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The Positive Side Encourages Every Person with HIV to Make the Treatment Decision That Is Right for Them

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The Positive Side Encourages Every Person with HIV to Make the Treatment Decision That Is Right for Them HeAltH inFormAtion & views winter 2013 volume 15 issue 1 Claudia Medina blows Ready the cover off secrets, foR ouR stigma and denial close -up AIDS onscreen Just kids THE REAL Growing up with HIV DEAL Nighty - Night Sleep tight &$7,( 8 /GVÙUV CMGQWTTGNCVKQPUJKRVQVJGPGZVNGXGN %GEQOGC&$7,(0GODGT 7QHKPFQWVOQTGCDQWVVJGDGPGHKVUQHDGEQOKPIC&$7,(0GODGT XKUKVYYYECVKGECCPFENKEMQPVJGÚ%GEQOGC0GODGTÛDWVVQP INSIDE EDITOR’S LETTER From the Front lines This past October, the Supreme Court of Canada delivered Programs to help you stay on track 4 its verdict on two cases involving non-disclosure of HIV with treatment status during sex. While the judgement dismayed many HIV activists, it did define one situation in which people Chatty CAtie with HIV do not have to disclose their status before sex— 4 PHA s expose their tattoos 6 namely, when they have a low viral load (less than 1,500 ) and a condom is used. Go to www.aidslaw.ca for more info. Profile These rulings reinforce the false view that prevention Claudia Medina speaks openly 8 rests solely with the HIV -positive individual instead of being about HIV , sexuality and supporting PHA s a responsibility shared by both people. They may also lead to people with HIV feeling pressure to start treatment, not Gone but not Forgotten only for their own health but also to reduce their legal risk. AIDS memorials honouring 11 At the same time, new guidelines are suggesting that those who have passed people start HIV treatment at higher CD 4 counts. This is partly based on evidence that doing so can protect the body from damage caused by HIV , but it’s also based on evidence that starting earlier reduces the risk of transmitting HIV . For people with HIV , all of these changes mark a shift from making treatment decisions based solely on their own health (and readiness to start, of course) to making decisions that include the potential impact on other people. However, it is only the HIV -positive person who must deal with the side effects and risks, many of which are still unknown. The Positive Side encourages every person with HIV to make the treatment decision that is right for them. And we think the needs of the person living with the virus should always come first. You should not feel pressured to start treatment solely for the benefit of others. Y Of course, we are here to provide information and sup - T A N I port, whether it’s about HIV treatment or another aspect of L O H living well with HIV . In this issue we look at managing lipid H S O J HIV : levels, getting a good night’s sleep and growing up with . N O I T We also have stories of tattoos, beach weddings and A R T S meeting Fashion Television goddess Jeanne Beker. Would U L L I we expect anything less from the great people living with HIV in this country? Absolutely not. —David McLay Growing Up with HIV The stories of children born positive 14 AiDs on the silver screen Movies that reflect our shared history 18 www.positiveside.ca sleep tight Winter ISSN 55=5-=<4= Derek Thaczuk, Diane Peters, Not catching enough zzzs? Find out how 22 Volume ! Issue Publications Agreement Jennifer McPhee, Maggie you can hit the hay and sleep soundly Number 5;4;7:5 Atkinson, Melissa Egan, Sean Publisher: Hosein, Tim Rogers CATIE Editor-in-chief Ask the experts 949-999 Richmond St W David McLay Creative Direction Pointers for managing your lipids 26 Box 5548 and Design Managing Editor Toronto ON M9V 7B5 David Vereschagin, Debbie Koenig Art Posi+ive Canada Quadrat Communications Illustrator and graphic designer 28 Editors © 6456, CATIE (Canadian Cover Image Morgan McConnell Anna Kohn, RonniLyn Pustil AIDS Treatment Information Claudia Medina, photographed Exchange). Contributors by Michelle Gibson visual AiDs All rights reserved. Ann Silversides, Darien Taylor, Farewell to Fashion Cares 30 Get a free subscription to The Positive Side by visiting www.positiveside.ca or calling 1.800.263.1638. Winter 2013 THE POSITIVE SIDE 3 FROM THE FRONT LINES what’s happening across Canada Adherence Support CATIE educator Melissa Egan profiles programs across the country that aim to make HIV meds a little easier to swallow. Sticking to your HIV medication schedule—a.k.a. adherence—is crucial to fight the virus and prevent drug resistance. But “take as directed” isn’t always as straightforward as it sounds. Side effects, drug interactions, depression, an irregular routine and “treatment fatigue” can all throw up roadblocks. A few innovative programs offer people living with HIV support and strategies to overcome barriers and stay on course. AIDS Community Care Montreal HIV Care Program Windsor Regional Hospital Windsor, Ontario One of the most comprehensive adherence sup - port programs in Ontario is the HIV Care Program at Windsor Regional Hospital. This