VIDC Signs The Vancouver Consensus

Following the recently concluded IAS 2015 (international Aids Society Conference 2015) at the Vancouver Convention Centre last July 19-22, 2015, the Vancouver Consensus was created.

Here is a short excerpt from the Vancouver Consensus website:

In 1996 the global HIV community gathered in Vancouver to share evidence that triple-combination antiretroviral treatment held the power to stem the tide of deaths from AIDS.  The treatment era had begun. Today, as we gather again in Vancouver, we recognize a new transformative moment in the fight to end AIDS.

…

We call on leaders the world over to implement HIV science and commit to providing access to immediate HIV treatment to all people living with HIV. We call on donors and governments to use existing resources for maximum impact and to mobilize sufficient resources globally to support ARV access for all, UN 90/90/90 goals for testing, treatment and adherence, and a comprehensive HIV response. We call on clinicians to build models of care that move beyond the clinic to reach all who want and need ARVs. We call on civil society to mobilize in support of immediate rights-based access to treatment for all.

Science has delivered solutions. The question for the world is: When will we put it into practice?

VIDC is proud to be one of the signatories of the consensus!

On July 24, Dr. Brian Conway, President & Medical Director of VIDC, proudly signed the Vancouver Consensus and invites all those who care about access to HIV treatment for all those who would benefit from it to do the same.

In light of data presented at the recent 8th International AIDS Society Conference on HIV Pathogenesis, Treatment & Prevention, it is now evident that all HIV-infected patients will benefit from the initiation of antiretroviral therapy, regardless of their CD4 cell count. It must therefore be our goal to identify and offer treatment to all men and women living with HIV infection.  This is especially true of the most vulnerable and disenfranchised to whom we may offer care.  For them, engagement in the health care system, and the prospect of benefiting from this engagement, may also be a positive tool of social change.

-Dr. Brian Conway

To read more about the Vancouver Consensus, and to view a complete list of the signatories, click here.

Community Pop-Up Clinics (CPCs)

Our Community Pop-Up Clinic Poster

As part of our commitment to a holistic approach to medicine and to spreading awareness and education, we close our clinic doors (almost) every Friday afternoon. Yes, we stop clinic operations — or at least those that require the doctor to be present – to pursue our commitment!

This is where you’ll find Dr. Brian Conway on Friday afternoons. No, he’s not moonlighting as a podiatrist!

On Friday afternoons, the VIDC team can be found on different locations in the Downtown East Side (DTES) holding our Community Pop-Up Clinic (CPC). We can be found at various drop-in centres, homeless shelters, and soup kitchens in and around the DTES. At these CPCs, we register anyone and everyone interested in getting tested for HIV and HCV. The goal of is to bring awareness and to engage patients who would otherwise not have access to diagnosis, treatment, and/or care.

The clinic is set up such that from the very beginning, engagement is the main goal. Our team of research assistants and coordinators are on the front line doing registration. We talk to anyone and everyone who shows interest and explain to them how the tests work, help them with registration, and direct them as necessary. Following that, our HCV Nurse, Yashna Bhutani, takes over. She sets up the clinic part of our CPCs. She will have her own room – or corner, whichever is available – and does the testing. We use OraQuick® Tests for HIV and HCV. Basically? Yashna just needs to swab the insides of their cheeks – no blood involved – and the results come out in about 10-15 minutes. The test checks for the presence of antibodies, your body’s response to infection. If the test comes out positive — which indicates that your body has fought or is fighting either HIV or HCV — then we recommend more thorough blood tests. (To find out more about how OraQuick® works, click here.)

Yasha set up and ready for testing!

The final part of the process involves the revelation of the results. If anyone tests positive for either HIV or HCV, Dr. Brian Conway is right there to provide immediate specialist consultation. Additionally, our HCV Research Nurses, Shawn and Yashna, would also have counseling sessions with these patients. Often these patients are unaware of their infection — let alone the treatment options and care available for people dealing with Hepatitis C. This is why it is very important to have Dr. Conway, Shawn, and Yashna available at the site to provide counseling, support, and consultation for these people. Sometimes hearing the news — both the good and the bad — from someone well equipped to help is all they need to have hope and feel better.

Nurse Shawn Sharma counseling a patient who tested positive for HCV about treatment options and how HCV is not a death sentence anymore.

The idea with the rapid tests is for individuals who do not need extensive (and sometimes expensive) blood work done to not have to do it. If the test for antibodies is negative, why else would you need further confirmatory tests? The hassle in getting a doctor to sign off on a lab requisition form, the trouble of going to the lab to get your blood drawn, the long wait at laboratories, and the agony of waiting for your results — these are the things we try to eliminate through our Community Pop-Up Clinics. Basically, our CPCs are geared towards lessening inconvenience, hassle, stress, and fear involved with getting tested – the goal is to make it as simple and accessible as possible to get as many people tested and engaged as possible.

Our CPCs are sometimes known as Testing Fairs to the community (and even among the staff, actually).

The main goal of our CPCs: There is a problem, there is cure available, let’s get the word out and stop the spread of these diseases.

Our CPC was also recently featured on the 24hrs Vancouver Newspaper, click here to see the article.

Psychologist Bill Coleman PhD At VIDC

For our Hep C Support Group last Friday, June 26, we had Clinical Psychologist, Bill Coleman PhD, come and facilitate our meeting.

Dr. Coleman has been a counselor for 25 years and has been working extensively in a sexually transmitted clinic for over 10 years. His experience with individuals dealing with sexuality, addiction, and incarceration issues has made him a very valuable partner of VIDC. Every couple of months, Dr. Coleman would come facilitate one of our Hep C Support Group meetings and have a little bit of a group counseling session with us.

