Philadelphia FIGHT

For the rugby team, see Philadelphia Fight.

Philadelphia FIGHT

Formation	1990
Legal status	Non-profit
Purpose	End the AIDS epidemic within the lifetime of those currently living with HIV.
Headquarters	Philadelphia, Pennsylvania
Website	Philadelphia FIGHT

Philadelphia FIGHT Community Health Centers Philadelphia FIGHT (FIGHT) is a federally qualified health center (FQHC) located in Philadelphia, Pennsylvania. Founded in 1990, it provides comprehensive and culturally competent primary care, advanced HIV treatment, and supportive services to underserved and low-income communities. As an FQHC, Philadelphia FIGHT prioritizes equitable access to high-quality healthcare regardless of an individual's ability to pay.

In addition to its medical services, the organization offers programs in consumer education, advocacy, social services, and research. Its initiatives support people living with HIV, individuals at high risk, families, young people, and those transitioning from incarceration, addressing the social determinants of health to reduce disparities and promote wellness across the community.

About

Mission

"Philadelphia FIGHT is a comprehensive AIDS Service Organization providing state of the art, culturally competent HIV primary care, consumer education, advocacy, social services, outreach to people living with HIV and to those who are at high risk, and access to the most advanced clinical research. Our goal and hope is to end the AIDS epidemic within the lifetime of those currently living with HIV."

History

Philadelphia FIGHT (Field Initiating Group for HIV Trials) was established in 1990 as a community-based organization dedicated to providing comprehensive care, education, and advocacy for individuals affected by HIV/AIDS. The organization's inception was significantly influenced by Dr. John L. Turner, an openly gay physician and endocrinologist, who was among the first to treat HIV patients in Philadelphia during the early years of the epidemic. Dr. Turner served as Philadelphia FIGHT's founding Principal Investigator, offering hope and solace to those living with HIV at a time when treatment options were limited.

In its early years, Philadelphia FIGHT focused on bringing clinical trials and research on potential treatments and vaccines to the local community. The organization expanded its services over time to include primary care, consumer education, and advocacy, addressing the broader needs of individuals living with HIV/AIDS.

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Health Centers

• John Bell Health Center: Provides comprehensive primary medical care to adults aged 18 and older, focusing on culturally competent services regardless of insurance status or ability to pay.
• Jonathan Lax Treatment Center: Specializes in state-of-the-art, patient-centered primary medical care for people living with HIV, offering cutting-edge treatments and research opportunities.

• Pediatric and Adolescent Health Center: Offers high-quality, accessible primary care to children and youth from birth through age 18, including immunizations, well-child visits, and integrated dental services. Y-HEP Adolescent and Young Adult Health Center: Provides inclusive and accessible healthcare for youth aged 13 to 24, including primary care, mental health services, sexual and reproductive health, and PrEP.

Dental Services

• FIGHT Family Dentistry: Committed to delivering high-quality clinical care with a trauma-informed approach, welcoming patients with dental anxiety or a history of infrequent dental visits. Services include oral health examinations, cleanings, fillings, and dentures.

Mental Health Services

• Diana Baldwin Mental Health Clinic: Provides culturally competent behavioral health services addressing the psychological, social, and emotional needs of patients, including counseling and psychiatric care.

Collaboration with Broad Street Love

• Broad Street Love Health Center: A satellite site of the John Bell Health Center, this clinic offers primary care services to guests of Broad Street Love, a partner organization dedicated to serving individuals experiencing homelessness and poverty.

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Health Services

• C a Difference / Hepatitis C: A comprehensive hepatitis C testing and linkage-to-care program housed at the John Bell Health Center, offering support and treatment for individuals affected by hepatitis C.

• LGBTQIA+ Gender and Sexuality Health Services: Offers an array of gender and sexuality health services for LGBTQIA+ individuals.
• MAT and Harm Reduction Services: Provides various forms of medications for addiction treatment (MAT), with medical professionals evaluating and determining the best course of action for each individual.
• PrEP (Pre-Exposure Prophylaxis): Offers medication taken once daily to prevent HIV infection, with comprehensive support services to facilitate access and adherence.

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Education Programs

• Project TEACH (Treatment Education Activists Combating HIV): Educates individuals living with HIV to become community health educators and advocates, offering courses on HIV treatment, prevention, and leadership skills.

• Critical Path Learning Center: Provides a space dedicated to health information and digital literacy resources. Developed from the AIDS Library and Critical Path Project, the Center aims to reduce stigma and improve health outcomes through education and technology access.

• Community Health Training Alliance: Hosts workshops, conferences, webinars, and symposiums on critical health topics affecting vulnerable communities, including events during AIDS Education Month.

