Brett Dow and Greg Riehl presented information on HIV in Saskatchewan, at the 4th Western Canada CANAC Nursing Symposium focusing on nursing, aboriginal populations, cultures, current trends, and where the epidemic is going. Things are looking better as Saskatchewan's Strategy is being implemented and supported throughout the province.
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Are you Skexperienced?
1. Are you SKexperienced?
4th CANAC Western Canadian HIV Nursing Symposium
March 15, 2013
Brett Dow MN – Manager Access Place and Outreach Services
Prince Albert Parkland Health Region
Greg Riehl RN MA – Aboriginal Nursing Student Advisor
Saskatchewan Institute of Applied Science and Technology (SIAST)
2. Outline
• Current Scenario –
– What is happening in SK
• Role of Nurse
• Role of our clients
• Discussion
• From your piers to our
peers, what a great way
to collaborate!
4. “One of the things that is destroying
people with AIDS is the stigma which
we attach to it. When a person
realizes that they’re suffering from a
disease which is shunned by friends,
by parents, they feel ‘I’m a castaway’.
Then they lose the determination to
fight. One thing we must avoid is
allowing people to lose hope for the
future.”
The HIV/AIDS epidemic has become yet another disease Aboriginal peoples contract at accelerated
rates, and at younger age, than in non-Aboriginal populations. Many of the social determinants that
contribute to risk of HIV infection for Aboriginal peoples are associated with disempowerment,
poverty, forms of abuse, lack of education, and discrimination. Aboriginal women are infected at a rate
far higher than in non-Aboriginal populations. In turn, their unborn children are at higher risk of
infection. Prevention, education, open discussion, and acceptance of infected or affected persons in
Aboriginal communities, are urgently needed.
Healing Our Spirit BC Aboriginal HIV/AIDS Society Statement on HIV/AIDS
7. What’s Missing?
Above: HIV and AIDS in Saskatchewan 2010, SK Ministry
of Health, Nov 30, 2011
Right: HIV and AIDS in Saskatchewan 2011, SK Ministry
of Health, Nov 30, 2012
12. Culture
• Harm Reduction is new to First Nations.
• HIV is still pretty taboo in a lot of communities.
– BCR??? What the? Are you serious?
• Leaders hold the power to help.
• The problematic use of drugs is not the
“problem”, it is a symptom of much broader
social problems that face First Nations, Inuit
and Métis in Canada
14. SK HIV Strategy 2010-14 Goals:
Reduce the number of new HIV Infections
Improve quality of life for HIV infected individuals and
Reduce risk factors for acquisition of HIV infection
Community Engagement Harm Reduction Clinical Management Surveillance
and Education and Prevention and Research
http://www.health.gov.sk.ca/hiv-strategy-2010-2014
15. SK HIV Strategy 2010-14 Successes:
We are currently looking at our success, that is the plan
BUT, we need to focus on lived experiences, not just the numbers
Community Engagement Harm Reduction Clinical Management Surveillance
and Education and Prevention and Research
http://www.health.gov.sk.ca/hiv-strategy-2010-2014
18. FIXED!
What?
• Improved access to
mental health and How & Why?
addictions services
• Multi-sectoral
• Improved access to
• Multijurisdictional
clinical services
• Community and
• Improved access to harm
leadership support
reduction
• Client centred
• Holistic (physical,
emotional, mental,
spiritual)
19.
20. Above: The HIV/AIDS Medicine Wheel
By Albert McLeod
http://www.catie.ca/en/positiveside/springsummer-
2004/wheel-turns
Right: The Seven Sacred Teachings
http://www.thesharingcircle.com/sacred_teachings.html
22. Contact information
Greg Riehl RN BScN MA
Brett Dow RN BScN MN
Manager of Access Place and Outreach Services Aboriginal Nursing Student Advisor
Prince Albert Parkland Health Region Aboriginal Nursing Student Achievement Program
Access Place Saskatchewan Institute of Applied Science and
101 - 15th St E Technology (SIAST)
Prince Albert, SK, S6V 1G1 Room 150.1 Wascana Campus
Phone: 306-765-6542
4500 Wascana Parkway, PO Box 556
Cell: 306-960-3201 (25D5F531)
Fax: 306-765-6543 Regina SK S4P 3A3
Email: bdow@paphr.sk.ca Phone: 306.775.7383
Cell: 306.550.8176
Email: greg.riehl@siast.sk.ca
You can find our Professional Practice
Group here, please like us -
https://www.facebook.com/pages/SK-HIV-
Hep-C-Nursing-Education-
Organization/259234590779534
Editor's Notes
It pushes all the news buttons: it is a health emergency, it has a human face, it has elements of science, medicine, religion, it has deep grief and moments of extreme joy.It often has enemies: governments, the church, religious bodies, the fraudsters and snake-oil salesmen.It has heroes: the people living with HIV, community groups and NGOs fighting on the frontline of the epidemic, the scientists and researchers working for new treatments, a vaccine, a cure, and the doctors and nurses caring for the sick and dying.It is clear that HIV and AIDS is more than a disease that infects individuals.It is a social, economic and, in some countries, security crisis.
