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ACCESS PLACE P. A. Update 101 – 15 TH Street East Prince Albert, SK January 31, 2012
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Services: Sexual Health Clinic Straight to the Point Harm Reduction Program (Needle Exchange) Housing Project 601 North – Drop in Centre
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Positive Care Program – Hepatitis C support, care and treatment – HIV support, care and treatment – Case Management Community education and outreach
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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
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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
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Our Partners in HIV and Hep. C Care: Cooperative Health Center Lab Methadone Assisted Recovery Program Nursing Staff at Prince Albert Correctional Centers
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Big River First Nation Ahtahkakoop First Nation Numerous other First Nations Communities P. A. Metis Women – Donna Lerat
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What is Happening:
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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.
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55 New Cases – January 1 – December 31, 2011
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Mean age of new clients, by gender (n=55)
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Ethnic Origin– New Cases
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43.6% of New HIV Cases have accessed the Positive Care Program
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New Cases on Treatment
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Total Number Of HIV Clients (includes new cases) 265 Client Charts 63 % (148)Active Clients -Regular Contact
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73.0 % of Active Clients are Hep. C Positive
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Initial CD 4 Counts
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Overall Picture Male and Female
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On prophylaxis: 6.1% On Treatment – 58.2 % On treatment obtaining an un-detectable viral load -23.3%
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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 4 428 624362146152210228 WARNINGDANGERURGENTDANGER WARNING CD 4 % 12.62.11.93.06.55.48.07.5 Viral Load 67,206 63,545 347<4000
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In 2011 there were: 5 Deaths 6 pregnancies– all on treatment
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What we see:
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Adherence Know thy patient
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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
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Aboriginal status (n=169) Total = 88.2 % Aboriginal
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Less than grade 12 education: 76.3 % Methadone vs. 44.0 % Aboriginal vs. 31.5 % general pop
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Deaths: Observed/Expected
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6.8% 21.2% 25.8% 15.5% Woody et al, J Addict Med 2007
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Psychiatric Comorbidity PTSD Depression, Anxiety Bipolar Disease ADHD Alcohol Related Neurodevelopmental Disorder (ARND)
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