outpatient clinic is run by a group of devoted service providers that includes two pharmacists, physicians, nurses, a psychologist and a dietitian. Every person who comes to the clinic becomes Starting HIV treatment can be a difficult decision to make; part of a community of care that emphasizes an staying on it for years and doing so without support can be attentive and holistic approach to improving adher - even harder. In Montreal, people with HIV who are interested ence. This includes one-on-one counselling, the use in exploring their treatment options or discussing adherence of dosette boxes and scheduled medication pickups. challenges one-on-one need look no further than AIDS A link with the pharmacy gives this clinic its edge— Community Care Montreal ( ACCM )’s treatment information records of when each person is due for a refill help facilitator, Sylvain Beaudry. Members can call or visit him to staff track how often prescriptions are being discuss any issues they may be experiencing. renewed. This can prompt discussion about how Starting in fall 2013, ACCM will offer the innovative My patients can be further supported to take their meds. Life with HIV workshop series, which will focus on antiretro - In recent years, the need for adherence support virals—how to incorporate them into your life, manage side has expanded, as many long-term survivors are also effects and stay adherent. The agency also ensures that taking meds for other conditions, such as high cho - clients have the most up-to-date information by inviting lesterol, depression and osteoporosis. With HIV meds pharma cologists and other healthcare professionals to high - comprising just some of the many pills they must light new meds and discuss those currently available. take in a day, this program has become integral to If you’re after a way to stay adherent or have questions the continued support of people living with HIV . about your treatment, ACCM ’s staff is ready to support you. www.wrh.on.ca [email protected] 4 THE POSITIVE SIDE Winter 2013 Maximally Assisted Therapy Program Northern Vancouver Alberta HIV Program Edmonton At the crack of dawn, 365 days a year, the doors of the Downtown Community Health Clinic open to offer breakfast With a strong focus on treatment programs to people in the Downtown Eastside. This tiny but busy space tailored to each individual, the Northern Alberta in a community where many lack stable housing provides a HIV Program is a shining example of how excellent chance to get out of the rain, enjoy a cup of coffee and access adherence supports can make a difference in health supports. Some people come for an appointment at people’s lives. Working to build strong connections the clinic, while others drop in for their daily dose of HIV with the people it serves has been the model of medication. The clinic has had great success helping its success for this clinic, which provides care to people members stay on their meds and the addition of the Maxi - living with or affected by HIV across northern Alberta mally Assisted Therapy ( MAT ) Program has contributed and the Northwest Territories. hugely to that success. The staff includes a psychologist, social workers, The MAT team of nurses, community workers, social pharmacists and other healthcare providers who worker and pharmacist offers a wide range of adherence place their relationships with patients at the fore - supports. Members are encouraged to use services that front of care. Appointments can last more than an range from counselling and regular checkups for blood work hour and the pharmacist is careful to customize to appointments with the nutritionist or infectious disease HIV treatment to each individual’s life. This involves doctor. Additionally, outreach teams travel throughout the getting to know a person’s work schedule and living city to distribute medication to members regardless of where situation as well as any confidentiality issues they they are, ensuring that adherence isn’t affected by lack of bus may be dealing with related to their meds. Under - fare, having no fixed address, depression or drug use. MAT standing the context of a person’s treatment in this outreach workers have brought treatment to some of the way makes it easier to pinpoint any barriers to most hard-to-reach people in Vancouver. adherence and to find strategies that help people Evaluation of the program has shown that nine out of stick with their treatment. every 10 MAT clients now have a suppressed viral load and After seeing more and more pregnant women adherence rates appear to be high. The program is also access its services, the program has increased its beginning to see evidence of lowered transmission rates. focus on this group. Clinical pharmacist Michelle Foisy and her team have started a comprehensive treatment support plan that is both collaborative and For a comprehensive guide to preparing for HIV treat - customized to the needs of pregnant women and ment, choosing the right combination and adhering to new moms.
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