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Jaime A. Rebeles, LVN, ACLPN (He/Him)
Director of Clinical Operations, Valley AIDS Council/Westbrook Clinic
Years as an ANAC member: 4
What does Latinx AIDS Awareness Day mean to you?
Having grown up in deep South Texas and worked in the nonprofit sector for my entire 24-year career, I have seen firsthand the health disparities in the Latinx community. The vast majority of the people I have served lack access to health care due to limited resources and often rely on local emergency departments as their primary source of care.
For the past 14 years, I have worked at Westbrook Clinic, where I continue to see patients who do not seek medical care until they are critically ill. Many present to the emergency room with conditions such as PCP/PJP pneumonia, cachexia, oral thrush, CMV, or cryptococcal meningitis, often with CD4 counts in double digits. Even then, it can be difficult for them to remain compliant with treatment and follow-up appointments because they must make impossible choices — such as whether to miss a day of work without pay to attend a medical appointment or go to work so they can put food on the table for their families.
In our community, there is still significant misunderstanding and stigma surrounding HIV. Many individuals avoid testing or treatment because, in their view, “not knowing” feels easier than facing a diagnosis. This mindset — out of sight, out of mind — has deep roots in the Latinx community. Today, additional challenges arise as some individuals are afraid to leave their homes due to fear of being detained by ICE. In response, our clinic has expanded telemedicine services to meet their needs while keeping them safe.
Overall, there is still much work to be done in this population to improve education, increase HIV testing, and emphasize treatment as prevention. My commitment remains to break down these barriers, address disparities, and ensure that every individual has the opportunity to receive compassionate, quality care.
Why did you join the fight to end HIV/AIDS?
In December 2010, shortly after finishing nursing school, I began losing weight and experiencing severe fatigue, night sweats, fevers, and a persistent cough. I suspected HIV, but I ignored the symptoms because I had my state board licensing exam scheduled for December 29, 2010. A week before the exam, on December 24, I saw my primary care doctor who diagnosed bronchitis, prescribed an albuterol nebulizer and antibiotics, and told me to return in 2–3 days.
By December 27 I was using the nebulizer hourly just to keep my airway open. After nearly passing out in the shower, my parents rushed me to the hospital. In triage my oxygen saturation was 72%; my lips and nail beds were cyanotic. I was taken to a trauma room where a team of doctors and nurses evaluated me. The physician told me my chest X-ray looked like Pneumocystis pneumonia (PCP) and warned that I would likely have a long hospitalization and might be intubated. I refused to accept that diagnosis — I still wanted to go home and study for my board exam — but the doctor told me not to make any plans.
My condition worsened: I became septic, had an adverse reaction to a blood transfusion, and coded twice. I was admitted to the ICU and placed in a medically induced coma. My parents were told I had only a 10% chance of surviving; if I woke, there was concern about possible brain damage from oxygen deprivation. I had a tracheostomy, bilateral chest tubes, a PEG tube, a Foley catheter, a rectal tube, and multiple central lines.
After 41 days in a coma, I began to improve and was eventually taken off the ventilator with no significant brain injury. I spent 72 days in the hospital total and had to relearn how to walk, talk, eat, bathe, and feed myself. At discharge I weighed 95 pounds — down from 160. The infectious disease doctor discussed discharge options with a case manager: apply for disability and continue specialist care or go to a nearby free clinic “that takes poor people with little to no health care resources” — the very clinic I now direct. When the case manager asked what I planned to do, I instinctively said I would go home, continue recovering, and take my board exam. She countered that I needed to decide where I wanted to spend my last days — home on hospice or at a hospice facility.
That moment changed me. I was not ready to be written off. I focused every ounce of energy on recovery, completed intensive inpatient physical and occupational therapy, and continued outpatient therapy after discharge on March 9, 2011. I took my board exam in June 2011 and earned my Licensed Vocational Nursing license. In September 2011 I had a four-hour interview with Valley AIDS Council and was hired as a floor nurse. Over the following 14 years I worked my way up and am now the Director of Clinical Operations for all three of our organization’s clinics.
This experience — near death, recovery, and the choice the system offered me — is why I joined the fight to end HIV/AIDS. It taught me how fragile health care access can be, how critical compassionate, comprehensive care is for people with HIV, and how much impact a single clinic can have. I became determined to make sure no one is dismissed, and to turn my survival into service for others.
What words of wisdom might you pass on to those entering the field?
I tell every candidate that I interview for positions with our organization that once they find employment doing something they love they never have to work a day in their life. I have such a passion for what I do and the impact that I have been able to contribute to my community that it is a luxury to be able to get pain to do something I love so much. It is extremely rewarding to see your contributions in this field for individuals who have been marginalized and stigmatized for so many years and make them feel comfortable to be who they are and accept them with open arms. Often times my we are the only people in their lives that know about their HIV diagnosis and they feel comfortable disclosing things in their lives that otherwise there would have no one else to talk about it with. Finding your purpose in life is essential.
Who/what inspires you?
I was very fortunate to work with Dr. Dora Martinez, Chief Medical Officer of Valley AIDS Council/Westbrook Clinic, for nearly 10 years. When she joined our organization from a local FQHC, she had no prior experience treating HIV. However, her dedication to learning and her passion for taking on the most complex patients was truly inspirational. She gave me the opportunity to work alongside her and learn how to manage even the most challenging cases.
Now, when I see extremely ill patients in clinic — even those with CD4 counts of zero — I don’t flinch, because Dr. Martinez provided me with the wisdom and confidence to deliver the best possible care. As I’ve taken on more of an administrative role in our organization, I continue to carry forward the standards she instilled in me.
Every day remains a learning experience, and I am still inspired by Dr. Martinez’s example — especially her unwavering commitment to spending quality time with patients and ensuring they feel truly cared for. Those values continue to shape the way I lead and practice today.
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