Ybor Youth Clinic, a facility specifically designed for adolescents and young adults, recently expanded the healthcare services it offers Tampa Bay area adolescents and young adults to include confidential family planning. The clinic is sponsored by USF Health and Lazydays Employee Foundation.

In partnership with the Hillsborough County Department of Health, USF Health clinicians have started offering confidential and comprehensive family planning services to patients ages 13 to 24, regardless of their ability to pay. Services include gynecological visits, testing and treatment for HIV and other sexually transmitted infections, pregnancy testing and birth control.  The clinic’s comprehensive care includes coordinating referrals to other healthcare organizations or professionals throughout the community.

The youth clinic opened last year in the heart of Ybor City to provide a welcoming environment for all youth, including the historically marginalized, such as those who are homeless; gay, lesbian, bisexual or transgender; and HIV-infected.  USF faculty members from the Department of Pediatrics Infectious Diseases and Adolescent Medicine Division and other clinic practitioners provide care to these youth who often would not otherwise receive care.

USF Health pediatric nurse practitioner Terri Berger, MSN, ARNP, CPNP, examines a patient at the Ybor Youth Clinic.

One young man visited the clinic recently for treatment of a sexually transmitted disease, and Ybor Youth Clinic Medical Director Dr. Diane Straub detected the patient’s high blood pressure during a medical history and examination. He was educated about the symptoms and complications of untreated hypertension and referred to primary care through the Hillsborough County Health Care Plan.

“We serve as an entry point to the healthcare system for many of the older adolescents and young adults with little or no support,” said Dr. Straub, chief of adolescent medicine at the USF Health Morsani College of Medicine.  “It may be sexual health issues that bring them here — concern about STDs or the need for contraceptives. But once we get them in the door, we can address preventive care and conditions, like hypertension, which could develop into severe health problems without treatment.  We help them find a primary care home.”

Confidential services offered by the clinic in collaboration with the health department encompass the following:

–          Women’s health, including gynecological exams, pap smears, and other testing as needed

–          Men’s health

–          Birth control

–          Emergency contraception (“morning after pill”)

–          Sexually transmitted infection (STI) testing, treatment, and prevention counseling

–          HIV testing, risk reduction counseling, treatment and referrals

–          Pregnancy testing, options counseling, and referrals

–          Health education

–          Connections and referrals to community programs, including DACCO, Camelot Community Care’s Homeless Youth Program, and the Crisis Center of Tampa Bay
The Ybor Youth Clinic is located at 1315 E. 7^th Ave., Suite 104, Tampa, FL 33605.  For more information, please call (813) 396-9021, or visit the website:
http://yboryouthclinic.health.usf.edu

Photo by Caroline Murphy, USF Health Department of Pediatrics

Project PrEPare will enroll participants at 14 sites across the country,  including USF Health’s Ybor Youth Clinic

Tampa, FL (Dec. 10, 2012) — The University of South Florida is one of 14 clinical sites across the country participating in a follow-up study of the first medication approved to help prevent sexually-acquired HIV infection in people at high risk for the disease.

Project PrEPare is a research study that will target young men who have sex with men (YMSM) – a high-risk group with the largest proportion of new HIV infections in the United States.  USF will conduct the only study in the Tampa Bay area to reach this particular population as part of its membership in the national Adolescent Medicine Trials Network for HIV/AIDS Interventions (ATN).

The study will gather additional data on the safety, acceptability and feasibility of the FDA-approved drug known as Truvada ® – a once-daily pill containing tenofovir and emtricitabine, two antiretroviral medications usually used to treat HIV.  Researchers want to determine if this pre-exposure prophylaxis, or PrEP for short, could become part of a comprehensive HIV prevention package for YMSM in the real world.  

Nationwide, Project PrEPare will follow about 200 HIV-negative YMSM, ages 18 to 22.  USF Health plans to begin enrolling 25 study participants in January at its Ybor Youth Clinic, a new facility for underserved and at-risk youth.  
 
