Over the past four decades, the health care landscape for HIV has significantly changed. In the southeast, a handful of pioneers have shaped new terrain for access to comprehensive and compassionate care for those living with or at risk for HIV. Among them is tenured Professor James Raper, Ph.D., CRNP, J.D., FAAN, FAANP, FIDSA, who has directed the UAB 1917 Clinic since 2007, and is known on UAB’s campus for his commitment to community and excellence.
Using his skill set in nursing and patient care, his background in law, and his heart for service, Raper has profoundly impacted the course of care for patients in Alabama and beyond.
On Dec. 1, Raper will officially retire from over four decades of service.
Providing hope and healing in the southeast
Raper’s career in health care began over forty years ago in nursing. He received his Bachelor of Science in Nursing from Kent State University in 1979, and in 1982 completed his Master of Science in Nursing from the University of Alabama in Huntsville. In 1994, he earned his Ph.D. from the UAB School of Nursing.
Joining the 1917 Clinic staff in 1995, Raper has seen the clinic’s legacy form shape.
What began as a small clinic in January 1988 at 1917 Fifth Ave. South has grown into a comprehensive care center—an NIH-funded ambulatory clinic that has treated more than 12,000 patients with HIV. Since 1997, it has also received highly regarded HRSA Ryan White Early Intervention Service funding and, in 2011 accessed the Federal 340B Drug Pricing Program 340B which helps support outpatient health services.
When asked about some of the greatest successes in directing the 1917 Clinic, Raper says, "I am extremely proud of the highly dedicated multidisciplinary team of medical, dental, mental health and allied health professionals providing care, service, and conducting research at the 1917 Clinic.”
The clinic is truly comprehensive in nature; it hosts wide-ranging services for those living with HIV—many that Raper encouraged.
The 1917 Clinic at Dewberry includes a dedicated UAB Hospital Medical Center Pharmacy, the Alabama Vaccine Research Clinic, Alabama Clinical Trials Unit, the Multicenter AIDS Cohort study/Women’s Interagency HIV Study Combined Cohort Study, and a multitude of patient support services. Furthermore, it includes dental, Hepatitis-C, endocrinology, nephrology, neurology, chronic pain care, nutrition, Pre-Exposure Prophylaxis and psychiatric specialty clinics for those living with or at risk for HIV.
Raper has led many of these efforts alongside his colleague and founder of the 1917 Clinic, Michael Saag, M.D. “Dr. Raper is the most effective leader of a clinical operation I with whom I have worked,” says Saag.
“His insights, wisdom, judgment, vision, and fairness permeate everything he does. Unlike many administrators, Dr. Raper works in the clinic daily, seeing patients and experiencing the 'system' like all the rank-and-file employees, much like a platoon leader in the military. This real-world exposure allows him to truly relate to the folks he is leading while, at the same time, enabling him to enact changes that are practical, efficient, and effective. He is a joy to work with and be around. We will all miss our daily interactions with him deeply."
Offering space for all in times of need
Raper says one notable success in his career was the clinic’s relocation in 2020. “I’m elated that after many years enduring the woefully overcrowded and inadequate conditions at the CCB, we were able to relocate to our new space within the Dewberry Specialty Clinic in December 2020.”
1917 Clinic at DewberryRaper explains that in addition to “abundant surface parking, the substantial upgrade provides 27 exam rooms, two procedure rooms, and significant clinical/administrative offices.”
But the most significant success of his career was in 2013 when he led the integration of 800+ HIV and AIDS patients in Birmingham who were left without health care when the Jefferson County Commission went bankrupt and Cooper Green (CG) Mercy Hospital was required to close its doors.
At that time, some Birmingham patients received HIV care at St. George's Clinic at CG. UAB and the staff of 1917 Clinic stepped in and worked closely with the Medical Director, Dr. Jane Mobley, and administration of St. George's to facilitate a transfer of all 800+ patients to 1917.
“It was a miracle,” Raper reminisced in a previous article. "Two organizations were working hand-in-hand to ensure patients were not left without services.”
Under Raper’s leadership, the HIV and AIDS patients from St. George's Clinic found a health care home at UAB in the 1917 Clinic.
