BACKGROUND

Seek and Treat for Optimal Prevention of HIV/AIDS (STOP HIV/AIDS), a program conceptualized by the BC Centre for Excellence in HIV/AIDS (BC-CfE), aims to expand access to HIV treatment, care and medications among hard-to-reach and vulnerable populations. The STOP Outreach Team involves collaboration between nurses, health care professionals, social workers and others in order to provide for the broad spectrum of needs of their clients living with HIV. In 2012, based on its success, the BC provincial government announced $19.9 million in funding for the provincial Health Authorities towards the program’s growth.

STOP Outreach Team members across the province work with vulnerable populations who have suffered trauma and lack trust in traditional health care systems. Many of their clients are simultaneously facing addiction and homelessness problems, while dealing with access to HIV treatment and care. STOP Outreach Nurses work with approximately 35-40 clients at a time.

The success stories from the STOP program show the resilience that exists within vulnerable communities, as well as the importance of holistic support systems to address a broad spectrum of health, social and economic needs.

This case study provides an example of a success story. A client, through the services provided by the STOP Outreach Team, was able to achieve stability and improved health. The client’s name has been changed for privacy concerns.

CASE STUDY

“Ross” met with the STOP Outreach Team in Vancouver while at a STOP Team HIV testing event in March 2012. At intake, the 40-year-old individual’s CD4 counts were alarmingly low at <10 and his viral load measured at over 200,000/mL. Ross struggled with severe opioid and methamphetamine IV addiction, required support with food security and housing, and faced multiple challenges to restarting his HIV antiretroviral medications (ART).

The program STOP Outreach Team in Vancouver, under Vancouver Coastal Health, supported Ross in getting into three different residences and placed in several shelters. However, he faced multiple evictions and incarcerations. He was connected to the John Ruedy Immunodeficiency Clinic (IDC) at St. Paul’s Hospital. There, he re-started methadone treatment and became engaged in his medical care. He also became a member of The Dr. Peter’s Centre Day Health Program for meals and additional nursing support.

During this time, the client struggled and was on and off methadone. He failed many attempts to restart HIV treatment. He required a significant amount of support to stay on methadone, as he would lose his dosing prescription on the way from the clinic to the pharmacy. He had multiple hospital admissions in relation to AIDS-related illnesses and often left the hospital against medical advice.

In addition to these physical health issues, he struggled with suicidal ideation and hopelessness. He required a great deal of support to accomplish day-to-day tasks as his life was very chaotic and he was often intoxicated.

A turning point finally came in 2015 when Ross became stabilized at a detox centre, after many failed attempts at detox over the years. He then restarted on ART and was transferred to a treatment centre. He eventually left the treatment centre after facing stigma and abuse due to his HIV status. The STOP staff supported and encouraged Ross to reintegrate into the centre. He returned and completed his treatment program before moving into a recovery house.

Ross eventually moved to independent sober housing and began attending appointments independently. His CD4 count increased to 150 and his viral load reached undetectable levels, making likelihood of transmission negligible.

At this time, Ross hopes to become a mentor to assist others in facing their addiction and in growing towards wellness.