Sue Lawrence, nurse practitioner (NP,) in Hope and Boston Bar is on the cutting edge of treatment and prevention in the field of HIV. Lawrence brought The Hope Standard up to speed on some new developments in the controversial world of an illness that is rapidly becoming less stigmatized and accepted by the medical community and society as a whole.
“I’ve been an NP for six years as a family practitioner for Fraser Health,” said Lawrence. HIV care was largely coastal, and people were having to be transported to Vancouver for treatment. There’s not a high population of known HIV patients here, but perhaps more than we think.”
Untested patients are to be factored into the undisclosed numbers of people living with HIV. Exposure, education, and standardized testing for the virus are key components to prevention according to Lawrence. By standardizing HIV tests and working them into regular lab work, the stigma is lessening with the familiarity of what would traditionally be considered a frightening proposition to most — an HIV test.
If the virus is caught early, treatment can begin with immediacy, and people can live full and productive lives with proper medications. Lawrence was asked by Fraser Health to embark on a preceptorship for treatment through the B.C. Centre for Excellence HIV/AIDS program offered by St. Paul’s Hospital in Vancouver. After completing an intensely concentrated month long program online, where she studied the extensive list of new medications available to patients, Lawrence was prepared to take on HIV patients in Boston Bar and Hope.
“I first had exposure to the virus in 1985, when I was studying at UBC to get my RN and my roommate was sick and went into hospital — at that time no one knew what HIV was and there was a lot of fear around it. When our landlord found out about my friend, we were all evicted, and that’s when I decided I wanted to do a thesis about HIV and AIDS,” said Lawrence.
Through her research Lawrence discovered that HIV is prevalent among marginalized people. She noted that HIV was high in First Nations women, with 38 per cent of HIV sufferers stemming from an aboriginal background.
“When looking at these numbers, one has to take into context drug use and sex — I wanted to find out why it was happening, and I discovered there was a correlation between poverty and racism,” she said.
HIV does not discriminate, it doesn’t just affect the marginalized population, everyone is at risk according to Lawrence.
“One of the major drives in treatment is prevention,” said Lawrence. “Today we offer everybody an HIV test — it’s not just ‘at risk’ individuals, it’s important to note that everyone is at risk. HIV testing is now the standard of care.”
By standardizing the care of HIV, it erodes some of the fear around it. The virus can be treated when it is exposed in an individual. With new medications that decrease the viral load to zero, people can live a normal life, and even have sexual relations with partners who do not carry the virus.
Higher numbers of people being treated, means the virus is on the decline. Having a viral load of zero, is the equivalent to not having the virus, but that doesn’t mean a patient can go off of medications. The viral load will go up if a patient stops taking medications.
“People can come to me and I can treat them for HIV from beginning to end — the idea is not to judge, but to get you well,” said Lawrence.
Medications differ from person to person, and often a drug cocktail of five classes of available antiretroviral drugs against HIV can be used to treat the virus and prevent its spread. The stigma around HIV often hinders prevention when people are too scared to come in for a test, so by making it easier for patients to come in and get tested, Lawrence is making prevention and treatment possible. People who are wanting to be tested for HIV, or treated for the virus can come to a clinic in Hope, or Boston Bar and ask to see Sue Lawrence.
They will be provided an envelope containing a form, which they can fill out, disclosing the reason for seeing Lawrence and then seal it for confidentiality.
“For most people it can come as a shock, but once you’ve been tested and are positive, we can treat you,” said Lawrence. “I can treat someone and help them build supports and find ways and coping strategies to keep them emotionally healthy.”
Lawrence also lectures grade 8 and 12 students on the treatment and prevention of HIV at the local schools.
“By creating awareness, you can create change,” she said.