“Despite the short time frame and challenges associated with moving patients and personal health records from one health system to another, we successfully transitioned 97% of St. George's 813 patients to the 1917 Clinic, largely mitigating the potential negative impact of St. George’s Clinic closure.”
The 1917 Clinic was also fortunate to employ many of those from St. George's who would have been left without employment.
Following a path of purpose and determination
Raper has reckoned with a fair share of challenges navigating his many professional roles, including faculty leader, scientist, provider, and administrator—all while on a national stage advocating for HIV and AIDS health care and research, as well as locally within the state of Alabama on reducing restrictions for nurse practitioner patient care.
“Achieving a healthy work-life balance has always been challenging for someone who accepts the challenge of performing the multifaceted work demands of being a health care servant-leader dedicated to playing a leadership role on the local, regional, and national stage. This has been particularly true in my career as a clinician-scientist-administrator. I am fortunate to have a supportive and forgiving husband,” he says.
Personally, Raper identifies a personal life-changing moment in his career when he had a stroke that left him visually impaired. He says returning to work after that physical crisis in 2014 brought renewed tenacity to his mission to help others. “[It] has provided me with a stronger scene of purpose and determination to help others face seemingly insurmountable challenges,” he reflects.
Among his many roles, degrees, certifications, and years of experience; Raper also has a long list of community service endeavors. From his involvement with AIDS Alabama and other local nonprofits to his participation on committees and boards within the nursing community, Raper has lived a career devoted to his communities and the individuals who make them.
Kathie M. Hiers, CEO of AIDS Alabama, says Raper has been a leading light in patient and community care in Alabama. “Dr. Jim Raper is an institution. For persons living with HIV in Alabama, he has been a lifeline. Jim works long, long hours without complaint. His patients are his focus. All of us will have to work harder, as no one person can fill his shoes. I hope Jim enjoys a long, happy retirement!"
When asked, ‘what advice would you give to those who want to make a difference in their community as you have?’ Raper responds, “One must make a conscious decision to be selfless in one’s determination to maintaining a sustained commitment, be willing to do the hard and frequently poorly compensated work, find joy in working in collaboration with others which will sustain one’s purpose when advancement is difficult and slow. And, it is really good to have fun along the way.”
Moving towards a future of equity
Regarding the future of the 1917 Clinic, Raper knows it will continue to be a national leader in HIV-related research and care delivery. “[1917 Clinic] will continue working hand-in-glove with its community partner agencies to lift up the lives of persons with and at risk for HIV while educationally preparing burgeoning health care providers to meet the future needs of the community we serve.”
Collectively, Raper says we can continue to improve access to care for those at-risk or living with HIV in Alabama by coming together united. “Access to care for those at-risk or living with HIV can best be achieved when individuals, groups, and communities work together to fight stigma.”
He also says we can continue improving care by “promoting health equity through advocacy and appropriate resource allocation.”
Raper says it’s imperative, moving forward, to “create an environment that not only provides access to the person(s) in need of care but simultaneously rewarding those who dedicate their careers to achieve optimal care and service to those in need. Without an appropriately rewarded workforce, there will be no access to care.”
Beginning his new chapter
Raper says he is looking forward to relaxing in his retirement. “After working tirelessly since I was 16 years old, a 43-year career in Nursing (27 years as a nurse practitioner), I initially plan to focus on fun, food, health, family, and relaxation.” Raper says he loves to cook and is excited to spend time in the kitchen.
As he wraps up his four-decade career in service, he reflects on his surprise at a career that allowed him to fulfill his calling: "I never expected to find a position that would allow me with the ability to fulfill my desire to provide direct patient care; manage clinical, business and strategic operations; and make meaningful contributions to the Nursing profession while participating in HIV health advocacy on the national stage as well as achieving academic success.”
A celebration was held on Nov. 18, 2022 to celebrate Raper’s service and commitment to his patients, staff, and UAB.
A new fund, the UAB School of Nursing “Jim Raper Endowed Professorship in Nursing,” has been created in honor of Raper’s service to UAB, nursing, and the community-at-large.