20 years of providing hope for HIV patients

When Health Sciences North's HAVEN program started 20 years ago, HIV infection was considered a fatal disease.

Most patients died within 10 to 15 years of being infected.

“Today, it's a completely different story,” Dr. Roger Sandre, the medical director of the HAVEN program, which provides medical care to those with HIV in northeastern Ontario, said. “I can't emphasize how controllable this infection is, like many other chronic diseases.”

The difference has come though advances in drug treatments, he said, speaking to Northern Life Jan. 16 at a celebration of the clinic's anniversary.

Twenty years ago, there were only two antiviral drugs to treat HIV.

To emphasize how far things have come since then, Sandre, who has been working with the HAVEN program for 18 years, points at a colourful poster depicting the roughly 25 drugs now available to treat the same infection.

Doctors are able to “completely suppress” HIV with these drugs, with far fewer side effects than in earlier years.

Treatment can also now be tailored to specific patients due to advances in HIV viral load testing and genotyping, he said.

“We have patients who have had the infection now for probably 15 or 20 years,” Sandre said. “Some patients have pulled through, and are now on effective therapy. Patients now that are getting infected have a lot of hope for treatment.”
Sandre said he hopes a vaccine against HIV will be developed in the next several years.

David McNeil, the hospital's vice-president of clinical programs and chief nursing officer, said in a press release he's proud of what the HAVEN program has accomplished.

“Every day, the treatment team at HAVEN exemplifies compassionate care, especially for people facing significant health and social challenges.”
In the meantime, there are “ongoing challenges” regarding HIV in northeastern Ontario. Most people who are infected these days are intravenous drug users, Sandre said.

These patients are harder to treat because, on top of their addictions issues, many are homeless, have mental health problems, and are facing other health issues such as Heptatitis C infection, he said. These patients often end up missing appointments, which can be dangerous to their health.

HAVEN social worker Linda Mansfield-Smith said it's her job to provide emotional support and counselling to everyone who walks in the clinic's door.

Providing care to intravenous drug users is especially challenging, she said.

“There are outreach workers on the street, and they carry our message about care and treatment to patients who live on the street,” Mansfield-Smith, who has been working with the HAVEN program since the beginning, said.

“I remember when we didn't have anybody on the street reaching out to patients. That was a huge gap.”

While the societal stigma against HIV has lessened over the years, it's still not gone, she said.

This, in itself, can be a barrier to receiving care, because patients are worried someone they know will see them going to an HIV clinic, Mansfield-Smith said.

She said she feels “privileged” that so many patients have trusted the HAVEN program enough to walk through the doors and share their stories with staff.

Sandre said the program just received telemedicine capability so patients in northern communities won't have to travel to Greater Sudbury for their appointments.

He's not sure many patients will actually use the technology, though, given the stigma linked to HIV.

“Some patients who are HIV-infected who live way up north may not want to go to their small telemedecine clinic in their community,” Sandre said. “They actually prefer to come to a larger centre, because it gives them anonymity.”

For more information about the HAVEN program, visit www.hsnsudbury.ca or phone 705-523-7059.

Services provided by HAVEN
-HIV medical care
-Nursing care
-Emotional support and counselling
-Advice about HIV drugs
-Nutrition counselling
-Information about HIV
-Special lab testing
-Research studies
-Consultation with other health providers

Posted by Arron Pickard