ACCESS PLACE P. A. Update 101 – 15 TH Street East Prince Albert, SK January 31, 2012
Services: Sexual Health Clinic Straight to the Point Harm Reduction Program (Needle Exchange) Housing Project 601 North – Drop in Centre
Positive Care Program – Hepatitis C support, care and treatment – HIV support, care and treatment – Case Management Community education and outreach
Positive Care Program Team: Dr. K. Williams Dr. S. Skinner Dr. K. Stewart Dr. L. Lanoie Dr. V. Parekh Dr. J. Mwana Dr. M. Markentin
Marlene Allen- Nurse Manager Chasity Vermette – HIV Outreach Nurse Shelley Crawford – Hep. C Nurse Clinician Barb Bowditch – Case Manager Kathy Hunker- Nurse Practitioner Jacqueline Natomagen – Medical Office Assistant Karen Bear – Housing Coordinator
Our Partners in HIV and Hep. C Care: Cooperative Health Center Lab Methadone Assisted Recovery Program Nursing Staff at Prince Albert Correctional Centers
Big River First Nation Ahtahkakoop First Nation Numerous other First Nations Communities P. A. Metis Women – Donna Lerat
What is Happening:
2011 New HIV Cases – Prince Albert Parkland Health Region Note: New HIV statistics are taken from the actual positive lab reports and reporting forms. Data Compiled by Positive Care Program Charts.
55 New Cases – January 1 – December 31, 2011
Mean age of new clients, by gender (n=55)
Ethnic Origin– New Cases
43.6% of New HIV Cases have accessed the Positive Care Program
New Cases on Treatment
Total Number Of HIV Clients (includes new cases) 265 Client Charts 63 % (148)Active Clients -Regular Contact
73.0 % of Active Clients are Hep. C Positive
Initial CD 4 Counts
Overall Picture Male and Female
On prophylaxis: 6.1% On Treatment – 58.2 % On treatment obtaining an un-detectable viral load -23.3%
A tool we use to monitor HIV Blood-work : Normal Range & TX Started Kaletre Combivir TX Changed Atripla Test Units Dec.18,08Aug 28,10Aug.30 10Sept13,10Nov 8,10Feb. 2, 11June 9,11Oct. 5,11 CD WARNINGDANGERURGENTDANGER WARNING CD 4 % Viral Load 67,206 63, <4000
In 2011 there were: 5 Deaths 6 pregnancies– all on treatment
What we see:
Adherence Know thy patient
Our study Retrospective chart review, 200 random patients Goal: describe population of methadone clients by examining medical charts for demographic and social characteristics at time of admission
Aboriginal status (n=169) Total = 88.2 % Aboriginal
Less than grade 12 education: 76.3 % Methadone vs % Aboriginal vs % general pop
Deaths: Observed/Expected
6.8% 21.2% 25.8% 15.5% Woody et al, J Addict Med 2007
Psychiatric Comorbidity PTSD Depression, Anxiety Bipolar Disease ADHD Alcohol Related Neurodevelopmental Disorder (ARND)