The Seek and Treat for Optimal Prevention of HIV/AIDS (STOP HIV/AIDS) program, conceptualized by the BC Centre for Excellence in HIV/AIDS (BC-CfE), aims to expand access to HIV testing, care and treatment for all BC residents. In particular, the STOP program seeks to engage vulnerable populations experiencing difficulties in accessing traditional services. From the perspective of outreach staff working “out in the field”-meaning in cities and regions across the province- what challenges are they meeting and overcoming on a regular basis?
The BC-CfE spoke with outreach nurses, counsellors, social workers and outreach workers who are part of the STOP Outreach Team at Vancouver Coastal Health (VCH). We got their perspective on what success looks like when addressing the complex issues of the social determinants of health, such as access to housing, employment and other support services.
The staff recognize that progress, especially when intertwined with systemic inequities or obstacles, is not quick work. But there are victories that lead to encouragement and can boost self-esteem or wellbeing among their clients. “Some success creates more success,” says Lynden Neudorf, a Counsellor with the VCH STOP Outreach Team.“When people come in to see me they are able to say ‘This is what I want to work on’. [We are able] to take some things that have been stigmatized and to actually celebrate those things in their life – and to make them strengths.”
Members of STOP outreach teams across the province serve vulnerable populations, many of whom have suffered trauma and lack trust in traditional health care systems. Getting to know a client, understanding their concerns and moving them into cascades of care (from testing to treatment to sustained treatment) can take time-even if it’s just getting to the first step. Still, major gains can be achieved. “It’s also how you measure success. Sometimes it takes six months to get blood work,” says Lauren Taylor, a Registered Nurse with the VCH STOP Team. “We have people who are homeless but are still able to stay [on] HIV treatment, through community support.”
The team has also noticed the needs of their clients are shifting. With the overdose crisis overtaking Vancouver (as well as BC and regions across North America), they are seeing gaps in services. “The attitude among our group is we want to become advocates to help to effect change because we see the needs. There is no quick answer and we are all working as fast as we can,” added Taylor.
Finally, a key component to the team’s success, from their point of view, is the support they offer to each other in confronting challenging problems. “One of the biggest things is the team’s collaboration. You can try [to confront a challenging situation] on your own, but if you bring it back to the team you can talk about how to get a client more involved,” said George Schwab, an Outreach Worker with the VCH STOP Team.
As we look to curb the spread of HIV and reach an AIDS-free generation through the implementationof Treatment as Prevention¨, it is essential to ensure the most hard-to-reach populations are being connected to care. Outreach teams across the province are working towards advancing the goals of the STOP HIV/AIDS¨ program. This is essential to getting to zero new AIDS infections, which has now adopted as United Nations Sustainable Development Goal to be reached by the year 2030 based on the UNAIDS 90-90-90 Target.
Stay tuned to the blog. We will be share quotes and perspectives from outreach teams across the province to highlight their important work.
What is Treatment as Prevention? Watch this video to learn more.