Along with a daily dose of Truvada, study participants will receive a full range of HIV preventive services – including a proven behavioral HIV prevention intervention, monthly HIV testing, free condoms, counseling, diagnosis and treatment of sexually transmitted infections, and medical follow-up.  Each person will be followed for at least 48 weeks, and some could be monitored for more than 2 years.

“While many treatment options are available for HIV-infected youth, we have very little to offer in the way of medications or other biomedical interventions for prevention,” said Dr. Diane Straub, local principal investigator for Project PrEPare and chief of the USF Health Department of Pediatrics Division of Adolescent Medicine.

“It is vitally important to develop practical ways for young people to protect themselves to stem the tide of the HIV epidemic.  This study will specifically focus on young adults, and is the first to do so.”

In July, the U.S. Food and Drug Administration approved Truvada for the indication of preventing HIV infections in people having sex with infected individuals.. The approval was based upon several large clinical trials showing that this PrEP significantly reduced the risk of contracting HIV, particularly when individuals adhered to the daily drug regimen. This means that one does not need to be part of the research study in order to receive the drug. He/she may obtain the drug by speaking with their primary care doctor. 

USF’s Dr. Diane Straub is the local principal investigator for Project PrEPare, which will investigate whether combination anti-HIV therapy may be feasible as part of a comprehensive prevention package.

Despite Truvada’s established track record for safety and effectiveness among HIV-infected and unaffected adult populations, few enrolled in U.S. clinical studies of  PrEP have been younger men, defined as those between ages 18 and 24.

Project PrEPare will target this high-risk group to gain a better understanding of the young men’s unique behavioral and biological considerations.  For example, researchers want to know whether younger men will stick closely to taking PrEP and how adherence may affect the medication’s effectiveness. They will evaluate if being in the study leads to any changes in a participant’s sexual risk behavior.

ATN, the national research network overseeing Project PrEPare, is primarily supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development, with additional funding from the National Institute on Drug Abuse and the National Institute of Mental Health.

For more information on Project PrEPare, visit http://health.usf.edu/nocms/publicaffairs/now/pdfs/Project PrEPare press materials.pdf.

To learn how to get involved with the Tampa study site, please contact USF Health outreach coordinators Jeremiah Kerr, jkerr1@health.usf.edu or Jadawn Wright, jwright@health.usf.edu, or call (813) 396-9137

Project PrEPare was reviewed and approved by the University of South Florida Institutional Review Board (IRB).  The study number is: Pro00010056. 

-USF Health-

USF Health’s mission is to envision and implement the future of health. It is the partnership of the USF Health Morsani College of Medicine, the College of Nursing, the College of Public Health, the College of Pharmacy, the School of Biomedical Sciences and the School of Physical Therapy and Rehabilitation Sciences; and the USF Physician’s Group. The University of South Florida is a global research university ranked 50^th in the nation by the National Science Foundation for both federal and total research expenditures among all U.S. universities.

Media contact:
Anne DeLotto Baier, USF Health Communications
(813) 974-3303 or abaier@health.usf.edu

//www.youtube.com/watch?v=H3efL4gfaMo

When Diane Straub swims, the first thing you notice is how fast she moves.

She slices through the water, sending out sprays of glistening sparks.

The next thing you see is that the muscled guy in the next lane is falling behind.

She belongs here, in the pool.

Not until you’ve realized all these things do you remember that most of her right leg is gone.

USF Health pediatrician Dr. Diane Straub swims regularly at the South Tampa YMCA.

Today, Dr. Diane Straub is a top pediatrician at USF Health. She’s chief of the Division of Adolescent Medicine and associate director of that residency training program. She also is co-principal investigator of several research grants, including the USF site of the Adolescent Trials Network, a multi-center NIH network focused on teen HIV and AIDS.

But 20 years ago, Dr. Straub was in Barcelona, earning her first gold medal in the Paralympic Games. Four years later, in Atlanta, she won her second. Both medals came in U.S.team relays that set new world records.

So today, as the 2012 Paralympic Games begins in London, Dr. Straub will watch with a special excitement. She is delighted that this year, legions of others around the world will share her interest, thanks to a highly visible ad campaign and, most of all, the inspiring performance of runner Oscar Pistorius. Pistorius, the first double amputee to compete in the Olympics, reached the semi-finals of his 400 meter race inLondon.

