Adult Immunization

More than 50,000 U.S. adults die each year from vaccine preventable diseases and their complications, more than breast cancer, HIV/AIDS, or motor vehicle accidents.  However, vaccination rates remain low.  Adult vaccinations can protect against illness, absenteeism from work, hospitalization, and even death.

The poor vaccination rates in adults are not only taking a toll on the country’s health; they are also impacting the bottom line.  The estimated direct costs of treating just two of these diseases‐influenza and pneumonia in adults alone are over 35 billion dollars.

Vaccines are safe!  The CDC estimates that for Americans born between 1994 and 2013 vaccines will prevent 322 million illnesses, 21 million hospitalizations, and 732,000 deaths over the course of their lifetimes.

For adults it is particularly important that they receive all their vaccines.  The immune system weakens as adults age.  Older adults are more likely to develop complications from vaccine preventable diseases.  Immunity from some vaccines can decrease over time, which means booster doses are necessary to maintain protection.  Older adults are also much more likely to have chronic conditions which can increase the risk of complications from some infection.

Please make sure to talk to your provider about staying up to date on all your vaccines.

Dr. Rosenstock
Joel Rosenstock,

Dr. Rosenstock is the past president of the Infectious Diseases Society of Georgia. He previously spent eight years in the US Navy serving in the Republic of Panama and was awarded the meritorious service medal. An expert in tropical medicine, he previously served as the Medical Advisor to CARE, the relief organization and founded Peachtree Travel Clinic, one of the largest travel clinics in the southeastern United States. Dr. Rosenstock has been the Medical Director at AbsoluteCARE since its inception and has been providing care to patients infected with HIV since 1981.


Influenza is a contagious respiratory illness caused by a virus.  The young and the elderly are at particular risk of complication and death.

Symptoms include fever, cough, sore throat, muscle and body aches, headache and fatigue.

Three to eleven percent of the US population becomes sick with influenza each year.

People with influenza can be contagious beginning one day prior to symptoms and for the first 3–4 days after the illness begins.

Complications include bacterial pneumonia, ear infections and worsening of chronic medical conditions.

The most important step in preventing influenza is to get a flu shot yearly.  Even if the flu vaccine does not prevent the acquisition of flu, it will less the severity of the illness and the risk of complications.

AbsoluteCARE will begin offering flu vaccine in September.  Please discuss which flu vaccine is most appropriate for you based on your age and underlying medical conditions.

Dr. Rosenstock
Joel Rosenstock,

Dr. Rosenstock is the past president of the Infectious Diseases Society of Georgia. He previously spent eight years in the US Navy serving in the Republic of Panama and was awarded the meritorious service medal. An expert in tropical medicine, he previously served as the Medical Advisor to CARE, the relief organization and founded Peachtree Travel Clinic, one of the largest travel clinics in the southeastern United States. Dr. Rosenstock has been the Medical Director at AbsoluteCARE since its inception and has been providing care to patients infected with HIV since 1981.

AbsoluteCARE Nutrition Department’s Recipe of the Month

Quick & Healthy Summer Side Dish

Are you looking for an easy, delicious, and healthy side dish to pair with your next summer meal? Well then this recipe meets all of the criteria! “Golden Lemon‐Crumb Tomatoes” is the perfect low calorie, low‐carbohydrate side dish that incorporates tomatoes, herbs, low‐fat cheese, and fresh lemon juice. It will pair well with chicken, fish, pasta, or really any entrée! You certainly can’t go wrong with this recipe, especially now that tomatoes are in season. Enjoy!

Golden Lemon‐Crumb Tomatoes

Makes: 4 Servings

INGREDIENTS (Key: T = Tablespoon, t = teaspoon, oz = ounce)
½ cup plain fresh soft bread crumbs
2 T chopped fresh parsley
½ t dried basil, crumbled
½ t grated lemon zest
2 oz low‐fat feta cheese, crumbled
2 large tomatoes, halved crosswise
1 ½ T fresh lemon juice
Cooking Spray


  1. Preheat the oven to 350°F.
  2. In a small bowl, stir together the bread crumbs, parsley, basil, and lemon zest. Toss gently.
  3. Add the feta. Toss gently.
  4. To assemble, lightly spray a 9‐inch pie pan with cooking spray. Place the tomato halves in the pie pan. Spoon the lemon juice over the halves. Top the tomatoes with the breadcrumb mixture. Liberally spray with cooking spray.
  5. Bake for 30 minutes, or until the tomatoes are tender when pierced with a fork and beginning to slightly brown.
  6. Let stand for 10 minutes before serving.

NUTRITION INFORMATION (for each serving)

Calories: 52
Fat: 0.5 grams
Cholesterol: 0 milligrams
Total Carbohydrates: 9 grams
Fiber: 1 gram
Sodium: 270 milligrams
Protein: 4 grams

“Golden Lemon‐Crumb Tomatoes” The New American Heart Association Cookbook. 7th edition. 2004. Page 472.

