加拿大慈善機構表示，醫療保健系統不具備治療老年愛滋病患者的能力
衛生部長Duclos表示：「消除障礙是關鍵」
資料來源：娜塔莎·奧尼爾 / CTVNews.ca 作家 / 2022 年 11 月 23 日 / CTV 新聞 / 財團法人台灣紅絲帶基金會編譯
衛生部長讓-伊夫·杜克洛 (Jean-Yves Duclos) 談加拿大對抗愛滋病/愛滋病毒流行病的下一步行動。
在魁北克舉行的世界上最大的愛滋病毒和愛滋病國際會議重點關注對原住民社區的影響。 圖里亞·伊茲里報道。
加拿大的愛滋病例數一直在上升，並且對原住民社區的影響尤為嚴重。
在加拿大，越來越多的老年人感染了人類免疫缺陷病毒 (HIV)。 但據一家總部位於多倫多的慈善機構稱，目前的醫療保健系統還沒有準備好照顧越來越多的愛滋病毒陽性的加拿大老齡化人口。
總部位於多倫多的 HIV/AIDS 倡導慈善機構 Realize 表示，加拿大各地的長期照護院和醫療保健機構不具備治療老年 HIV 患者的能力，他們更有可能患上慢性病。
Realize 的國家計畫經理 Kate Murzin 在周三接受 CTVNews.ca 的電話採訪時說：「他們往往更容易患上心血管疾病、糖尿病和其他慢性疾病，除了感染愛滋病毒之外，他們還必須控制這些疾病」。” 「他們現在正在經歷愛滋病毒和老齡化之間的重疊，這在他們的健康、身體健康以及其他社會因素方面造成了很多複雜性，例如，成年後的經濟保障」。
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HIV 是一種性傳播的血源性病原體。 世界衛生組織 (WHO) 稱 HIV 是一種攻擊人體免疫系統的感染，特別是白血球細胞。 如果病毒成功地破壞了這些細胞，一個人的免疫系統就會被削弱。 這使得其他嚴重感染得以發生，包括結核病、口腔癌、肺癌和肝癌以及真菌感染。
Murzin 說，HIV 感染者面臨更大的殘疾、行動不便和認知問題的風險。 Murzin 說，這些挑戰會影響他們的生活品質，如果沒有幫助或適當的照護，愛滋病毒感染者的身心健康可能會因此惡化。
在周三發送的一封電子郵件中，加拿大愛滋病協會執行主任肯米勒告訴 CTVNews.ca，與愛滋病毒打交道的人和他們接受的照護類型存在著「恐懼」。
「一般來說，醫務人員沒有接受過有關照顧愛滋病毒感染者的複雜性的適當培訓，支持人員通常接受的培訓更少」，米勒說。
1997 年，加拿大推出了針對 HIV 的抗反轉錄病毒療法 (ART)，使人們能夠與病毒一起生活。 2015 年發表的一項先前研究解釋說，接受 ART 的加拿大人的壽命攀升至 65 歲。 這意味著自 2000 年以來增加了 16 年。
Miller 說，隨著越來越多的 HIV 患者步入老年，照顧那些感染 HIV 的老年患者通常不是整個培訓的重點。
HIV 可以透過性活動或共用針頭或注射器傳播。 在晚期階段，HIV 可導致後天免疫缺陷症候群 (AIDS)，從而使免疫系統嚴重受損。 據聯合國愛滋病規劃署稱，自 1980 年代愛滋病毒/愛滋病被列為流行病以來，全世界已有數百萬人死於與愛滋病相關的疾病。
根據加拿大統計局的數據，2018 年估計有 62,050 人感染愛滋病毒。2020 年，新診斷病例為 1,639 例，比 2019 年報告的 2,122 例新病例減少了 21%。
由於 HIV 感染者的壽命延長，感染可以繼續傳播。 Murzin 說，在一個地方簡化 HIV 治療和老齡化將有助於限制 HIV 的傳播。
「現在，人們通常從他們的家庭醫生那裡獲得 HIV照護，或者最常見的是從傳染病專家那裡獲得治療」，她說。 「但傳染病專家絕不會接受過培訓或準備為人們隨著年齡增長而面臨的所有慢性病提供照護」。”
Murzin 說，透過教育員工了解 HIV 感染者面臨的額外複雜性以及衰老，其他問題也可以得到緩解。
「在 1996 年之前，針對 HIV 的治療選擇非常有限。因此當在 [when] 接受診斷……你基本上被告知要把事情做好，因為你不會存活超過六個月或一年是非常痛苦的」， 她說。
米勒說，愛滋病毒患者不僅需要擔心自己的健康，而且向他人透露自己的狀況通常也充滿判斷力。
「污名化仍然是愛滋病毒傳播的最大驅動力之一」，米勒說。「當有人擔心陽性結果時，可能會阻止他們伸出援手。這是使新的 [HIV 檢測] 舉措變得更加重要的因素之一」。
Realize 和來自世界各地的其他組織齊聚一堂，發出 10 項行動呼籲，以提高感染 HIV 的老年人的生活品質。 12 月 1 日是世界愛滋病日，這些組織表示，他們的目標是提高人們對 HIV 感染者面臨的挑戰以及衰老的情緒和復雜性的認識。
一些關鍵點包括低障礙的獲得照護、健康的生活條件、有針對性的研究和賦權、決策桌上的席位、打擊年齡歧視以及將性健康視為整體健康的一部分。
米勒在電子郵件中說：「到目前為止，生活品質比往年要好，但它總是可以變得更好」。 「首先要創建一個系統，支持那些在晚年改變收入的個人，並至少為每個需要它的人提供基本的支持。牙科、身體、社會心理和住房支持」。
2022 年 8 月 1 日，星期一，在蒙特婁舉行的 2022 年愛滋病會議上，一名婦女走下樓梯，旁邊寫著「直到恐懼變成希望」的信息。（加拿大媒體/格雷厄姆.休斯）
Health-care system not equipped to treat older HIV patients, says Canadian charity
Natasha O’Neill / CTVNews.ca Writer / November 23, 2022 / CTV News
‘Removing barriers is key’: Duclos
Health Minister Jean-Yves Duclos on Canada’s next steps in fighting the AIDS/HIV pandemic.
