ANKORS

In Canada, there are many health organizations and health researchers (such as Dr. Gustafson and Dr. Montaner) that are recommending that HIV testing become routine for all adults who have not been tested in the past year, for more regular HIV testing for at-risk individuals, for anyone who requests it, and as part of regular hospital admission screening.  As it stands, HIV testing is only available for high-risk people and pregnant women.

In the USA, the U.S. Preventative Services Task Force is proposing that HIV testing for people between the ages of 15 to 65 occur in doctor’s offices become routine testing.  This recommendation is supported by many leading health organizations such as the Centre for Disease Control and Prevention (CDC) and the American College of Physicians.

Currently, in both Canada and the USA, HIV testing is available for people deemed “high risk”.  However, that categorization leaves many HIV+ people in the dark about their diagnosis.  According to CATIE, researchers say that 20 to 25% of all HIV+ Americans do not know that they are infected with HIV and therefore are not protecting others from the spread of infection, nor are they catching the illness in its early stages when it is most responsive to treatment.  In  November 2012 CMA Journal, Dr. Julio Montaner, an HIV/AIDS researcher stated that 25% of all HIV+ Canadians do not know they are infected; 50% of HIV+ Canadians receive the diagnosis after substantial damage has already occurred to their immune system. HAART is most effective when treatment is started when the CD4 count is 500 or above  (CD4 count of an HIV- person is between 600 to 1200).  According to a 2012 UBC report on HIV testing, 60% of HIV+ people in BC are starting anti-retroviral therapy later than they could have started, due to a late diagnosis.

For more information:

http://hiv.ubccpd.ca/routine-hiv-testing-summary/

http://www.cbc.ca/news/health/story/2012/11/20/us-hiv-routine-testing-guidelines.html

http://www.catie.ca/en/catienews/2012-11-30/canadas-leading-medical-journal-calls-routine-hiv-testing

According to a (2013) study conducted in the USA, researchers have found that there is an increased risk for HIV-positive people to have an accelerated rate of liver damage upon co-infection by HCV.

In order to minimize risks for contracting HCV, harm reduction practices around sexual practices and substance use are imperative, along with regular testing for those people in high-risk groups.

Here at ANKORS, we offer HepC education and support in a confidential and safe environment.

Laura is the contact person at the office.

In order minimize the spread of HCV due to IV drug use, ANKORS offers a needle exchange program that is based out of the office, along with a mobile service.  Please see http://www.ankors.bc.ca/needle.php for contact information.  The Selkirk College Street Nurses are also able to provide mobile needle exchange, and harm-reduction kits on Mondays and Thursdays in Nelson.  Inhalation and IV drug harm reduction kits are available at ANKORS.

This is a fabulous resource for reducing the risk of infection/transmission of HCV

http://www.hepcinfo.ca/en/simple/staying-safe

For the link to the relevant January 18, 2013 CATIE News Bulletin:

http://www.catie.ca/en/catienews/2013-01-18/rapid-pace-liver-damage-recent-hcv-co-infection

Naloxone (or Narcan) has been proven to reduce the number of accidental overdoses amongst heroin/opiate users.  It is often called a short-acting “opiate overdose antidote”. However, many overdoses occur in locations that are not quickly accessible to front-line health workers.  Therefore, it makes sense for opiate users and individuals who support opiate users, to be trained to carry and administer Naloxone.

“In San Francisco, where naloxone distribution stared in the late 1990s, heroin overdose fatalities have decreased from a peak of 155 in 1995 to 10 in 2010, according to a SFDPH press release describing the study findings.” (Source: San Francisco Department of Public Health. Study Shows Naloxone Cost-Effective in Preventing Overdose Deaths. Press release. December 31, 2012).

ANKORS is currently accepting registrations for its second Naloxone Training and Overdose Prevention course.  We encourage all heroin/opiate users and their supporters, along with community health outreach workers to attend.