Dr. Rosenstock’s Reflections on HIV Long‐Term Survivors Day

I started practicing infectious disease in October of 1981. I’d chosen the perfect specialty for a young, over‐confident military doctor. Infections were fascinating problems to solve, and they usually had solutions. Every case seemed like a winnable battle, after which I’d triumphantly send a cured patient off to live life to the fullest. Needless to say, 1981 threw us all a curve ball.


It’s almost a cliché to say now, but if you weren’t there when the AIDS crisis hit, it’s impossible to understand what it was like. It was a stunning time of loss for LGBTQ communities, and a period of intense uncertainty for healthcare providers. My long‐time nurse, Mary Burns, and I lost two to three patients per week in those early days, almost all of them gay men. We saw their loving partners step up and become part of their care teams. We saw their intense devotion through unimaginable anguish, during a time when their relationships weren’t recognized in life or death. It was beautiful and horrific to witness. Their names will echo through our practice forever.


Our dying patients taught us about dignity, chosen family, altruism and forgiveness. They laid bare the consequences of stigma and hatred. They acted up against stigma, silence and healthcare bureaucracy. My remarkable nurses and medical assistants became family to our patients and to each other. We were united in our grief and in our shared commitment to fight alongside our patients.


In the mid‐1990s, the pace of death slowed with the advent of effective treatment, and we eventually had time to catch our breath and refocus on treating HIV as a chronic illness. So many of those caring partners held on just long enough to reap the benefits of all the studies they’d participated in. One of our patients had lost 59 friends and was awaiting his own demise when protease inhibitors came along. He’s still with us today. Our patients became People Living With HIV, and I grew up to be a doctor who saw people first, infections second. My patients led me to the realization that I loved being able to get to know their whole stories.


To my patients who are long‐term survivors of HIV: Thank you. Thank you for staying here with us despite the stigma, the grief, the survivor’s guilt, and the insensitivity of so many care providers. Thank you for putting your bodies on the line in the early days to test new treatments; for your tireless, unapologetic political activism. Thank you for being a beacon of hope for the newly‐diagnosed, and for helping to build a medical system that would serve your communities best. It’s been the honor of a lifetime to care for you at every appointment.


Dr. Joel Rosenstock, CMO

Dr. Joel Rosenstock, CMO 

Peripheral Artery Disease

Peripheral Artery Disease (PAD) is caused by build up of plaque in the arteries bringing blood to your extremities, organs and brain.  The plaque is formed by cholesterol, calcium, platelets, and fibrosis tissue which are all found in the blood.  After an artery is damaged the body begins healing by forming plaque at the damaged site.

The plaque will harden over time and result in narrowed arteries which obstructs blood flow. The plaque can break off the artery wall and form clots or obstruction of the artery resulting in decreased flow of blood to important tissues. PAD can cause a variety of symptoms ranging from skin changes to organ failure. Knowing and addressing your risk factors can help prevent this significant health problem.

The American College of Cardiology and the American Heart Association have identified groups with increased risk.

  • Over age 70 years old
  • Age 50 to 70 with history of tobacco use
  • Age 40 to 50 with Diabetes Mellitus and at least one additional risk factor (male, African American, family history of atherogenesis, tobacco use, elevated cholesterol, and hypertension)
  • Abnormal lower extremity pulse examination
  • Known Arteriosclerosis

Your healthcare provider will diagnose PAD by comparing blood pressure in arms & legs, usually via ultrasound and physical exam and blood tests.

Prevention of PAD continues to be the best intervention. The US preventive health taskforce recommends smoking cessation, a heart healthy diet, management of elevated cholesterol, and controlling diabetes and/or hypertension.  All of these strategies reduce your risk of this common and significant problem.  Discuss your risk with your health care provider at your next annual exam.

David Stahura, DO

David Stahura, DO

Penicillin Allergies

Penicillin is one the of the most commonly used antibiotics.  About 1 in 10 patients have a penicillin allergy recorded in their medical records. Many allergies are diagnosed in childhood and may be a rash caused by a viral infection versus a true allergy. Penicillin allergies tend to fade away for about 80% of people over a 10‐year span. Most patients with a penicillin allergy recorded with their medical record can tolerate penicillin‐like antibiotics.

Penicillins are among the safest antibiotics. Having an unverified penicillin allergy may result in other antibiotics being used to treat infections, which could result in treatment failures, healthcare‐associated infections (like Clostridium difficile), and adverse side effects.

Penicillin allergies can be evaluated by your physician evaluating a thorough history of the reactions.  Skin testing for a penicillin allergy is the usual next step in evaluation. If no reaction occurs, the first dose of penicillin can be used in the future.  It is important to remember that allergic reactions can occur anytime, so being cautious is always appropriate.

If you have a history of penicillin allergy, ask your physician how you can be evaluated.

David Stahura, DO

David Stahura, DO

Ref: American Academy of Allergy Immunology

Support and Social Groups Available at AbsoluteCARE

Support Group
Please check out the updated list of support and social groups currently offered to our members. We hope you’re interested in joining us! If you have any questions or concerns, contact Emily Brown, our director of community engagement, at or 404–994-4234.

Peers of Georgia

A monthly support group for People Living with HIV and their families, friends and supporters. People who are not members of AbsoluteCARE are welcome!