Last week the topic was values, or inner spirit as some might call it; or basically, who we are independent of our actions — because sometimes our actions are caused by our circumstances not really by who we truly are inside. Dr. Coleman broke down what our values are comprised of into three main components: how we see ourselves, how we see others, and how we see the world.

It was a very informative and interactive meeting where attendees were able to express their thoughts and feelings about who they think they are.

To close the session, Dr. Coleman directed us to the Barrett Values Centre website where we could get a free personal values assessment. Some of us had our results printed and we were able to sit down and discuss with Dr. Coleman, over lunch, what the results meant and how we should use this information.

Defining who we are is a struggle everyone has to deal with, a struggle that becomes harder to overcome when disease/illness and life circumstances get in the way. Our goal last week was to remind everyone that our situations do not define who we are. As part of our commitment to holistic care, this was a necessary session to encourage our patients to not let the disease and the illness take over their lives.

We love having Dr. Coleman over not just for his insights, but also because he is a health care professional that is very dedicated to his clients. His office is less than a minute’s walk away from our clinic, and he provides affordable counseling for those who need it. Find out more about him and his practice on his website.

Drug Interactions Cheat Sheets

Last Friday, June 19, we had one of our Lunch Talks at the clinic. Our very own Dr. Brian Conway gave a mini-lecture over lunch — sponsored by Merck — on drug interactions.

Bottom line: Be aware of what you’re taking!

The talk was very informative and quite extensive for the amount of time we had, and typing up all that information would be too much for a blog post! Fortunately, Dr. Conway gave us a shortcut to all that knowledge: The University of Liverpool’s Drug Interaction websites!

There’s the http://www.hiv-druginteractions.org/ for HIV drugs and http://www.hep-druginteractions.org/ for HCV (Hep C) drugs.

Basically, the site allows for public access of PDF charts detailing which drugs have interactions with each other and whether or not these interactions are negligible or deadly.  It has a very easy-to-understand scheme: interactions labeled in GREEN are drugs you can take together, YELLOW are drugs you want to take with caution, and RED labeled drug interactions are just NO. And for people interested in why the labels are colored as such, the site also has an area detailing the information behind the specific labels.

The sites are very informative and user-friendly. And also quite comprehensive — from Ibuprofen to Cocaine to other antivirals!

Here are some screenshots:

List of printable charts you can access through hiv-druginteractions.org

An example of what a printable chart looks like. Labels are colored for easy scanning, and symbols are used to give more information about the specific interactions.

An example from hep-druginteractions.org. Different symbols, same color scheme — green, yellow, and red.

They also produced (free) apps!

These are available in both the Apple App Store and the Google Play Store. Click on the photos below for the Apple App Store. Or search for HEP iChart and HIV iChart for the HCV and the HIV drug interactions app respectively.

Inside the HCV App

HIV App

You start by selecting the HIV or HCV drug you’re interested in and then select the other drug (cough medicine, pain medication, recreational drugs, alcohol, etc.) you want to check and voila!

Just like the charts, if it’s safe, the label is green.

Yellow if co-administration should be done with caution.

Red if the interactions have adverse effects and co-administration should not be done.

This is an amazing resource for individuals living with HIV or HCV (Hep C), the health care professionals working with them, and family and community members that want to look out for them. A convenient cheat sheet in the palm of your hand — or on your wall if you choose to print the charts out.

HOWEVER, these apps and charts do not replace your doctor’s orders. Always run things by your doctor if you’re unsure of the medications you’re taking.

 

Why We Have A Support Group At Our Clinic

Huth, Edward J. Medicine in Quotations: Views of Health and Disease through the Ages. 2nd ed. Philadelphia: American College of Physicians, 2006. Print.¹

After ignoring Eric Cassell’s lack of gender sensitivity in his language (we’ll let it slide as it was written in the 1970s), his statement actually resonates very well with the VIDC mission. Our holistic approach to healthcare understands this difference and, as such, addresses both the illness and the disease.

Initiatives like our DTES Pop-Up Clinics and VIDC Connect stem from this and seek to engage the community through awareness building and information dissemination. And we don’t stop there! We directly engage with our patients through our Hepatitis C (HCV) Support Group.

Every Friday from 10AM to 12PM we have breakfast, a discussion group, and lunch for patients who deal or have dealt with Hepatitis C (HCV). Our discussions are led by our HCV Nurse, Shawn, who prepares a presentation on anything and everything that’s related to dealing with Hep C — healthy living, coping with the illness, GMOs, new treatments, drug interactions, etc.

Yes, we made it easy to invite people who would benefit from the group — we have our own business cards!

It’s a discussion group meant to inform, educate, and provide social support for patients dealing with the illness and disease brought about by the Hep C Virus. Sometimes attendees just sit and listen to Shawn, sometimes they have very lively discussions on how they feel about healthy food options, and other times they have very heartfelt discussions on what it feels like to live with Hep C. Whatever the case is, it’s always a space where people can feel safe, cared for, and listened to.

Following Eric Cassell’s quote, there is a huge difference between the illness and the disease caused by HCV. The medication can only deal with the disease, and that’s why we have the Hep C Support Group to help patients tackle the illness.

As Dr. Brian Conway MD, FRCPC would often remind us,

A person’s well-being is like a four-legged chair and physical health is just one of the legs. If we want to ensure someone is fully healthy, we need to address all four aspects of his/her person — and social health is one of them. [Paraphrased]