Lauren MacKenzie, MD, MPH, PhD
@lmacid.bsky.social
👩🏻⚕️HIV & ID physician
🏥Assistant Professor, University of Manitoba
❤️Associate Medical Director, Manitoba HIV Program
💊Passionate about improving access to equitable testing and treatment for HIV and other STBBIs
🏥Assistant Professor, University of Manitoba
❤️Associate Medical Director, Manitoba HIV Program
💊Passionate about improving access to equitable testing and treatment for HIV and other STBBIs
🎯Additional innovative and meaningful interventions are needed to address the convergence of houselessness, mental health, substance use, and socioeconomic factors driving the HIV syndemic in MB
December 1, 2024 at 8:28 PM
🎯Additional innovative and meaningful interventions are needed to address the convergence of houselessness, mental health, substance use, and socioeconomic factors driving the HIV syndemic in MB
🎯Health disparities in MB are shaped by structural and social determinants of health
🎯Indigenous Peoples in MB are disproportionately impacted due to the ongoing influences of colonization, structural racism, and intergenerational trauma
🎯Indigenous Peoples in MB are disproportionately impacted due to the ongoing influences of colonization, structural racism, and intergenerational trauma
December 1, 2024 at 8:28 PM
🎯Health disparities in MB are shaped by structural and social determinants of health
🎯Indigenous Peoples in MB are disproportionately impacted due to the ongoing influences of colonization, structural racism, and intergenerational trauma
🎯Indigenous Peoples in MB are disproportionately impacted due to the ongoing influences of colonization, structural racism, and intergenerational trauma
🎯At a population level, maximizing ART uptake for
HIV has been shown to prevent the transmission of HIV and decrease the incidence of new HIV diagnoses
🎯This concept is referred to as “Treatment as Prevention” or “TasP”
HIV has been shown to prevent the transmission of HIV and decrease the incidence of new HIV diagnoses
🎯This concept is referred to as “Treatment as Prevention” or “TasP”
December 1, 2024 at 8:28 PM
🎯At a population level, maximizing ART uptake for
HIV has been shown to prevent the transmission of HIV and decrease the incidence of new HIV diagnoses
🎯This concept is referred to as “Treatment as Prevention” or “TasP”
HIV has been shown to prevent the transmission of HIV and decrease the incidence of new HIV diagnoses
🎯This concept is referred to as “Treatment as Prevention” or “TasP”
🎯PLWH who have undetectable viral loads do not sexually transmit HIV
🎯This concept is known as “U=U” or “Undetectable = Untransmittable
🎯This concept is known as “U=U” or “Undetectable = Untransmittable
December 1, 2024 at 8:28 PM
🎯PLWH who have undetectable viral loads do not sexually transmit HIV
🎯This concept is known as “U=U” or “Undetectable = Untransmittable
🎯This concept is known as “U=U” or “Undetectable = Untransmittable
🎯 With advances in modern-day ART, HIV has evolved into a manageable chronic health condition
🎯Two fundamental goals of HIV care are to link people to ART & support them to reach and sustain an undetectable viral load
🎯This optimizes health for PLWH & eliminates onward sexual transmission
🎯Two fundamental goals of HIV care are to link people to ART & support them to reach and sustain an undetectable viral load
🎯This optimizes health for PLWH & eliminates onward sexual transmission
December 1, 2024 at 8:28 PM
🎯 With advances in modern-day ART, HIV has evolved into a manageable chronic health condition
🎯Two fundamental goals of HIV care are to link people to ART & support them to reach and sustain an undetectable viral load
🎯This optimizes health for PLWH & eliminates onward sexual transmission
🎯Two fundamental goals of HIV care are to link people to ART & support them to reach and sustain an undetectable viral load
🎯This optimizes health for PLWH & eliminates onward sexual transmission
💊As of June 2024, Manitoba HIV Medications Program now covers most medications used for the prevention and
treatment of HIV, including:
💊pre-exposure prophylaxis
💊post-exposure prophylaxis
💊ART for people living with HIV
treatment of HIV, including:
💊pre-exposure prophylaxis
💊post-exposure prophylaxis
💊ART for people living with HIV
December 1, 2024 at 8:28 PM
💊As of June 2024, Manitoba HIV Medications Program now covers most medications used for the prevention and
treatment of HIV, including:
💊pre-exposure prophylaxis
💊post-exposure prophylaxis
💊ART for people living with HIV
treatment of HIV, including:
💊pre-exposure prophylaxis
💊post-exposure prophylaxis
💊ART for people living with HIV
💊Until recently, PLWH were required to meet their Pharmacare deductible before HIV medications were covered by the province (unless they had drug coverage through EIA OR NIHB)
💊This was cost prohibitive for many PLWH and a barrier to HIV care
💊This was cost prohibitive for many PLWH and a barrier to HIV care
December 1, 2024 at 8:28 PM
💊Until recently, PLWH were required to meet their Pharmacare deductible before HIV medications were covered by the province (unless they had drug coverage through EIA OR NIHB)
💊This was cost prohibitive for many PLWH and a barrier to HIV care
💊This was cost prohibitive for many PLWH and a barrier to HIV care
🏥This expands
the Program’s capacity for HIV care from 3 (Health Sciences Centre, Nine Circles Community Health
Centre and 7th Street Health Access Centre) to 5 provincial HIV care sites.
