This year the theme for World AIDS Day is Communities Make the Difference. It is an important theme that recognizes the value of community and that much happens when people come together. Communities have come together to provide care, to tackle stigma and to create spaces where people are recognized and remembered. Some of these communities are being led by people living with HIV; other communities are being led by nurses in an effort to provide care, challenge discrimination and ensure human rights are being upheld.
There are many examples that show what can happen when communities come together. Here is one example, which is inspiring, shared by Jeff Rheinhart, the current treasurer of CANAC:
In July of 2018, I attended a planning meeting around gay men’s health in Toronto, hosted by the Ontario HIV Treatment Network (OHTN). While there, I found myself in a small breakout session with other healthcare providers, community workers and people living with HIV to discuss healthcare access for people with HIV who do not have immigration status or health insurance in Canada. There was a willingness in the room to respond to the needs of people who live in Canada ‘undocumented and uninsured’. One year later, in August 2019, we opened the Blue Door Clinic.
The Blue Door, at its heart, represents a combination and culmination of all of the important lessons we’ve learned about HIV care since the 80s. As a clinic specializing in HIV treatment and care for people who are precariously insured or who lack access to care due to immigration status or insurance status in Toronto, the clinic aims to make a dent in the remaining 10-10-10 of the cascade. Many in the HIV movement consider this part of the cascade where priority efforts are needed to curb the epidemic. But aside from those high level policy foci, I started to think more about the Clinic’s operation and its relationship to some of the ideals of HIV nursing.
We often think about GIPA and MIPA (greater and meaningful involvement of people with HIV/AIDS), but sometimes have a hard time translating that into practice. For Blue Door, part of GIPA/MIPA had to be listening to people with HIV for years, some of whom reported to us that, despite efforts to meet their needs, their immigration status still made it hard to access care; listening and holding that in our minds, waiting for the stars to align, like they did that day in July 2018, to make a move towards making a change. As nurses, we hear about the challenges of our clients, respond to what we can within the systemic limits around us and foster patience in ourselves to be able to change the system when opportunities arise.
From the beginning of the movement, community collaborating was a cornerstone of the HIV response. And so community and ASO partners are cornerstone to the Blue Door’s success, helping to identify people who could use the service and support them as they navigate through the medical pieces of HIV care. Clinically, we know that interdisciplinary care improves outcomes for clients. The Blue Door works with doctors, nurses, social workers, case managers, coordinators, peer workers, reception staff and managers to respond to client needs. This holistic care would not be possible without the combined partnership of ten different health and social service agencies.
All of this comes together for just 6 hours each month of clinic time. A tiny grain of sand in the hourglass that makes up all the time spend to address HIV and its impact. But a grain of sand that is impactful, meaningful and collaborative and one that I am proud to share with you on World AIDS day.
We hope you will find time this week to join your local communities in an efforts to address pressing issues in HIV care, treatment and prevention, and to draw attention to the importance of protecting the human rights of people living with HIV.