Meeting Times: 4th Wednesdays 12:00PM-1:30PM

Facilitator and Contact: Please contact Freda Jones at 404–231-4431 x3132 or

One Roof 

One Roof is an HIV peer support group open to all AbsoluteCARE members living with HIV. Our different backgrounds and experiences will remind us that under this One Roof we can inspire each other.

Meeting Times: Every first and third Tuesday at 5:30PM – 7:00PM, with our first meeting on March 19th, 2019.

Staff Facilitator and Contact: Please contact Jonathan at 678–666-3278 or

Life With(out) Substance

Life With(out) Substance is an unique, open‐minded, and affirming substance use peer support group open to all AbsoluteCARE members with past or present substance use. Our focus will be on life, and how substance use affects it, at all levels, and what recovery looks like for individuals, relationships, and communities.

Meeting Times: Life With(out) Substance meets every second and fourth Thursday at 5:30PM – 7:00PM, with our first meeting on March 28th, 2019.

Staff Facilitator and Contact: Please contact Jonathan at 678–666-3278 or

#SheMatters Women’s Health Happy Hour

#SheMatters is a casual, fun happy hour for women living with HIV and their allies to discuss various health and social topics in a relaxed environment. People who are not AbsoluteCARE members are welcome to attend!

Meeting Times: Every 3rd Thursday, 6:30pm to 8:30pm

Facilitator and Contact: Please contact Freda Jones at 404–231-4431 x3132 or

Come As You Are

Come As You Are is a social group for gracefully aging (35+) gay men living with HIV who are members of AbsoluteCARE. We meet monthly and our activities include pot‐lucks and fine dining, bowling and escape rooms, museums and festivals, and more. All are welcome; cost and transportation sponsorship is available for any in need, and is anonymous.

Meeting Times: Once per month; variable depending on activities and interests.

Staff Facilitator and Contact: Please contact Jonathan at 678–666-3278 or to join!

Monthly HIV Lunch & Learns

These monthly lunch and learns are an opportunity for patients and community members living with HIV to learn about different aspects of living with HIV.

Meeting Times: 2nd Wednesday at 12:00pm-1:30pm

Facilitator and Contact: Please contact Freda Jones at 404–231-4431 x3132 or

Sue Westgate Receives Dean’s Teaching Award

Congratulations to Susan, our National Director of Behavioral Health, for receiving the Dean’s Teaching Award at University of MD, School of Social Work for a graduate class taught this past fall. Her course was titled, “Working With Individuals with Chronic and Life‐Threatening Illness”. The Dean’s Teaching Award is given based upon student satisfaction and student overall recommendation of the instructor.

We are so fortunate to have Sue as part of the AbsoluteCARE team. Well done!

Weight Loss Surgery Options

There are multiple types of surgery for people who struggle with excess weight. These surgeries are now much less invasive and much safer than back in the 90s. Hundreds of thousands of these surgeries are done each year and follow up over 5–15 years has shown sustained weight loss of 25–30% of body weight. Plus, the risk of serious complications is very low, like that of a gall bladder surgery. The improvement in heart and brain health, diabetes, blood pressure, cholesterol, and even risk of cancer, is significant.

The most common surgery involves cutting the stomach to a “sleeve” that is shaped like a banana. It reduces hunger and makes people feel full so they lose weight. A couple months after the operation, they go back to eating normal food but smaller amounts of it. The other common operation is bypass and that is more effective, but has slightly more complications. It is still very safe and preferred for those who are very obese.

Consult with your healthcare provider to determine if you’re a candidate for weight loss surgery.


Anuj Malik, MD
Board Certified in Obesity Medicine

Beginning Hormone Therapy for Gender Transition

Hormone therapy (HRT) can have positive and important impacts on a transgender person’s quality of life. First, you need to make the decision that you are truly ready to start your hormone therapy. Once you start, some changes cannot be undone. One question to ask is how will HRT impact my life? If you make the decision that HRT is right for you, the next step is finding a healthcare provider (HCP) to prescribe your HRT and monitor your therapy. It is important to find an HCP you feel comfortable with and one who has experience in prescribing HRT for gender transition.

Your HCP will perform a physical assessment prior to starting your HRT and may also request a mental health assessment. HCPs have a responsibility to be sure you are making an informed decision and that you meet the physical and mental standards for eligibility and readiness for HRT. Following the mental health assessment, the mental health professional will then make recommendations to your provider. Your HCP will then do the physical exam, order baseline laboratory testing, and discuss the process of initiation of your HRT. Once complete, your HCP will make recommendations on dosages and frequency of your HRT and how you will be monitored during your transition. Ongoing care will include follow up appointments with your HCP to monitor your hormone levels and the effectiveness of your therapy. You may also be followed by your mental health provider in certain circumstances.

Remember, HRT is a lifelong commitment and requires monitoring to optimize your transition and your overall health. Finding the appropriate HCP is an important first step to building a happier, healthier quality of life for you!

If you’re interested in scheduling an appointment to discuss beginning HRT, please give us a call at 404.231.4431.


Terry Hackworth, NP‐C