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The Institute for Community Justice (ICJ) is a comprehensive prison services and reentry program that provides health linkages, supportive services, education, and advocacy for individuals, families, and communities affected by mass incarceration. As a program of Philadelphia FIGHT, ICJ aligns with the organization's mission of promoting health equity and justice for marginalized populations.

Programs and Services

ICJ focuses on supporting successful reintegration into society for individuals impacted by mass incarceration. Its services include:

• Reentry Support:
  • Digital literacy training
  • GED preparation
  • Workforce development
  • Healthcare linkages
  • Family reunification efforts
  • Discharge planning for individuals transitioning out of correctional facilities
• Education: ICJ offers educational programs to help individuals build knowledge and skills, such as digital literacy and GED preparation.
• Reducing Recidivism: ICJ’s comprehensive support services have been associated with a 53% reduction in recidivism among participants.
• Prison Linkages and Prison Support: This initiative addresses healthcare needs during and after incarceration, including discharge planning for those in correctional facilities.
• Mentorship Programs: Programs like MANN UP focus on mentorship, personal development, and peer support.
• Case Management and Healthcare Access: ICJ’s case management team connects participants to healthcare services offered by the community health centers at Philadelphia FIGHT.

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FIGHT Research Department

The Research Department at Philadelphia FIGHT conducts advanced clinical research focused on improving HIV treatment strategies and developing potential cures for the virus. The department specializes in a variety of human subjects research, including biomedical, clinical, social and behavioral, epidemiological, and quality assurance studies. These efforts aim to advance scientific understanding and enhance care for people living with or at risk of HIV.

Research Areas

Philadelphia FIGHT's research encompasses the following areas:

• Biomedical Research: Studies in this category aim to understand physiological and disease processes, evaluate medical interventions, and test the safety and efficacy of treatments. Examples include vaccine trials, medical device research, and HIV therapy development.
• Clinical Research: This type of research evaluates biomedical and behavioral interventions. It often involves FDA-regulated drugs, devices, or biological products to determine their effectiveness in managing or curing disease.
• Social and Behavioral Research: Focusing on individual and group behavior, this research gathers data through surveys, interviews, observations, and experimental designs. It aims to evaluate interventions and generate knowledge about mental processes and social dynamics.
• Epidemiology Research and Retrospective Chart Reviews: These studies examine health outcomes, interventions, and disease patterns to assess cost-effectiveness and efficacy. They may involve analyzing aggregate data or medical records to improve healthcare delivery.
• Quality Assurance Activities: These efforts measure the effectiveness of programs and services, contributing to generalizable knowledge that enhances healthcare practices.

Clinical Trials

Philadelphia FIGHT conducts clinical trials to test new HIV medications and treatments. Trials are controlled experiments that evaluate the safety and effectiveness of interventions over a specified period. Participation is voluntary, free of charge, and governed by a consenting process that informs patients of risks and benefits.

