All Things to All People

PAN’s Executive Director, Evin Jones, wrote an article that was published in Positive Living Magazine and we would like to share it with you.

All Things to All People
Regional AIDS service organizations are adapting to big needs and diverse populations

HIV/AIDS-related service delivery outside of the Lower Mainland is changing. With relatively fewer social services in general, changing trends in the HIV epidemic, and changing funding requirements, regional communities have had to do more with less. In some cases, the changes in direction have been dramatic.

The reality of hepatitis C is impacting organizations One of the most prominent trends is how regional health authorities are adopting a blood-borne pathogens or integrated approach when allocating funding. This means that many agencies outside of the Lower Mainland are expected to provide services for people living with hepatitis C (HCV).

James Boxshall, acting executive director at AIDS Vancouver Island (AVI), knows this well. “One of the biggest shifts conceptually and practically over the past ten years has been the integration of HCV into our work,” he says. “Where looking back we saw HIV as the main thrust of our work, now we see both HIV and HCV within a larger context and act within that the best that we can. This dovetails nicely with our long-standing work around harm reduction and prevention.”

Indeed, one of AVI’s greatest ongoing challenges is responding to the closure four years ago of the fixed-site needle exchange in Victoria. As a result, they’ve had to greatly step up mobile exchange efforts and secondary distribution.

At Positive Living North (PLN) in Prince George and Smithers, 40 percent of members are co-infected with HIV/HCV. HCV mono-infection is a huge issue particularly among street-involved people. Access to treatment has been greatly complicated by the closure of the viral hepatitis clinic.

At their most recent strategic planning, the staff and board of PLN asked themselves if the organization was ready to become an HIV and HCV (mono-infection) agency. For the time being, the answer is no. “We recognize the need is there,” says their executive director, Vanessa West, “but it’s very much a resourcing issue.”

At the same time, PLN does provide service to HCV monoinfected persons through their flagship prevention program, the Fire Pit Cultural Drop-in Centre. The Fire Pit works to address the needs of the urban Aboriginal population, the homeless, and/or street-involved population in the downtown core. Originally a small fledgling program that started in the basement of the Central Interior Native Health, the Fire Pit is now in its eighth year and thriving.

HCV inclusion is also consistent with the recognition of the impact of the social determinants of health on the HIV epidemic. “At AVI, it has always been understood that the contextual pieces that put people at risk need to be addressed. Housing, food security, and income security are essential issues to those who come to us for services, be they at-risk, infected with HIV, and/or HCV,” says Boxshall. “We need to address those related issues and we approach that by seeking active partnerships and collaborations with other organizations such as Cool Aid Housing Society and the community health clinic. The result is a holistic approach and organizationally, we’re increasingly confident with that.”

Many organizations are addressing HCV as part of their harm reduction and prevention work. Indeed, a province-wide survey of Pacific AIDS Network (PAN) members in 2011 revealed that 83 percent are addressing HIV/HCV co-infection and 72 percent are providing services pertaining to HCV mono-infection.

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