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New research study aims to make sexual health testing more accessible by University of Alberta

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A new research study will allow people to access free, quick and confidential testing for HIV, hepatitis C and syphilis in participating community pharmacies.

The study — Adaptation of Point of Care Testing for Pharmacies to Reduce risk and Optimize Access to Care in HIV, HCV and syphilis (APPROACH) 2.0 — has launched in Alberta, following launches in Newfoundland and Labrador and Nova Scotia last December.

APPROACH 2.0 seeks to fill a need in sexual health-care services. The number of people with sexually transmitted blood-borne infections is on the rise. However, many simply don’t know they have these infections, which prevents them from getting effective treatment, explains Christine Hughes, interim dean of the Faculty of Pharmacy and Pharmaceutical Sciences and the Alberta lead for APPROACH 2.0.

“If you’re diagnosed early and get on treatment for HIV, for example, your overall trajectory in terms of your own personal health is much better. And, in the case of hepatitis C and syphilis, we have curative treatments which are available,” says Hughes.

Along with improving personal health, better access to testing could also benefit public health, Hughes notes.

“If you don’t know your status, you can’t take measures to reduce your risk of transmission. That’s critical because there’s data showing that a high proportion of HIV transmissions occur from people who don’t know that they have the infection,” she says.

Breaking down barriers

Making sexual health testing services more accessible is challenging because of numerous barriers that exist. Some are physical barriers, such as lack of access to a primary care provider, clinic or testing site, especially in rural or remote communities. Other barriers such as stigma and previous discriminatory or negative experiences in health-care settings may also dissuade people from getting tested.

“When we think of people who are less likely to access our usual health-care systems, they’re often groups that have experienced stigma or have other challenges that are well documented,” says Hughes. “We need to look at reaching people in a safe, inclusive way, but also being able to offer alternative options.”

For many who have avoided sexual health testing because of these barriers, pharmacies can provide a more appealing alternative, says Dylan Moulton, a clinical pharmacist and pharmacy manager at Medi-Drugs Millcreek, one of the pharmacies participating in the study.

“Pharmacists are absolutely removing barriers to health-care access, especially for equity-seeking groups who don’t always feel comfortable accessing traditional health-care spaces that don’t feel safe to them,” Moulton says.

By providing testing for syphilis, hepatitis C and HIV through this study, researchers are trying to determine how efficiently and effectively they can reach people and fill that gap in care at the community pharmacy level.

“Sexual health is a private matter for a lot of people,” says Moulton. “Pharmacists are often seen as trustworthy health-care professionals that people feel comfortable sharing their concerns with.”

Moulton and fellow Medi-Drugs Millcreek pharmacist Jyoti Palak are offering their services as part of the study, and recently completed the required training that all study participants must undertake.

An inclusive, sensitive approach

In addition to completing virtual modules about the specific infections the study is screening for and the point-of-care testing methods being used, participating pharmacists receive stigma awareness training “to ensure we’re providing this care inclusively and in a trauma-informed way,” says Moulton.

They also have in-person training in which they cover additional topics, such as how to navigate potentially sensitive conversations with patients and how to take next steps when a patient tests positive for an infection. In these cases, the pharmacists will order further testing to confirm the results and directly connect the individuals with a health-care professional who can assist them in navigatingthe next stage in their care.

Participating pharmacies are offering two types of point-of-care tests to people who wish to be screened — a rapid fingerstick test or a dried blood spot test. Both tests require just a few drops of blood, obtained from a finger prick, and can be conducted in a private room at the pharmacy.

The point-of-care tests also effectively address another barrier many people may face — needle phobia.

“There are a lot of people who don’t get blood tests done because they’re terrified to get their blood taken,” says Moulton. “They’re often afraid to get an intravenous blood draw, but not necessarily afraid to get a finger poke, as it is quick and relatively painless.”

The rapid fingerstick test can screen for either HIV or hepatitis C and provides results within minutes. The dried blood spot test takes about two to four weeks to obtain results but can screen for all three infections at once.

APPROACH 2.0 follows in the footsteps of the APPROACH pilot study, in which 123 rapid point-of-care tests for HIV were performed over six months in Newfoundland and Labrador and Alberta.

“[The pilot study] was really well received from clients being tested. People were really positive about the information they received from the pharmacists, and the convenience,” says Hughes. However, many clients were seeking testing for additional infections beyond HIV, which is one of the main reasons the latest study expanded the options available for testing to include hepatitis C and syphilis, she explains.

APPROACH 2.0 will run for one year, with 17 pharmacists in eight pharmacies in Alberta participating.

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Canada to donate up to 200,000 vaccine doses to combat mpox outbreaks in Africa

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The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.

It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.

Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”

Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.

Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.

A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.

On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.

Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”

But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”

“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.

Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.

Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.

Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.

“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.

“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”

This report by The Canadian Press was first published Sept. 13, 2024.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

The Canadian Press. All rights reserved.

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How many Nova Scotians are on the doctor wait-list? Number hit 160,000 in June

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HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.

The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.

Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.

“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”

The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.

A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.

Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.

“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.

Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.

The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.

“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.

This report by The Canadian Press was first published Sept. 11, 2024.

The Canadian Press. All rights reserved.

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Newfoundland and Labrador monitoring rise in whooping cough cases: medical officer

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ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.

Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.

Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.

Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.

The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.

“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.

Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.

Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.

Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.

A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.

This report by The Canadian Press was first published Sept. 10, 2024.

The Canadian Press. All rights reserved.

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