Please drop by the office and speak to Karen, or phone/email her at:
Karen Newmoon (Admin Coordinator)
(250)505-5506
information@ankors.bc.ca

BEYOND BEHAVIOURS: Uncovering the social production of HIV epidemics among gay men, is a one day conference that will address the health and social inequities that gay men with HIV experience in Canadian society. All people involved in gay men’s health are invited to attend.

Key questions that will be addressed are:

• How do we think of diseases as a socially-produced phenomenon?
• What is the relationship between social and health inequity?
• How do social actions and structures affect gay men’s sexuality?
• What are the implications for prevention and health promotion?

Location: Vancouver, BC
Date: April 15, 2013
Hosted by: Community Based Research Centre, in collaboration with Universities Without Walls

For more information see: www.cbrc.net

Sleep is vital to our health and well-being: It can help regulate hormones, reduce stress, manage our weight and improve immune function. A lack of sleep can impair our memory, affect our ability to focus, deprive us of energy and leave us more susceptible to infection. Over time, this can lead to depression and anxiety, which can make it even harder to sleep.

Adherence to a pill-taking schedule is crucial for successful HIV treatment, and poor sleep can make this challenging.

Many people living with HIV experience sleep problems. These can occur at any stage of HIV infection. Upwards of 75 percent of people report sleep issues on a regular basis. Some have difficulty falling asleep, some have trouble staying asleep (due to poor-quality sleep or frequent nightmares) and others wake up too early.

Causes of sleep problems:

• HIV itself – HIV-infected cells in the brain, which produce neurotoxins and chemical signals that may impair the sleep of some people
• Medications – such as efavirenz (Sustiva, also found in Atripla) used to treat HIV, interferon used to treat hepatitis C and other drugs prescribed for HIV-related illnesses
• Mental health issues – such as depression and anxiety
• Alcohol and drug use – heavy drinking or using drugs, especially stimulants such as cocaine, speed and ecstasy

Other causes of sleep problems can include changing hormone levels (for example, high or low levels of thyroid hormone, changes in estrogen levels during menopause and declining levels of free testosterone), calcium and/or vitamin B₁₂ deficiencies, and infections (including a cold or flu).

Strategies for promoting good sleep

• Try to set a strict bedtime and rise-time schedule
• 2 hours before bed time, start to dim bright lights, turn off computer monitors…
• Sleep in total darkness
• Cut back on caffeine (avoid caffeine after 10am & cut back on total quantity)
• Talk with physician about sleep problems & try to find a drug regime that works
• Avoid reliance on sleeping pills
• Eat a balanced diet

For the link to the relevant January 15, 2013 CATIE News Bulletin:

http://www.catie.ca/en/positiveside/winter-2013/sleep-tight

Due to the growing participation of HIV-positive individuals in observational databases in Canada, researchers are able to analyze trends and changes in the health of HIV-positive people over the long term. One of these databases, NA-ACCORD, is the largest of its type of joint Canadian/ American data.

An outstanding result from this database is that the number of HIV-positive individuals under regular doctor care (1 or more doctor visits per year), increased between the years 2000 and 2008. (In 2008, 19% of clients were not engaged in regular care. This is a change from 24% in the year 2000).

Not surprisingly, some risk factors for incomplete physician care were found to be:

• injection-street-drug use
• low income

Examples of barriers faced by drug users and people with low incomes may include the following:

• difficulty interacting with a complex medical-health system
• costs associated with clinic visits (such as transportation)
• fees associated with the cost of insurance for drugs
• fees associated with the dispensing of prescription medicines

Regular physician care helps to:

• reduce the number of life-threatening infections
• increase the likelihood of remaining on antiretroviral therapy (ART)
• improve the level of HIV awareness, and education about transmission

Recommendations:

Despite the increased number of HIV-positive individuals remaining in care, there is a need to add to current clinic resources- especially outreach and intensification of community-specific services. Collaboration with local aboriginal organizations is essential for service providers to maintain cultural safety while working with the aboriginal client. The inclusion of broad inter-sectoral relationships during HIV care, is recommended to decrease the barriers faced by many drug users and low income clients.

*However, the injection of funds into HIV programs in Canada is the essential piece to get more individuals into regular care for betterment of both their physical and psychological well-being.