Research Publications

HIV Treatment

• Changes in Body Mass Index Associated with Antiretroviral Regimen Switch Among Treatment-Experienced, Virologically Suppressed People Living with HIV in the United States
  • Authors: Karam Mounzer, Laurence Brunet, Ricky Hsu, Jennifer Fusco, Vani Vannappagari, Cassidy Henegar, Jean van Wyk, Melissa Crawford, Janet Lo, Gregory Fusco
  • Summary: This study examined the link between switching antiretroviral therapy (ART) regimens and changes in body mass index (BMI) among people with HIV who already had experience with ART and had suppressed viral loads. They found that switching regimens often led to increased BMI, especially in women, highlighting the need to consider weight changes when making treatment decisions.
• Preliminary Acceptability of a Home-Based Peripheral Blood Collection Device for Viral Load Testing in the Context of Analytical Treatment Interruptions in HIV Cure Trials: Results from a Nationwide Survey in the United States
  • Authors: Karine Dubé, Shadi Eskaf, Elizabeth Hastie, Harsh Agarwal, Laney Henley, Christopher Roebuck, William B. Carter, Lynda Dee, Jeff Taylor, Derrick Mapp, Danielle M. Campbell, Thomas J. Villa, Beth Peterson, Kenneth M. Lynn, Linden Lalley-Chareczko, Emily Hiserodt, Sukyung Kim, Daniel Rosenbloom, Brad R. Evans, Melanie Anderson, Daria J. Hazuda, Lisa Shipley, Kevin Bateman, Bonnie J. Howell, Karam Mounzer, Pablo Tebas, Luis J. Montaner
  • Summary: This research explored the acceptability of a new at-home blood collection device for people participating in HIV cure trials that require frequent viral load monitoring. The study found that both people with HIV and healthcare providers were generally receptive to this method, suggesting it could improve convenience and adherence in clinical trials.
• We are looking at the future right now: community acceptability of a home-based viral load test device in the context of HIV cure-related research with analytical treatment interruptions in the United States
  • Authors: Karine Dubé, John Kanazawa, Christopher Roebuck, Steven Johnson, William B. Carter, Lynda Dee, Beth Peterson, Kenneth M. Lynn, Linden Lalley- Chareczko, Emily Hiserodt, Sukyung Kim, Daniel Rosenbloom, Brad R. Evans, Melanie Anderson, Daria J. Hazuda, Lisa Shipley, Kevin Bateman, Bonnie J. Howell, Karam Mounzer, Pablo Tebas & Luis J. Montaner
  • Summary: Expanding on the previous study, this research focused on gathering qualitative data from people with HIV about their perspectives on using a home-based viral load testing device. The findings emphasized the potential of this technology to empower individuals in their care and reduce the burden associated with frequent clinic visits.
• NK Response Correlates with HIV Decrease in Pegylated IFN-α2a-Treated Antiretroviral Therapy-Suppressed Subjects
  • Authors: Emmanouli Papasavvas, Livio Azzoni, MD, PhD, AV Kossenkov, N Dawany, KH Morales, M Fair, BN Ross, Kenneth Lynn, A Mackiewicz, Karam Mounzer, MD, Pablo Tebas, MD, JM Jacobson, Jay Kostman, MD, L Showe, Luis J Montaner, DVM, DPhil
  • Summary: This study investigated the role of natural killer (NK) cells, a type of immune cell, in controlling HIV in individuals on ART who received an additional treatment (pegylated IFN-α2a). The results showed a correlation between higher NK cell activity and lower HIV viral load, suggesting potential avenues for immune-based therapies.
• Placebo-controlled randomized clinical trial testing the efficacy and safety of varenicline for smokers with HIV
  • Authors: RL Ashare, M Thompson, K Serrano, F Leone, David Metzger, Ian Frank, Robert Gross, A Hole, Karam Mounzer, RG Collman , EP Wileyto, R Schnoll
  • Summary: Recognizing the high rates of smoking among people with HIV, this trial assessed the effectiveness and safety of varenicline, a smoking cessation medication. The findings supported varenicline's use in this population, demonstrating its ability to aid in quitting smoking with a manageable safety profile.
• Plasma and antibody glycomic biomarkers of time to HIV rebound and viral setpoint
  • Authors: LB Giron, Emmanouli Papasavvas, Livio Azzoni, MD, PhD, X Yin, A Anzurez, M Damra, Karam Mounzer, Jay Kostman, I Sanne, C Firnhaber, H Tateno, Q Liu, Luis J Montaner, Mohamed Abdel-Mohsen
  • Summary: This research delved into the complex relationship between specific sugar molecules (glycans) in the blood and the time it takes for HIV to rebound after stopping treatment. Identifying these biomarkers could help predict treatment outcomes and guide the development of new therapies aimed at achieving HIV remission or cure.
• Real-world efficacy of direct-acting antiviral therapies in patients with HIV/HCV
  • Authors: S Patel, D Jayaweera, K Althoff , JJ Eron, J Radtchenko, Anthony Mills, Graeme Moyle, S Santiago, Paul Sax, J Gillman, Karam Mounzer, Richard Elion, GD Huhn
  • Summary: This study evaluated the effectiveness of direct-acting antiviral therapies (DAAs) for hepatitis C virus (HCV) in people co-infected with HIV. The results confirmed the high success rates of DAAs in curing HCV in this population, contributing to real-world evidence supporting their widespread use.
• Validation of the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) chronic kidney disease risk score in HIV-infected patients in the USA
  • Authors: AM Mills, KL Schulman, Jennifer Fusco, Laurence Brunet, R Hsu, A Beyer, G Prajapati, Karam Mounzer, Gregory Fusco
  • Summary: This research aimed to validate a risk score for predicting chronic kidney disease in people with HIV. The study confirmed the accuracy of the D:A:D risk score in a US population, providing a valuable tool for identifying individuals at higher risk and informing preventive strategies.

