Meet the Doctor: Hussein Safa, MD
Hussein Safa, MD, is an attending physician in the Immunodeficiency Center and medical director of the Pride Program at Einstein Medical Center Philadelphia. His specialties are family medicine, HIV and LGBTQ+ primary care. He is certified by the American Board of Family Medicine and the American Academy of HIV Medicine.
We spoke recently with Dr. Safa about his career, his interests, and HIV and LGBTQ+ care at Einstein Healthcare Network.
Q: Why did you decide to become a doctor?
A: I grew up in Lebanon and witnessed many wars. When I was 16 years old, people from the organization Doctors Without Borders came to help. The fact that these doctors would risk their own lives really moved me and sparked an interest to help others. Plus, I was always interested in science and math. I landed on becoming a physician because it combined all my interests.
Q: Tell us about your education.
A. I came to the United States in 2007. I was the first person to complete college in my family, so it was a very big deal. After college at Fordham University, I went on to Creighton University School of Medicine in Omaha, Neb. I completed my residency in family and social medicine and did the comprehensive HIV care track at Montefiore Medical Center, Albert Einstein College of Medicine, in the Bronx, NY.
In medical school, I was founder and president of the Medicine Gender and Sexuality Alliance, committed to advocating for LGBTQ+ patients and healthcare workers. I also co-developed curriculum that addressed the health needs of lesbian, gay, bisexual, transgender and non-binary individuals.
Q: Why did you choose your specialty?
A: I was interested in many different areas of medicine, but during the family medicine rotation in medical school I got placed in a clinic that did HIV primary care. It helped me realize that the best marriage for me was family medicine and HIV, especially because I already had a strong interest in HIV. When I applied to residency programs, I was extremely fortunate to have been accepted to a residency that combined both of my clinical interests.
Q: When were you first aware of HIV?
A: When I was 10 or 11 years old, living in Lebanon, my mom and I were watching a dramatization on TV about a young man who contracted HIV from a blood transfusion. The man was Lebanese, living somewhere in Africa. The show depicted how he was ostracized and treated cruelly by others out of fear and ignorance about how the virus is contracted. I remember feeling bad for the man and the stigma he faced.
Later on, when I moved to New York City, I quickly learned that there continued to be a lot of stigma and discrimination against people living with HIV despite advances in treatment.
Q: What are your particular areas of clinical interest?
A: My clinical interest in family medicine is HIV management, which includes anti-retroviral therapy to control the virus so it is undetectable, and providing gender-affirming care through the Pride Program, which includes hormone replacement therapy and possible surgical referral to help patients transition into the gender they identify as.
I’m particularly interested in the cardiac risk that HIV poses to patients. It is believed that this is due to the inflammatory process by the body in trying to control the virus. I’m interested in understanding how that risk can be managed in primary care by providing medication along with counseling about a healthy diet and exercise. Patients with severe symptoms are referred to a cardiologist.
Q: What drew you to Einstein?
A: After completing my residency, I was looking for clinical positions in HIV and LGBTQ+ affirming primary care. Einstein’s Immunodeficiency Center has an interdisciplinary team approach with a great support system of social workers, case managers and behavioral health experts. Data shows that the best outcomes for people with HIV are in settings where they get all this support.
The community served by Einstein Medical Center Philadelphia also is similar to the folks I worked with at Montefiore Medical Center in the Bronx. Their health-related issues and challenges are often rooted in systems of oppression like racism and poverty, which create barriers to healthcare access. I am committed to using my privilege as a healthcare provider to work in solidarity with my patients, collaborate with them on their healthcare goals, and be a trusted resource when it comes to their health needs.
Q: Why should people come to Einstein for HIV and LGBTQ+ care?
A: We have an amazing team of doctors, nurses, social workers and behavioral health staff, and we strive to offer a holistic approach to care. This means we take into account the health of the whole person, which includes the psychosocial component of their health. Paying attention to factors such as food insecurity and housing, which have a tremendous impact on people’s health, leads to better health outcomes for themselves and their community.
Einstein’s Immunodeficiency Center provides comprehensive primary and specialty outpatient HIV care for adults by doctors and nurse practitioners certified in HIV medical care. We also have HIV prevention services.
Einstein’s Pride Program offers LGBTQ+ patients age 18 and up and their families a professional, safe, caring home for their healthcare needs in primary care and affiliated physicians in specialties such as behavioral health, OBGYN, plastic surgery and endocrinology.
Q: What’s new in HIV medicine?
A: In HIV, there are a lot of new, exciting things. A new, long-lasting injectable antiretroviral therapy (ART) for HIV has just been approved by the Food and Drug Administration. It’s a monthly injection called Cabenuva that combines two medications, cabotegravir and rilpivirine. Einstein will offer this to patients as soon as it’s distributed and available to pharmacies by the manufacturer.
Researchers are also working on an implant (similar to birth control implants) where a patient will get an implant in the arm once a year. This will also improve adherence and will help people psychologically if they develop “pill fatigue” after taking multiple pills each day for years.
Q: What are some of the issues and barriers that need to be addressed for LGBTQ+ patients?
A: There are many barriers to care, especially in the trans community. Some of the barriers have to do with insurance issues, race, socioeconomic status and gender, which leads to continued stigma. Sometimes the stigma comes from providers and staff who, due to their lack of knowledge and understanding, may not provide fully gender-affirming care, such as using the wrong pronouns or misgendering gender-diverse patients.
Something that we’re working on here at Einstein is modifying the top banner in the electronic medical record to show preferred names and pronouns, so it reduces the incidence of patients being misgendered. We’re hopeful this will go into effect in 2021. The Pride program has also offered training to staff and providers in different departments on how to have affirming interactions with patients.
Q: What are your interests outside of work?
A: Pre-pandemic, I used to go to at least one concert every month. Now, I enjoy watching concerts and attending parties online. I like all kinds of music, but my preferences are pop, rhythm & blues, and singer/songwriter performers. I am also an amateur photographer; I like taking photos of architecture, lighting and shadows.
Q: Who was an early role model for you?
A: My parents were role models for me. They were very hard-working and instilled a good work ethic in me. They also sacrificed a good deal for my sister, brother and me.
Q: Do you have a favorite book?
A: I have eclectic taste in books. Growing up in Lebanon, I loved the Harry Potter series. I have always liked books that focus on values such as pursuit of knowledge or courage or trust. Two books that were formative in my development were the novel The Unbearable Lightness of Being by Milan Kundera, and anything written by Herman Hesse. Another favorite is the dystopian novel The Handmaid’s Tale by Margaret Atwood.
Q: Do you have a favorite movie?
A: It’s a choice between Spirited Away by Hayao Miyazaki and Marie Antoinette by Sophia Coppola.
Q: Do you have a favorite vacation spot?
A: I’d like to go back to Hawaii – it’s paradise on earth. Also on my list would be a return trip to Berlin (especially East Berlin, which has so much history, art and great food), and Venice – the Jewel of Italy.
Q: What is something most people don’t know about you?
A: I am a minimalist in life. I like efficiency and have a lot of empty space in my apartment. My personality is pretty reserved, yet I could also be spotted wearing a bright red coat and gold shoes, which I love!