Expanding the lens of HIV services provision in Canada: results of a national survey of HIV health professionals

Abstract

Those living with HIV may experience a range of disabilities, including body impairments, activity limitations, and social participation restrictions. The aim of this study was to examine HIV services provision in Canada by exploring practices, referrals, and service delivery challenges from the perspective of HIV health professionals (including nurses, physicians, social workers, pharmacists, psychologists, and dieticians), and to explore differences in referrals and perceived service delivery challenges by professional group, jurisdiction, community size, and practice in a Northern region. We conducted a nationwide mail survey with the population of selected HIV health professionals in Canada using the Dillman tailored design survey method. Of the 731 deliverable mailings, we received 462 (63%) responses, with 36% of eligible respondents completing the survey (n=214). The large majority (90%) of HIV professionals were located in metropolitan or urban communities and worked predominantly in hospital in-patient (42%), out-patient (50%), and HIV specialty clinic (46%) settings in one of the three provinces (Ontario, Quebec, and British Columbia) with the highest HIV prevalence. HIV health professionals referred primarily, and at relatively high levels, to AIDS service organizations (79%) and social workers (84%) to address participation restrictions and social issues; a lower percentage referred to rehabilitation professionals and other service providers to address impairments, activity limitations, or participation restrictions. Of respondents, 74% perceived barriers to care specific to HIV. Our results suggest that there is little difference in referral patterns by profession, jurisdiction, community size, or northern region of practice. There is a need for increased information and education of HIV health professionals that may refer to rehabilitation and other health services. In addition, new approaches are needed to coordinate multisectoral care and enhance the access and delivery of HIV rehabilitation health services to better meet the disablement needs of people living with HIV in Canada.

A systematic review of HIV testing among Canadian populations

“…This finding is to be expected since these provinces also have the highest reported HIV prevalence in Canada. 50 Residents in rural communities have to overcome barriers such as a real or perceived lack of confidentiality, travel distances to sites, and inadequate services. 51 More research is needed into HIV testing in rural areas.…”

The need for a Rehabilitation Model to address the disparities of public healthcare for people living with HIV in South Africa

“…The rehabilitation framework took route in the ICF which propagates rehabilitation as a ‘dynamic process, including all prevention and/or treatment activities and/or services that address body impairments, activity limitations and participation restrictions for an individual’ (Worthington et al 2005). Worthington et al (2009) explored and developed the rehabilitation needs of people with HIV living in Canada through a national survey of health professionals as providing tools and support to do what is meaningful to them. These tools extend beyond health care and include vocational and fiscal support in addressing the rehabilitation needs of people living with HIV (Worthington et al 2009).…”

“…Worthington et al (2009) explored and developed the rehabilitation needs of people with HIV living in Canada through a national survey of health professionals as providing tools and support to do what is meaningful to them. These tools extend beyond health care and include vocational and fiscal support in addressing the rehabilitation needs of people living with HIV (Worthington et al 2009). …”

'Experience talks, resilience shapes' revisiting historic trauma: impact on treatment in indigenous males living with HIV/AIDS in British Columbia

“…However, as Worthington et al (2009) noted, as service needs of patients become more complex, community-based organizations are being extensively used to address social issues such as income, housing and psychosocial issues. New approaches, that include social support, are therefore needed to coordinate care and enhance access for HIV/AIDS patients in Canada.…”

“…There has been support for the implementation of a model similar to the San Francisco and Vermont models here in Canada (Worthington, O'Brien, Myers, Nixon, & Cockerill, 2009). …”