A Regina-based not-for-profit is hoping that a pair of initiatives will help reduce HIV rates across the province.
Wellness Wheel, a non-profit that works to improve access to care for chronic diseases, including HIV, outlined a pair of projects in a press release sent out Monday. The programs both aim to increase the number of people tested for HIV, Hepatitis C and other illnesses to stop the spread and help those who test positive to access treatment.
Saskatchewan has the highest rate of new HIV diagnoses in Canada. Data from 2016 showed the Prince Albert area having the highest incidence rate of new diagnoses, but in 2017, the area was surpassed by Saskatoon. Ensuring people get tested is one way to slow down the advance of the illness, which is easily treatable once detected.
“We know from statistics and modelling that anywhere between 20 and 25 per cent of people living with HIV in Canada and Saskatchewan are unaware of their status,” said Susanne Nicolay, clinic and project coordinator for Wellness Wheel.
“They have HIV but they don’t know. We also know that those folks are primarily responsible for transmission, so they’re spreading probably more than half of all the new infections.”
You can’t prevent the spread of the disease or get treatment yourself if you don’t know you have it. That’s why one of the main pushes from government agencies and non-profits in the province is on getting tested.
“If we really are serious about destigmatizing, levelling the playing field and creating a welcoming environment, we have to make efforts to make it critical for all people to get tested,” Nicolay said.
The pair of initiatives taken on by Wellness Wheel aims to help people from Regina, Saskatoon, Prince Albert and beyond get tested.
The first project is the development of the free ‘Get Tested’ guide.
The guide was created after months of consultations with communities. It provides materials to help successfully plan and hold local events to create awareness as well as access to testing for HIV. It also includes information about how to ensure anyone who does test positive is given the support and treatment information they need.
“It’s basically a plan or template for communities or providers who want to hold testing events,” Nicolay said.
“This could be used in context of HIV, but it could certainly be applied to hepatitis C, diabetes, pretty much anything where you wanted to do mass education and testing.”
The guide has been used in six communities to this point, including one in the Prince Albert area, she said.
“We’ve used it … with good success, had a lot of people come out. Of course, not everybody gets tested … but there are still opportunities for good conversation, discussion and education that at least opens the door.”
There has been interest in that program in the central and southern part of the province.
The other project Wellness Wheel is working on is currently isolated to Regina, but there has also been interest in that project from other parts of the province.
“The other initiative is our pharmacy testing project. This is unique, it’s the first of its kind in Saskatchewan,” Nicolay said.
Wellness Wheel has been working with a local Regina pharmacy for 18 months to offer HIV testing. For the project, the pharmacists were trained to offer an HIV point-of-care screening test. It uses a small finger stick to take a sample of blood and get a result within 60 to 90 seconds. Preliminary results from that test can show results that are non-reactive, reactive or indeterminate. Anyone with reactive or indeterminate results is referred to further testing for confirmation, as there is a small task of a false positive.
“It’s unique because it’s being done in the community. It’s unique because it’s pharmacists offering and actually doing the test,” Nicolay said.
“They are able to get the results immediately, and then we work together to link that individual to care if we do have unexpected results.”
While other pharmacies in Regina and Saskatoon are interested, a lot more work needs to be done before the HIV screening is available at other pharmacies across the province. Legislation needs to change, and there needs to be a discussion about pharmacists’ scope of practice as well as ethics.
Nicolay hopes though, that it can be done, which might help those in smaller communities get the screening they need.
“ think there are some smaller pharmacies and certainly some pharmacies that would be very interested to take this to their patient population,” she said.
“I’m thinking of even small communities where there isn’t a family physician in those communities but there might be a pharmacy. That might be an example of where this would be very helpful.”
Offering testing definitely isn’t for everyone. It can be onerous, Nicolay said, as it takes a bit of a time commitment and pulls pharmacists out of their work to support that patient at that moment. So far, though, results from that one Regina pharmacy have been positive.
“The pharmacists here are very keen. They really enjoy having access to the test and to talk to their patient population,” she said.
“If it happens to be the pharmacist … you see most regularly and you have a good relationship, then in my mind, that makes sense for the pharmacist to offer the test and to be involved in the care. They can certainly be that link to clinical care. The pharmacists here are well-linked with nurses, with the infectious diseases physician and specialist pharmacists. They’ve definitely done the groundwork to make really good connections.”
The projects are funded through a grant from ViiV Healthcare Canada, a company dedicated to developing HIV treatments.
The province has also recently introduced more funding to support HIV treatment in Saskatchewan. The 2018 budget included an additional $700,000 to ensure universal 100 per cent coverage of HIV drugs for Saskatchewan people, and to provide other HIV supports.
While any help is welcome, Nicolay thinks governments could do more.
“I would love for the provincial health authority and the Ministry of Health to be more involved and to dedicate more dollars. There are a lot of needs in the province. This is what I’m passionate about. So I think more dollars absolutely should be going towards HIV and hepatitis C,” she said.
“I don’t think though that that’s going to change anytime soon. So in light of that, I think other agencies, whether they’re for-profit or not-for-profit are quite able and should (help)if it fits with their mandate.”