CLINICAL COMPASSION

The Sexual Health Clinic Just Switched Locations And Already It Is Busy
Operating Under A New Name - Access Place

PRINCE ALBERT - It's a combination of services: the sexual health
clinic, the Straight to the Point needle exchange harm reduction
program and the hepatitis C/HIV program. The seven staff members who
run the place work together to provide services to hundreds of people
in Prince Albert monthly.

Access Place: The Sexual Health Clinic

The clinic is both stationary, at its new home underneath Addiction
Services at 101 15th Street East, and mobile. Shari Daughton, a nurse
in the clinic, makes frequent trips to the Bernice Sayese Centre, Won
Ska Cultural School, the Youth Activity Centre and the Indian and
MA(c)tis Friendship Centre.

In the clinic, anonymous HIV testing is available as well as testing
and treatment of other sexually transmitted infections. The staff also
refer individuals to physicians, addictions programs and other
agencies as required.

Outreach services include educational workshops, free condoms and
counselling for people infected with HIV or hepatitis C.

"You look at the problems that this person might be having ... then we
just help them go through all the routes," said Daughton.

In an effort to increase attendance at the Bernice Sayese Centre,
Daughton is running a draw for a Christmas basket during the month of
December.

Straight To The Point: Harm Reduction

When people hear the term "needle exchange" strong emotions often
follow - both positive and negative. Megan Belanger, who co-ordinates
the Straight to the Point needle exchange harm reduction strategy at
Access Place, is trying her best to ensure the response is positive.

"It's not that we are trying to enable drug users, that's not it at
all. And yes, we do think that addiction is a problem," she said.

"If somebody has HIV and they have an addiction, we are more worried
about their illness then we are the addiction. You can't help someone
with their addiction if they are a dead body.

"If we try to prevent the spread of (HIV) then we have live people
that we can work on their addictions with.

Belanger has worked with many of the estimated 500 people who use the
exchange monthly. She is proud that one of her clients began treatment
this week and another three went to addictions services for help.

"That's the best, when you can help somebody ... if I can help one
person get clean, then I've done my job," she said.

It's not always that good. Belanger has been yelled at and called
names - not by clients but by people who do not agree with the
exchange program.

"Sometimes I just want to throw a temper tantrum and scream and yet
. " she said.

Belanger has never done this because she realizes that opinions about
the program are founded in poor information, or an absence of it.

Medical health officer Dr. Leo Lanoie is less forgiving.

"You find people in the general public that are very knowledgeable and
then you find people that are incrediblly ignorant and make some
incredible ignorant statements," he said.

Lanoie argues that a needle exchange is a cost-saving and safety
measure. If an injection drug user shoots up incorrectly they can end
up with an abscess. If that abscess gets infected it needs to be
treated at the hospital at a cost of hundreds of dollars a day. If the
infection isn't caught in time, then the patient needs to be operated
on and the cost soars past the $1,000 per day mark.

A needle exchange has shown it can reduce HIV and hepatitis C
infection rates by removing an addicted person's need to share needles.

The exchange program in Prince Albert is a model example with a 98 per
cent syringe return rate - the highest in Saskatchewan. That would
also be due to Belanger strictly adhering to a "40 needles" rule. If
clients don't bring her any used needles they only get 40, which is
not many for an active user. There is a one-to-one exchange rate on
what gets brought back.

The harm reduction also serves as another door to access programs at
Access Place including HIV testing and counselling and STI testing and
treatment.

Programming: Hep C And HIV

The hepatitis C and HIV programs were established after it was
discovered that the hep C and HIV rates were increasing due to
intravenous drug use.

The treatment and counselling programs see 12 people per
day.

Hep C levels in Prince Albert and the surrounding area have always
been high. However, they have stabilized, according to Lanoie. HIV
rates, on the other hand, keep climbing.

"Up until about five or six years ago, you would see about 40 or 45
new cases a year and then about 2005 it started going up, now we are
seeing 180 new cases in the province," Lanoie said.

Along with treatment for both diseases the program staff try to help
connect clients with resources and give support.

"My job is to make clients feel comfortable and safe and let them know
if they have an issue they can come in," said Barb Bowditch, the
consultant HIV case manager.

"I think no matter where you go you run into stigma and discrimination
around HIV, so it's still there and it's still real."

Bowditch works with a 60-patient caseload ensuring they have support
mechanisms they need. She makes herself available to families and
friends of HIV infected persons in case they have questions and she
helps decode medical jargon for clients in hospitals.

On The Road

All the staff at Access Place spend a lot of time on the road -
they'll take clients to medical appointments or hospital or clinic.
They'll meet some clients outside Access Place to ensure
confidentiality.

Everyone who works at Access Place is willing to go their extra mile
for their clients, a particularly impressive fact considering the
controversy around some of their programs.

"They're people. They are just like another person and you treat them
like you want to be treated," said Daughton.You can't help someone
with their addiction if they are a dead body.

Uncertain Future

The province is currently conducting a review of needle exchanges
after concern was raised over discarded syringes. "The Minister (of
Health) wants to ensure that the needle exchanges are the best
practices for harm reduction," said Ministry of Health spokeswoman
Joan Petrie. "I'm hoping there'll be support and enhanced programming
and services .. I'm cautiously optimistic," said Barb Bowditch, the
HIV case manager at Access Place.