HIV Pre-Exposure Prophylaxis (PrEP)

• Are We Hitting the Target? HIV Pre-Exposure Prophylaxis from 2012 to 2020 in the OPERA Cohort
  • Authors: Karam C. Mounzer, MD, Jennifer S. Fusco, BS, Ricky K. Hsu, MD, Laurence Brunet, PhD, Vani Vannappagari, MBBS, MPH, PhD, Kevin R. Frost, Mark S. Shaefer, PharmD, Alex Rinehart, PhD, Keith Rawlings, MD, Gregory P. Fusco, MD, MPH
  • Summary: This study analyzed PrEP usage trends to determine if the people most at risk for HIV were receiving this preventive medication. The findings highlighted the need for increased PrEP access and targeted interventions to ensure equitable distribution among those who would benefit most.
• Urine Assay to Measure Tenofovir Concentrations in Patients Taking Tenofovir Alafenamide
  • Authors: Linden Lalley-Chareczko, M.A., Emily Hiserodt, M.P.H., Ganesh Moorthy, PhD, Athena Zuppa, MD M.S.C.E., Karam Mounzer, MD, Helen Koenig, MD, M.P.H.
  • Summary: This research focused on developing a urine test to measure levels of tenofovir alafenamide (TAF), a medication used in PrEP and HIV treatment. This non-invasive method offers a more convenient way to monitor medication adherence and ensure effectiveness.
• Barriers and Facilitators of PrEP Adherence for Young Men and Transgender Women of Color
  • Authors: Sarah Wood, M.D., M.S.H.P Robert Gross, M.D., M.S.C.E., Judy A. Shea, José A. Bauermeister, M.P.H., Ph.D., Joshua Franklin, Danielle Petsis, M.P.H., Meghan Swyryn, Linden Lalley-Chareczko, M.A., Helen C. Koenig, M.D., M.P.H., Nadia Dowshen, M.D., M.S.H.P.
  • Summary: This study investigated the factors that influence PrEP adherence among young men and transgender women of color who have sex with men. The findings shed light on the barriers these individuals face, including cost, stigma, and lack of access to healthcare, and identified potential strategies for improving adherence.
• Challenges to PrEP use and perceptions of urine tenofovir adherence monitoring reported by individuals on PrEP
  • Authors: Travis Hunt, Linden Lalley-Chareczko, MA, Giffin Daughtridge, Meghan Swyryn & Helen Koenig, MD, MPH
  • Summary: This research explored the challenges people face when using PrEP, including accessing the medication and maintaining consistent adherence. It also examined perspectives on using urine tests to monitor adherence, highlighting the potential benefits and concerns associated with this method.
• A case study of chewed Truvada® for PrEP maintaining protective drug levels as measured by a novel urine tenofovir assay
  • Authors: Linden Lalley-Chareczko, MA, Devon Clark, Athena Zuppa, MD, MSCE, Ganesh Moorthy, PhD, Caitlin Conyngham, Karam Mounzer, MD, Helen Koenig, MD, MPH
  • Summary: This case study examined the effectiveness of chewing Truvada® for PrEP in an individual who had difficulty swallowing pills. The results demonstrated that chewing the medication still resulted in protective drug levels, offering a potential alternative for people facing similar challenges.
• Delivery of TDF/FTC for pre-exposure prophylaxis to prevent HIV-1 acquisition in young adult men who have sex with men and transgender women of color using a urine adherence assay
  • Authors: Linden Lalley-Chareczko, MA, Devon Clark, Caitlin Conyngham, Athena Zuppa, MD, MSCE, Ganesh Moorthy, PhD, Karam Mounzer, MD, Helen Koenig, MD, MPH
  • Summary: This study evaluated different PrEP dispensation schedules (weekly, biweekly, monthly) and used urine tests to monitor adherence in young men who have sex with men and transgender women of color. The findings provide valuable insights for optimizing PrEP delivery and supporting adherence in these populations.
• Social Support Networks among Young Men and Transgender Women of Color Receiving HIV Pre-Exposure Prophylaxis
  • Authors: Sarah Wood, M.D., M.S.H.P., Nadia Dowshen, M.D., M.S.H.P., José A. Bauermeister, M.P.H., Ph.D., Linden Lalley-Chareczko, M.A., Joshua Franklin, Danielle Petsis, M.P.H., Meghan Swyryn, Kezia Barnett, M.P.H., Gary E. Weissman, M.D., M.S.H.P., Helen C. Koenig, M.D., M.P.H., Robert Gross, M.D., M.S.C.E.
  • Summary: This research examined the role of social support networks in PrEP adherence among young men and transgender women of color. The study highlighted the importance of social support in promoting successful PrEP use and identified potential interventions to strengthen these networks.
• Tenofovir urine assay to monitor adherence to HIV pre-exposure prophylaxis (PrEP)
  • Authors: Ganesh Moorthy, PhD, Linden Lalley-Chareczko, MA, Helen Koenig, MD, MPH, Athena Zuppa, MD, MSCE
  • Summary: This study focused on developing and validating a urine test to measure tenofovir levels, a key component of PrEP medications. This accurate and reliable method offers a practical tool for monitoring adherence and supporting individuals in maximizing the effectiveness of PrEP.
• Urine assay for tenofovir to monitor adherence in real time to tenofovir disoproxil fumarate/emtricitabine as pre-exposure prophylaxis
  • Authors: Helen Koenig, MD, MPH, Karam Mounzer, MD, Giffin Daughtridge, Caroline Sloan, Linden Lalley-Chareczko, MA, Ganesh Moorthy, PhD, Caitlin Conyngham, Athena Zuppa, MD, Luis Montaner, DVM, DPhil, Pablo Tebas, MD
  • Summary: This research further refined the development of a urine assay for monitoring PrEP adherence in real-time. The study validated the accuracy of the assay in various populations, demonstrating its potential for widespread use in clinical practice and research.
• Why do HIV PrEP Patients Become Lost-to-Care and How Can We Improve PrEP Retention?
  • Authors: Sahana Jayaraman, Linden Lalley-Chareczko, MA, Sarah Williams, Devon Clark, Caitlin Conyngham, and Helen C. Koenig, MD, MPH
  • Summary: This study investigated the reasons why people discontinue PrEP, aiming to identify strategies for improving retention in care. The findings highlighted common challenges such as cost, stigma, and side effects, informing interventions to address these barriers and support continued PrEP use.

