Mary R. Tanney, MSN, MPH, CRNP-PCBS, AAHIVS
Children’s Hospital of Philadelphia
Mary Tanney’s clinical practice is part of the Adolescent Initiative at the Children’s Hospital of Philadelphia (CHOP). She provides primary care and HIV specialty care to youth ages 13 to 24 who are infected with HIV. She works with two other providers who are HIV Specialists™ as well. Tanney’s clinic is part of the CHOP Care Network and is located in West Philadelphia; convenient to public transportation. At her clinic, Tanney and her colleagues provide care to about 175 youth between the ages of 13 and 24 annually. They typically see patients four days per week. Says Tanney, “In the early 1990’s, when I started in this work, I saw the children of HIV infected women. This was before we knew that we could prevent perinatal infection by following the landmark results of the 076 protocol. Today this is standard of care. As the epidemic spread, I started seeing mainly female adolescents who were infected by their male partners who were ‘on the down-low.’ Starting in 2000, we saw more youth who identified as LGBTQ youth.
Before Tanney went to nursing school, she was a high school science teacher. She did some volunteer work at a free medical clinic and met one of the first nurse practitioners. Tanney decided to go back to school to be a NP. She studied at Catholic University of America in Washington, DC for her BSN and then to the University of Pennsylvania for her MSN. Tanney was then licensed as NP in Pennsylvania. Tanney had the unique opportunity to have four years of public health nursing experience in Sudan; an experience that got her very interested in public health. This interest led Tanney to attend Johns Hopkins University for her MPH.
“I have been treating people living with HIV for 24 years now,” says Tanney, “When I became a nurse practitioner, I first practiced in a federally qualified health center and saw patients from birth to age 25. I did training in adolescents and young adults and started a clinic for that population. After that, I moved to the Adolescent and Family Planning Clinic that was part of an out-patient center connected to a hospital university system. I eventually took a job at Children’s Hospital of Philadelphia that combined clinical research and patient care in the division of adolescent medicine through NIH grant funding.” Tanney was motivated to pursue specializing in HIV care after seeing the impact of the disease on women and children. Recalls Tanney, “Most of the children died who were infected with HIV. So did most of the women. I saw the huge impact research made through the 076 study to prevent perinatal infection and the impact of treatment for people infected with HIV. I wanted to be part of helping to educate and prevent more HIV infection and to be part of the research to find better treatment options for HIV and hopefully a cure.”
Tanney says that most rewarding part of her job is helping youth live with their HIV and pursue their dreams. Helping education and reduce stigma around HIV has also been rewarding. Through the Adolescent Research Network that funds her work with HIV positive youth at CHOP as well as federal funding from the Ryan White Program Tanney’s practice has been able to provide comprehensive, interdisciplinary primary and HIV specialty care to their youth. Tanney’s clinic is nationally recognized as a center for research and treatment. “The only way we have been able to better understand and develop effective treatments for youth living with HIV is through access to adolescent-specific research. Adolescent HIV care and services require adolescent-focused, intensive case-management interventions. The number of young people being infected with HIV is growing. These youth present with multiple psychological problems such as basic subsistence issues, disclosure, housing, stigma, mental health issues and lack of social support. It has been challenging to maintain funding to provide these services to help youth become more knowledgeable, self-sufficient, and competent in managing their HIV.” Tanney’s practice has a medication readiness process they call AIM (Adolescent Initiative Model). Says Tanney, “We now know that everyone who has HIV needs to start ART as soon as they are ready. We have a Wellness Counselor who walks our youth through this process by working with the youth to develop an individualized treatment plan that will work with their life.”
All the youth that are diagnosed with HIV and referred to her clinical practice are initially linked to care through one of their Medical Case Manager (MCM) who is a licensed social worker. This direct link to care has proven to be an integral element of their Adolescent Initiative program’s success in retaining youth in care. Says Tanney, “We believe this success in retaining youth in care is closely linked to our ability to meet the unique needs of youth wherever they are: in clinics, community-based agencies, their homes, or shelters.”
Tanney has recently shifted some of her efforts to prevention by educating providers who see adolescents about HIV testing and STI screening, PrEP and PEP. “One of the biggest barriers to HIV testing is that many primary care providers are not following CDC guidelines and testing their patients 13 and over as part of routine health care.” Looking to the future of HIV care, Tanney applauds the improvements made in the field. Most people today can take one pill per day to treat their HIV and do very well. Since a vaccine and/or cure has not been found yet, the shift is moving toward prevention of HIV through PrEP and PEP, identifying other STI and making sure HIV testing is done, and treating everyone who has HIV with ART so they have an undetectable viral load and are less likely to transmit the virus to someone else. Currently, there is a lot of focus on the Continuum of Care; so focusing on identifying new infection and starting treatment as soon as possible, maintaining undetectable viral loads, and decreasing those who are lost to care are key.
Outside of her professional life in HIV care, Tanney enjoys traveling with her husband and learning about different cultures and religions around the world. She enjoys spending time with her children, two young adults, who she continues to learn from. She likes to exercise at the gym four or five times per week and enjoys biking in the warmer months. She enjoys spending time as part of a small faith group and recalls in her younger years working to get prescriptive privileges for nurse practitioners in the state of Pennsylvania.
When asked why she is an AAHIVM Member, Tanney says, “I joined AAHIVM as a way to stay updated in the world of clinical care for people who are HIV+. I actually joined after attending my first AAHIVM conference. I found it so informative and it gave me a great overview of the complexities of HIV care. It also has helped me in educating my patients as I transition them to adult care. It gives me resources regarding clinical issues and also when I need to transition youth who are moving out of state. The HIV Specialist™ Credentialing Program exam is an opportunity to review and problem-solve questions that I may not know.”
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