- Biggest obstacle is still fear/stigma/discrimination – no matter what the approach/initiative (expand briefly relating to FN communities)
Current state in SKProvides knowledge, insight, understanding etcWhat else can it do? re separating data on aboriginal specific...Note 2010 to 2011 for next slide Can an event or condition ever be said to have a single cause? So, when HIV prevalence is reported for Aboriginals in Saskatchewan, what does this mean?In most cases, HIV prevalence cannot be accurately determined from reported cases because many infections are undiagnosed or unreported. The best estimates are mainly based on the results of surveys of large groups of people.
-comment on why stats changed-how does this affect challenges previously referred to?
SK will most likely never have a safer injection site/ ~2000 people are using injectable drugs in RQHR, about the same in Saskatoon RQHR provides ~2 million needle/year, SHR less Injected drugs of choice in RQHR: cocaine, morphine, dilaudid, oxycontinRQHR distributes and collects more needles that SHR and has lower HIV and HCV rates!People from SK like BC, we like to visit, we like to move to BC, but like Newfoundland, we like to come home…The success of the strategy will mean that, over the next couple of years, we will see increased HIV rates due to increased testing and tracing. It is expected that the HIV rates will decline in years three or four as the intervention/prevention initiatives start showing effectiveness. Letter to Mark Lemstra Greg and Scott
Role of SK Nurses in the SK HIV/HCV Nursing Education OrganizationThe mission for the Saskatchewan HIV/HCV Nursing Education Organization is achieved through:Providing accessible and affordable education and learning opportunitiesCreating a network of members by which support and mentorship can occurServing as a provincial voice for issues related to HIV and Hepatitis nursing careAdvocating for the rights and dignity of people who are living with HIV/AIDS and/or HCV, or who are vulnerable to these infectionsSupporting a collaborative professional practice environmentPromoting professional growthImproving patient/client/resident outcomes
Saskatchewan has seen a significant increase in new cases of HIV since 2003 and currently has the highest rates in Canada at twice the national average. (20.8 vs 9.3/100,000) The epidemiology of HIV in Saskatchewan is different than the rest of Canada, with new HIV cases associated predominantly with injection drug use (75%) with First Nations and Métis women under age 30 accounting for a disproportionate number of those cases. What is the government doing to prevent the spread of HIV? Why is it up to the government?What is it/we doing to help those already infected?Does it have a program to provide antiretroviral treatments and drugs for opportunistic infections for people with HIV?Does it involve people with HIV, along with scientists, researchers, doctors, nurses and community groups in the development of its HIV Strategy? Does it even have a strategy? Is the Strategy an actual Strategy?How much money does it devote to HIV? What about sexually transmitted infections, which are often a precursor to HIV? What about NEP?Does it promote the use of condoms and encourage safer sex campaigns that accurately reflect the reality of people’s sexual lives?
-brief development description-all SK implementing, etc
We need to include stories and the voices of those providing care and those clients, individuals, families, groups and communities who receive care.
http://theprospectorsite.com/blog/?p=2753http://www.forbes.com/sites/afontevecchia/2011/11/15/is-gld-really-as-good-as-gold/ http://bizmology.hoovers.com/2012/02/22/anglo-american-reviewing-platinum-business-despite-record-2011/stacks-of-platinum-bars/ Silver – what you do not want done to yourself, do not do to others Confucius or One should not treat others in ways that one would not like to be treatedGold – do unto others as you would have them do unto you. Platinum – do unto others as they want done unto them, basically treat other people how they want to be treated. This is really what we are trying to do with all people working in the HIV Strategy.
-refer to need to look at all types of different approaches – including those outside healthcare-show video
3 examples of identify the problem/issue – and fix itNot quite that simplisticRefer to themes of 7 teachings when discussing the how & why (love, trust, humility, courage, respect, wisdom, honesty)
https://www.facebook.com/injectingadvice
-go figure....-so when I’m asked questions by people about how to achieve success in FN communities my reply is “ask them – they are the experts...”