Kitchener has changed the way it's helping people treat and prevent HIV — here's how

For years after Greg Mann moved from Hamilton to Kitchener, he still had to make a time-consuming, twice-monthly commute between the two cities.

Mann, who is HIV positive, spent more than four years with one standing appointment a month with his family doctor in Hamilton, and another with an HIV clinic at McMaster University. Once he did find a clinic in Waterloo, he said it remained difficult to get an appointment with a doctor.

"[It was] a huge strain on myself," said Mann, who is the coordinator of support services at the AIDS Committee of Cambridge, Kitchener, Waterloo and Area (ACCKWA).

Today, getting in to see a healthcare provider is a matter of seconds, not hours for Mann — ever since ACCKWA started hosting Thursday morning clinics with a nurse practitioner in December 2018.

"All I have to do is go across the hallway to my doctor's office, which for me is very handy," he said.

New push to offer 'one-stop shop'

Most people who visit ACCKWA's clinics probably won't have quite as fast a commute as Mann, but executive director Ruth Cameron says convenience is a driving factor behind the organization's recent push to offer multiple in-house healthcare services.

In addition to the primary healthcare clinic, ACCKWA started hosting a twice-monthly pre-exposure prophylaxis clinic in April, which distributes a medication that can prevent HIV infection.

Most recently, the organization opened another twice-monthly clinic with an infectious disease specialist in June.

"People are really pleased to find out that we can access all of these different healthcare options at one location that's relatively convenient for them," said Cameron, who said about 75 per cent of ACCKWA service users with HIV live in Kitchener.

Mann likened the model to that of a department store, with "everything you need under one roof." He also pointed to ACCKWA's non-healthcare related services, which range from peer counselling and language translation to grocery cards and bus tickets. 

Care gap in Waterloo area

Making it easy for people living with HIV to see a healthcare provider is a pressing need, according to Cameron. 

Today, she said people living with HIV can get to a point of viral suppression by taking antirretroviral medication. That means they aren't at risk of passing HIV on to other people, and can have a normal life expectancy, she said.

But past data shows that not everyone who could achieve viral suppression in the Waterloo area has been able to do so, Cameron said.

In 2014, data from the Ontario HIV Epidemiology Surveillance Initiative (OHESI) showed that of all the Local Health Integration Networks in the province, the Waterloo-Wellington LHIN had the greatest gap between those who were getting care for HIV and those who had actually gotten to that point of viral suppression.

"What we assume is happening is that there aren't enough supports in terms of maintaining adherence to medications and remaining in care," said Cameron, adding that she thinks ACCKWA's new healthcare services will help. 

"This design, where we've brought together a number of supports ... is considered the ideal to help people stay engaged in care."

As of the end of 2015, there were an estimated 15,917 people with diagnosed HIV living in the province, according to OHESI.

Stigma still a barrier

Diana Campbell, senior lead for AIDS service organization (ASO) and community initiatives with the Ontario HIV Treatment Network, said making healthcare more accessible and reducing travel time is a goal shared at the provincial level.

She added having clinics in a place like ACCKWA also means that people aren't discouraged from going to the doctor because of stigma.

"While we've made significant leaps and bounds in HIV research and treatment, unfortunately we haven't made the same leaps and bounds in reducing stigma," she said. 

"A lot of people don't even feel comfortable talking to their family doctor. When you go to a place where you know ... people are not going to judge you in any way it's just a safe place to access the help you need."

Going forward, Mann said he wants to get the word out about the clinics to "key populations" in the Kitchener-Waterloo area — including those who are newcomers.

"I'm really looking forward to what's going to happen with this one-stop shop," he said.