • General STI screening and management and the Rhode Island STI Clinic
    Depending on the individual interest of the fellow, they will have the option of other off-site clinical electives and international experiences.
• Tuberculosis clinics. Fellows will participate in a minimum of two two-week-outpatient blocks where they will attend weekly outpatient TB clinics. During these blocks they will learn about evaluation and diagnosis of TB disease, and the management of both latent and active TB, including the public health management of TB in coordination with the RI Department of Health.
• Inpatient service. Fellows who have completed residency in IM, Med/Peds, or FM will complete 4 weeks of inpatient Immunology service (primary admitting service for PWH) at The Miriam Hospital during the year. These will be completed in two 2-week blocks and will include weekends. Fellows who have completed an infectious diseases fellowship will complete 4 weeks of inpatient consults on the Infectious Diseases Consult Service at Rhode Island Hospital. The weeks on the consult service will scheduled in weekly rotations, and the fellow will have each Sunday off.

The didactic curriculum includes:

• Weekly one-on-one lectures with HIV experts from the faculty
• Infectious diseases clinical conferences
• Monthly HIV and hepatitis C didactics with the Brown infectious diseases fellows
• Support to attend one national HIV conference
• Web-based curriculum from the American Academy of HIV Medicine

• Our program is flexible to meet trainees’ interests from varying clinical backgrounds. We are excited to welcome fellows coming out of physician residency training programs in Internal Medicine, Med/Peds, and Family Medicine, or infectious diseases fellowships
• Our program offers an exclusive focus on HIV and tuberculosis care. In their primary HIV clinic, fellows will only follow PWH, individuals enrolling in PrEP, and individuals seeking hepatitis C treatment. Many HIV training programs are based in general primary care clinical settings. This program is based in a Ryan White HIV clinic, so fellows will exclusively provide HIV and TB-related care
• Our HIV clinic is a large, comprehensive, multidisciplinary care center. We care for over 2,000 PWH and provide primary care for the majority of those patients
• The RISE TB Clinic is unique in providing care for nearly all individuals with tuberculosis and latent TB in Rhode Island, giving fellows a unique state-wide perspective
• The HIV faculty are nationally and internationally known. Fellows have the opportunity for clinical learning from national experts, professional development, engagement in research opportunities, and building connections for the future.
• Funding support is available for conferences, CME, and the AAHIVM Specialist exam
• Our patients are wonderful!