“I think Oscar was vindication for all the athletes,” she said. “To say we are real athletes. We are real, world-class athletes.”

It’s one of the reasons Dr. Straub likes the BP USA ad campaign, which features U.S. Paralympic athletes alongside Olympians.

“It really showcases different athletes – not necessarily better athletes, just differently abled athletes,” she said.

Dr. Straub can’t put her prosthesis back on when her leg is wet, so she brings crutches with her.

Dr. Straub hopes people also will pay attention to the less visible side of the Paralympics: the way they highlight the hurdles overcome by athletes with the most severe disabilities. For her, the most inspiring moment of the Paralympics was in 1992, in Barcelona, when she watched swimmer Grover Evans, a quadriplegic, swim 50 yards – one length of the pool – in spite of his physical challenges.

“For him to swim 50 yards would be the equivalent of me doing a 4-mile swim,” Dr. Straub said. “For him to swim 50 yards was one of the most inspiring things I’ve ever seen. What he’s overcome is incredible.”

Evans, now a prominent Arkansas politician and advocate, is the embodiment of the poster that hangs on her office wall. All the swimmers at the 1996 Paralympics signed it – a surprise for her from her now-husband, then-boyfriend. It features the 1996 motto: “Triumph of the Human Spirit.”

***

Despite a busy career, Dr. Straub comes off as low-key and relaxed. People may read that motto and think of her, but she doesn’t realize it.

“Diane is an inspiration to her adolescent patients; she brings a warmth and boundless energy to her patient care,” said Dr. Patricia Emmanuel, chair of the USF Health Department of Pediatrics. “She also works tirelessly to advance the practice of adolescent medicine and assure that each patient is treated with respect and autonomy.   She is such an asset to USF Pediatrics.”

Dr. Straub often swims with a local team to stay motivated.

But once, Dr. Straub was just another kid who dreamed of being a doctor one day.

In 1988, Diane Straub was a student at Ohio State Universityand a member of the crew team. She grew up on a lake. Water was always a part of her life, and she remembers always being a swimmer.

After the traffic accident that took her leg, crew was no longer an option. Balance is such an intrinsic part of the sport that competing as an amputee just didn’t work.

But it took a long time for her to accept that. Ten days after her accident, her father carried her out to the lake, the stump of her leg wrapped in a garbage bag to keep water off the still-open wound. It got wet anyway.

She persevered. Diane Straub began to swim when she returned to Ohio State in the fall – doing laps purely so she would stay in shape for crew. The university had a disabled swim team, but she hesitated to join.

“They were very welcoming to me and I didn’t want to be part of it, because I couldn’t picture myself as being disabled,” she said. “I could only picture myself as an able-bodied athlete.”

It took a push from other swimmers to get her interested in serious swimming.

“I didn’t consider it until people on the team said, ‘You’re really fast. Why don’t you swim in the Paralympics?’ ”

She had never heard of them.

***

Dr. Straub had to win regional, then national competitions to reach the Paralympics. Still struggling to accept her changed status, she didn’t realize the magnitude of her accomplishments.

“It wasn’t until I got to Barcelona,” she said, “that I really understood what an honor it was to be there.”

In Barcelona, athletes were classified into competitive categories based on how much their disability would affect their sport.

So Dr. Straub swam against other athletes with a similar level of disability. Her category included others with amputations above the knee; those missing an arm below the elbow; those with mild cerebral palsy; or other disabilities. In the breast stroke, she swam in a different disability category, because the stroke’s kicking style makes missing a leg is a bigger disadvantage.

The tie-dye cover decorating her prosthesis used to be her husband’s T-shirt.

While the categories are necessary for the logistics of the event, Dr. Straub believes they can also inject a certain level of arbitrariness that can seem unfair. The same person could be classified in different ways at different events, changing their ability to medal. To her, that increases the need to focus on the meaning of the journey, rather than on winning a medal.