For the link to the relevant January 03, 2013 CATIE News Bulletin:
http://www.catie.ca/en/catienews/2013-01-03/remaining-hiv-care-improvements-north-america-much-still-needs-be-done

ART/HAART (potent combination anti-HIV therapy) suppresses the production of HIV, which allows the immune system to begin to repair itself- though not 100%.  Although ART does reduce the risk of illness due to AIDS-related infections, research suggests that HIV-positive people continue to have an elevated risk for developing tuberculosis (TB) compared to healthy HIV-negative people.  However, once a person has initiated ART, the risk of developing TB gradually decreases.

It is suggested that in order to decrease the risk of developing disease caused by TB, HIV-positive people should:

• start therapy before their immune system is severely weakened, and
• get tested for latent TB (LTB).

(Note: A person who is infected by TB without any symptoms of active infection, has latent TB.  There is a risk of latent TB developing into active TB within a few years, especially in the already immunosuppressed).

For more information on TB and Latent TB:
http://www.catie.ca/en/catienews/2012-12-04/tuberculosis-hiv-background-information

For the link to the relevant December 13, 2012 CATIE News Bulletin:
http://www.catie.ca/en/catienews/2012-12-13/risk-tb-among-hiv-positive-people-high-income-countries

Urban

Hello Everyone!

As an organization that continues to strive to bring services to those in need, Ktunaxa Health and Wellness Centre is looking to bring together a core group of individuals who not only work with the marginalized of our community, but who also have the ability to affect outcomes and services through their influence within the community.  We are asking for your involvement in our Urban Governance Initiative…

You are invited to attend an initial gathering of people from the downtown area to discuss ways in which we can better meet the needs of our homeless or at risk of being homeless populations.  We are searching for feedback on what you think is going well in Cranbrook with regard to these issues and what is perhaps not going so well but also, ways in which we may be able to improve these services to ensure a happier, healthier community.  Please see the attached flyer for detailed information.

Sincerely,

Heidi Hebditch, BSW/CWS

Operation Street Angel

hhebditch@ktunaxa.org

(250) 420-2756

Anti HIV therapy commonly known as ART or HAART has drastically reduced aids related deaths and infections. With this amazing news, many HIV positive people are considering having babies. Today, in Canada, the risk of mother to child transmission is generally less than 1% if you have a safe and healthy pregnancy.

Here are some tips for a healthy baby and a healthy pregnancy.
• use ART during pregnancy so that viral load is as low as possible
• access prenatal counselling and care
• intravenous AZT (zidovudine, Retrovir) for the mother during delivery
• Caesarean section (when medically necessary)
• a short course of oral anti-HIV medicines for the baby after birth
• use formula rather than breastfeeding (HIV can be transmitted via breastfeeding)
• don’t pre-chew food for the baby when solids are introduced (this can also transmit HIV)

As a result of reduced vertical transmission, many HIV positive women and some men are thinking about having children and doctors have come up with a plan so HIV positive men and women can have a safe pregnancy with healthy children.
Doctors and a team of researchers across Canada have come up with a guide for safe pregnancies for people with HIV called the “Canadian HIV Pregnancy Planning Guidelines” to help health care providers help people with HIV to have children. They are trying to reduce risks such as:
• reduce transmission from mother to child
• reduce transmission from one person to another when people are trying to conceive
• improve the health of HIV-positive women and their children
• reduce the stigma linked to HIV infection
• increase access to pregnancy planning and fertility services

Want to get involved in your community?

Feel passionate about social justice and health issues?

Believe in individual and community wellness for all?

ANKORS (Kootenay/Boundary AIDS Network Outreach and Support Society) currently has opportunities for volunteers to get involved in a variety of ongoing or short-term projects, including serving on the Board of Directors, helping with the 18^th annual AIDS Walk for Life, and participating in the day-to-day activities of the organization.

For more information, call Karen at 250-505-5505 or 1-800-421-2437, email information@ankors.bc.ca or drop by 101 Baker Street, Nelson, Mon–Thurs 10 am–4 pm.