Mental Health

• Correlation of PrEP Adherence to a Mental Health Diagnosis or Experience of Childhood Trauma in High-Risk Young Adults
  • Authors: Lindsay Young, Linden Lalley-Chareczko, MA, Devon Clark, Michael Ramos, Rachel Nahan, Gregory Troutman, Rose Cantor, Lane DiFlavis, Helen Koenig, MD, MPH
  • Summary: This research explored the connection between mental health, childhood trauma, and PrEP adherence in young adults. The findings indicated that individuals with mental health diagnoses or a history of childhood trauma were less likely to adhere to PrEP, emphasizing the need for integrated mental health support within PrEP programs.

Philadelphia FIGHT's Involvement with the BEAT-HIV Collaboratory

Philadelphia FIGHT is an integral partner in the BEAT-HIV Collaboratory, a consortium dedicated to advancing research toward an HIV cure. The Delaney Collaboratory to Cure HIV-1 Infection by Combination Immunotherapy (BEAT-HIV Collaboratory) consists of over 95 leading HIV researchers from top academic institutions, government agencies, nonprofit organizations, and industry partners. The collaborative aims to better understand HIV latent reservoirs and host factors governing viral control and reactivation, with the ultimate goal of achieving long-term remission or eradication of HIV through combination immunotherapy.

The BEAT-HIV approach integrates cutting-edge strategies such as:

• Broadly neutralizing antibodies (bNAbs)
• Adoptively transferred immune cells
• Novel latency-reversing agents
• Nanoparticle-based therapies

Community Engagement and Education

Philadelphia FIGHT leads the community outreach efforts for the BEAT-HIV Collaboratory in partnership with the BEAT-HIV Community Advisory Board. Using its established educational programs—such as Project TEACH, TEACH Outside, AIDS Education Month, and the Community Health Training Alliance—Philadelphia FIGHT facilitates public awareness about BEAT-HIV’s activities and progress in cure research. Events like the 2024 HIV Education Summit workshop, titled “Keep Going, Keep Moving, A Cure is in Sight,” showcase ongoing advancements.

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Events

• AIDS Education Month: recognized every June, FIGHT organizes summits about HIV prevention as well as youth, faith, and prison issues. FIGHT also organizes citywide testing for National HIV Testing Day on June 27 with other local agencies, including: ActionAIDS, GALAEI, and the Mazzoni Center.
• PrEP Week (September): A week-long program dedicated to HIV prevention, sexual wellness, and harm reduction, featuring various events to engage the Philadelphia community.
• World AIDS Day Prayer Breakfast (December 1): An event commemorating World AIDS Day, bringing together community members for reflection and discussion on the ongoing fight against HIV/AIDS.

Controversies

• Racism Allegations
  • Philadelphia FIGHT has been accused of racist employment practices by several former staff members, many of whom have advocated for the removal of the CEO and Board and the establishment of new, anti-racist policies. Philadelphia FIGHT has denied all allegations of racism and discrimination.

See also

• Kiyoshi Kuromiya
• Gloria Casarez

External links

• Philadelphia FIGHT Website
• Critical Path Project (Archived)