Her views didn’t keep her from doing that though; she won her first gold medal in Barcelona, as part of the 4×100 freestyle relay team.

Being in the company of so many other disabled athletes made Dr. Straub feel more comfortable with herself. She arrived in Barcelona wearing a prosthesis with a cosmetic cover. It was designed to look as much like her real leg as possible. It was also, she says now, an inconvenience. It got dirty. It had to be cleaned all the time. It was a pain.

Sometime in Barcelona, another athlete asked her: why are you wearing that? Why does it have to look like a real leg?

She hasn’t worn a cosmetic cover since.

***

The controversy over Oscar Pistorius’ appearance in the Olympics doesn’t entirely surprise Dr. Straub. After all, she has friends who sometimes seem to forget that she’s wearing a prosthesis – until they reach a flight of stairs and she lags behind.

So she jokes about the claims that Pistorius’ artificial legs might actually allow him to run faster, to create some kind of unfair advantage over athletes in full possession of both legs.

“I have to say, I’m not going to jump over any buildings in a single bound,” she said. “Yes, prosthetics make things easier, but it’s nowhere near an advantage. I think the gap (as technology improves) will continue to close – but I don’t think we’re anywhere close.”

That’s not even considering the issues that people with amputations often face with blisters and skin breakdowns. Running at Pistorius’ level has to make those problems even worse, Dr. Straub said.

“Limbs are not meant to take that kind of abuse,” she said. “He made it look easy – and it’s not.”

Ultimately, Dr. Straub said, even this controversy can help change people’s views of those with disabilities.

“The mind is like a rubber band,” she said. “Once it’s been stretched, it never quite goes back.”

A few years after winning her first gold medal, Dr. Straub spent a year at Harvard, working on her MPH. She went to swim one day in a pool with lanes marked by speed: “slow, medium, fast, intensive, disabled.” She hopped in the “intensive” lane and politely waited for the other swimmer to finish his lap before she started, so that he didn’t have to move over mid-lap. But this swimmer didn’t appreciate her gesture.

Excuse me, he told her. He spoke very slowly, as if she might have trouble understanding. This is the intensive lane. The disabled lane is over there.

Instead of arguing, she moved over to the disabled lane and began her swim – once again, proving herself in the pool. Dr. Straub had finished just one lap when the other swimmer in her new lane stopped her.

Excuse me, she told Dr. Straub. This is the disabled lane. The intensive lane is over there.

***

The following year, Dr. Straub was chosen to carry the Paralympics torch and hand it to President Bill Clinton on the White House lawn. The 1996 Paralympic flame was lit not from the Olympic flame, but from the eternal flame that burns in honor of Martin Luther King Jr., at Atlanta’s King Center. Dr. Straub likes the symbolism.

“It’s about freedom, and overcoming obstacles, and empowerment,” she said.

Dr. Straub went on to win her second gold medal in the Atlanta games, this time swimming the breast stroke lap for the 4×100 relay medley.

***

Today, Dr. Straub is swimming in the sunny lap pool at the South Tampa YMCA. She arrives there walking on her latest prosthesis, boldly decorated with an eye-popping tie-dye design. Despite the many demands on her time – in addition to her patients, research and students, she and her husband have two children, a girl, 11, and a boy, 7 – she continues to swim.

The flipper helps her swim faster, but she couldn’t use one in competition.

She’s parked in a handicapped space here, something that she felt guilty about for years, as if she should leave the spaces for people with more severe disabilities. She’s had to remind herself that close parking allows her more time on her feet with her patients.

She still remembers swimming years ago with Rudy Garcia-Tolson. Back then, he was at the beginning of his swimming career. Now Garcia-Tolson is a gold medalist featured in the BP ads. London will mark his third Paralympics.

Dr. Straub hopes people will be inspired by such lifelong commitment.

“It’s so encouraging for people to see that,” she says. “I have disabled kids in my clinic, and I want them to have the same dreams and aspirations as everybody else.”

– Photos by Eric Younghans, video by Eric Younghans and Danielle Barta, USF Health Communications

Follow @LisaGwrites
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