Heidi Behforouz

director, access treatment program

Heidi Behforouz is the founder and executive director of Prevention and Access to Care and Treatment, which serves Boston's sickest and most marginalized AIDS patients. One of the trickiest things about running a public health project is proving that it works. Prevention and Access to Care and Treatment (PACT), which Behforouz founded in 1997, is rare in that it shows measurable results. Using a standardized model of intervention, PACT-trained community health workers help inner-city AIDS patients, usually black or Latino, visiting them daily to make sure they take their meds and accompanying them to doctor's visits. These are disenfranchised patients many of whom are also burdened with other problems such as abusive relationships, substance abuse, and depression who, despite having had conventional case managers in the past, are sick and dying. PACT community health workers go a step further, forming a surrogate support network for the patient. "There is power [in] knowing the context of the person's life," says Behforouz. Having a health advocate pays off: 75% of PACT patients improve dramatically, according to internal data that Behforouz and her team collected. But what really sets PACT apart and why it's being replicated by other US cities (including Baltimore, New York, and Miami) and even in Peru is a twenty-five-point curriculum (including written modules and a patient workbook) that staff and patient work on together. The curriculum covers topics such as how to take antiretroviral medications, know what both a CD4 count and a viral load are, and how to schedule and prepare for appointments. Behforouz has also been asked to adapt the PACT model for other chronic diseases, such as diabetes, that disproportionately affect the poor.