The world’s largest international conference on HIV and AIDS in Quebec focuses on the impact on Indigenous communities. Touria Izri reports.
The number of HIV cases have been rising in Canada, and it’s having a disproportionate impact on Indigenous communities.
A growing number of older adults are living with human immunodeficiency virus (HIV) in Canada. But according to a Toronto-based charity, health-care systems currently in place are not prepared to care for the rising number of aging Canadians who are HIV-positive.
Toronto-based HIV/AIDS advocacy charity, Realize, says long-term care homes and health-care facilities across Canada are not equipped to treat older patients with HIV, who are more likely to experience chronic illness.
“They tend to be more likely to develop cardiovascular disease, diabetes, and other chronic illnesses that they have to manage on top of their HIV,” Kate Murzin, national program manager for Realize, said to CTVNews.ca in a phone interview Wednesday. “They’re experiencing the overlap between HIV and aging now, and it’s causing a lot of complexity in both their health, physical health, but also in terms of other social factors, for example, financial security in older adulthood.”
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HIV is a sexually transmitted bloodborne pathogen. The World Health Organization (WHO) says HIV is an infection that attacks the body’s immune system, specifically the white blood cells. If the virus succeeds in destroying these cells, a person’s immune system is weakened. This allows other severe infections to take hold, including tuberculosis, oral, lung and liver cancers, and fungal infections.
People living with HIV experience a greater risk of disability, mobility challenges, and cognitive issues, Murzin said. These challenges affect their quality of life and without assistance or proper care, the mental and physical health of those with HIV can deteriorate as a result, said Murzin.
In an email sent on Wednesday, Ken Miller, executive director of the Canadian AIDS Society, told CTVNews.ca there is a “fear” among people dealing with HIV and the type of care they receive.
“Generally speaking, medical staff are not being trained properly in the complexities of caring for people living with HIV and support workers are usually trained even less,” Miller said.
In 1997, Canada rolled out antiretroviral therapy (ART) for HIV, allowing people to live with the virus. A previous study published in 2015 explained Canadians undergoing ART had their lifespan climb to 65 years of age. This represents an increase of 16 years since 2000.
With more HIV patients living into older adulthood, care for those who are aging with HIV is generally not a focus throughout training, Miller said.
HIV can be spread through sexual activity or by sharing needles or syringes. In advanced stages, HIV can lead to acquired immunodeficiency syndrome (AIDS), which leaves the immune system severely damaged. Since the 1980s, when HIV/AIDS was labelled an epidemic, millions have died from AIDS-related illnesses worldwide, according to UNAIDS.
According to Statistics Canada, there was an estimated 62,050 people living with HIV in 2018. In 2020, there were 1,639 newly diagnosed cases, a 21 per cent decrease from 2019, when 2,122 new cases were reported.
Due to the increased lifespan of people living with HIV, the infection can continue to be transmitted. Murzin says streamlining both HIV treatment and aging in one place would help limit the transmission of HIV.
“Right now, people often get their HIV care either from their family doctor, or most commonly from an infectious disease specialist,” she said. “But an infectious disease specialist is in no way trained or prepared to provide care for all of the chronic illnesses that people face as they age.”
By educating workers on the additional complexities people with HIV face, along with aging, Murzin says other issues could be mitigated as well.
“Before 1996, treatment options were very limited for HIV. So receiving a diagnosis at a time [when]… you were basically told to get things in order because you wouldn’t survive more than six months or a year was extremely traumatic,” she said.
Not only did HIV patients need to worry about their health, but disclosing their status to others was usually filled with judgment, Miller said.
“Stigma continues to be one of the largest drivers for HIV transmission,” Miller said. “When someone is worried about a positive result, it can deter them from reaching out. This is one of the factors that makes the new [HIV testing] initiatives more important.”
Realize and other organizations from around the world have gathered to create 10 calls to action to increase the quality of life for older adults living with HIV. With Dec. 1 being World AIDS Day, these organizations say they aim to bring awareness to the challenges people living with HIV, along with the emotions and complexities of aging.
Some key points include low-barrier access to care, healthy living conditions, targeted research and empowerment, a seat at the decision table, combating ageism and considering sexual health a part of overall health.
“The quality of life is comparably better than previous years by far, but it could always get better,” Miller said in the email. “Starting with creating a system that supports individuals who are switching incomes at later years and providing at the very least the basics to every individual that needs it. Dental, physical, psycho-socio and housing supports.”
RELATED IMAGES
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A woman walks down a staircase next to a message reading ‘Until Fear Become Hope’ at the AIDS 2022 conference in Montreal, Monday, August 1, 2022. (THE CANADIAN PRESS/Graham Hughes)