By Angela Hill

Treatment as a prevention method for HIV

Nov 17, 2011 | 10:56 AM

With so many unique aspects to HIV in Saskatchewan, health care professionals are reading up on treatment and thinking outside the box.

“What we do need to become a little more inventive on, and thinking out of the box on, is making sure clients have access to meds in a timely manner and that we’re supporting them to ensure they’re taking them,” said Jim Myres, director of Disease Prevention with the Ministry of Health.

The provincial leadership team on HIV is working on ways to make anti-retroviral therapy, called ARTs, more accessible. They’re looking at partnerships and creative ways to get rid of the barriers to accessing medication.

The team’s pharmacist is working with the province to come up with a plan to make sure everyone can access medications smoothly, whether they are covered by the drug plan or non-insured health benefits, on reserve First Nations or off, said Johnmark Opondo, medical health officer for the provincial leadership team.

“The hope is that if we can bring the two main drug administrations together that, you as the patients, all you have to do is go to the pharmacy and get your meds. The insurance and the drug plans will then deal with the payment behind the scene,” he said.

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It’s about streamlining the process to “put the patient first,” Myres said.

“If you get a script from a physician saying you need these medications and you could take it to the pharmacy and get it right away regardless of your status — aboriginal or not — wouldn’t that be great,” he said.

“You get your medication same day and away you go. You move in the province and you go to a different pharmacy, no difference. They know you, here it is and away you go.”

This idea of streamlining a process and getting direct billing for HIV treatment appeals to Kelly Patrick, a health consultant with Prince Albert Métis Women.

“They’re being very creative asking the Feds, Health Canada and (First Nations Inuit Health) to consider direct billing,” she said.

As it turns out, it’s more than just the health of the HIV-positive individual that can be improved when the person takes ARTs.

There have been breakthroughs in recent years — if you start those infected with HIV on ART it improves their health, avoids opportunistic infections and there is a decreased chance of transmission to others, said Opondo.

“Treatment is a cool, new prevention tool that can be used for preventing further transmission of HIV. If we can do this in enough people then we can essentially get the viral load in the community down to a level where transmission from one person to the next is minimized.”

Studies out of Vancouver show this not only to reduce the incidence of new HIV infections, but the strategy quickly becomes cost effective, even with more people getting medication. Clinicians are taking this concept of treatment as prevention and applying it.

The pilot project STOP HIV/AIDS, which stands for Seek and Treat for Optimal Prevention, combines testing, treatment and outreach, in downtown Vancouver and Prince George, said Dr. David Tu, a family physician with the program.

The pilot isn’t over yet, but they’ve already seen decreased sickness and death associated with HIV, a smaller number of new cases and 100 per cent virus suppression on treatment, Tu said.

“You want to give people every opportunity for early access,” he said, because HIV is infectious and potentially fatal.

Knowing the importance of providing the medication early will help with the province’s work on HIV, said Opondo.

“And I think that is the difference between what we had proposed in the past to what the opportunities are today.”

As the provincial leadership team on HIV continues to roll out their plans, he said clinicians will be promoting early access and keeping people engaged.

“I’m very hopeful that if we continue with the same emphasis and momentum that we started with, then we will begin to see some results.”

See related: The face of HIV in Saskatchewan

ahill@panow.com

This story is the eighth in a series about the face of HIV in Saskatchewan. Research for this project was made possible by a journalism grant from the Canadian Institutes of Health Research.