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During the HIV/AIDS epidemic, Wisconsin — and especially Milwaukee — emerged as the paradigm for response and ongoing advocacy.
“Forty years. It’s an amazing amount of transformation that happened.”
Brandon Hill reflected on that era from a unique perspective: as the president and CEO of Vivent Health, which helped create an integrated model of care that’s now in six other states and touted nationwide.
“When you bring together social resources and address structural factors, we’re able to really bend the curve in the epidemic and allow folks living with HIV to live really healthy lives,” Hill said.
Wisconsin reported its first case of AIDS in 1982. Three years later, Vivent Health got its start as the AIDS Resource Center of Wisconsin (ARCW). By the early ’90s, the state had more than 1,000 cases and almost 600 HIV diagnoses. Then, thanks to anti-retroviral treatment in the mid-’90s, new AIDS cases in the state dropped significantly.
“When the AIDS epidemic began, it was a very difficult time,” said Doug Nelson, former president and CEO of the ARCW. “It was a brutal disease that before [had] no treatment, and therefore an AIDS diagnosis was essentially a death sentence.
“The fear and the misunderstanding, back in those early days, resulted in a lot of discrimination against people with AIDS and HIV.”
In Milwaukee, organizations like the Brady East STD clinic, the ARCW, healthcare workers, volunteers and others fought back against discrimination and the spread of infection. Over the years, the ARCW forged new paths — opening a dental clinic, connecting people to food, housing and litigation services, and launching its first medical clinic for those in need.
“For us, we definitely found — in ARCW’s history — that community-based care allowed folks to be hyper attentive to the needs of the population,” Hill said.
“Milwaukee was outstanding,” Nelson added. “It was progressive, and it was aggressive in supporting the fight against AIDS from the very beginning. City government, county government funded our prevention programs. The county actually funded the clean-needle exchange program, which is controversial but very important.”
According to Hill, 80% of people currently living with HIV in the state receive some service from Vivent Health. And 95% of their patients are virally suppressed, meaning the virus levels are low enough and not transmittable to others.
Still, prevention remains a key effort.
“One of the realities of the HIV epidemic is that once things became under control, they moved to the background,” Hill said. “And so folks in the age group under 30 were not directly connected with the actual crisis that was happening before they were born.”
From 2015 to 2024, the Wisconsin Department of Health Services reported an average of 200 to 300 new HIV cases each year. In this time, young men between 13 and 29 years old had the highest infection rate.
“This is where those prevention efforts become so crucial because we have no way of communicating this information if it’s not in school, if it’s not discussed between family members,” Hill said. “So a lot of our efforts are trying to reach and connect the group who, yes, we want to celebrate. But we don’t want to lose any footing.”
That means continuing to treat the whole patient, as the organization looks ahead to long-term care.
“The treatment not only has allowed the prevention of transmission, it’s also given people a much longer life,” Hill said. “And even this year, we know that we’ll have a patient that will turn 90 years old that’s in our care.”