the Program’s capacity for HIV care from 3 (Health Sciences Centre, Nine Circles Community Health
Centre and 7th Street Health Access Centre) to 5 provincial HIV care sites.
December 1, 2024 at 8:28 PM
🏥This expands
the Program’s capacity for HIV care from 3 (Health Sciences Centre, Nine Circles Community Health
Centre and 7th Street Health Access Centre) to 5 provincial HIV care sites.
the Program’s capacity for HIV care from 3 (Health Sciences Centre, Nine Circles Community Health
Centre and 7th Street Health Access Centre) to 5 provincial HIV care sites.
🏥The MB HIV Program is expanding options to access HIV care for people living with HIV in Northern MB and Winnipeg
🏥People newly diagnosed and living with HIV can now receive HIV care and primary care at the Thompson
Clinic in Thompson, MB & at the Aboriginal Health and Wellness Centre in Winnipeg
🏥People newly diagnosed and living with HIV can now receive HIV care and primary care at the Thompson
Clinic in Thompson, MB & at the Aboriginal Health and Wellness Centre in Winnipeg
December 1, 2024 at 8:28 PM
🏥The MB HIV Program is expanding options to access HIV care for people living with HIV in Northern MB and Winnipeg
🏥People newly diagnosed and living with HIV can now receive HIV care and primary care at the Thompson
Clinic in Thompson, MB & at the Aboriginal Health and Wellness Centre in Winnipeg
🏥People newly diagnosed and living with HIV can now receive HIV care and primary care at the Thompson
Clinic in Thompson, MB & at the Aboriginal Health and Wellness Centre in Winnipeg
🎯In only the first few months of operating, PATHS has demonstrated significant success in linking people to
HIV care and supporting them to achieve viral suppression, with over 75% of PATHS clients on HIV treatment, and nearly half of PATHS clients achieving viral suppression
HIV care and supporting them to achieve viral suppression, with over 75% of PATHS clients on HIV treatment, and nearly half of PATHS clients achieving viral suppression
December 1, 2024 at 8:28 PM
🎯In only the first few months of operating, PATHS has demonstrated significant success in linking people to
HIV care and supporting them to achieve viral suppression, with over 75% of PATHS clients on HIV treatment, and nearly half of PATHS clients achieving viral suppression
HIV care and supporting them to achieve viral suppression, with over 75% of PATHS clients on HIV treatment, and nearly half of PATHS clients achieving viral suppression
🎯The goal of PATHS is to:
🎯Provide wrap-around care with psychosocial supports to PLWH
🎯Offer & link to Indigenous led and culturally safe care
🎯Support PLWH to access and adhere to HIV treatment medication
🎯Support PLWH to transition to long term primary care services
🎯Provide wrap-around care with psychosocial supports to PLWH
🎯Offer & link to Indigenous led and culturally safe care
🎯Support PLWH to access and adhere to HIV treatment medication
🎯Support PLWH to transition to long term primary care services
December 1, 2024 at 8:28 PM
🎯The goal of PATHS is to:
🎯Provide wrap-around care with psychosocial supports to PLWH
🎯Offer & link to Indigenous led and culturally safe care
🎯Support PLWH to access and adhere to HIV treatment medication
🎯Support PLWH to transition to long term primary care services
🎯Provide wrap-around care with psychosocial supports to PLWH
🎯Offer & link to Indigenous led and culturally safe care
🎯Support PLWH to access and adhere to HIV treatment medication
🎯Support PLWH to transition to long term primary care services
🎯PATHS services are offered in non-traditional settings such as community spaces, agencies and drop-ins, shelters, encampments, residences, correctional settings, withdrawal management centers, hotels, parks & streets
December 1, 2024 at 8:28 PM
🎯PATHS services are offered in non-traditional settings such as community spaces, agencies and drop-ins, shelters, encampments, residences, correctional settings, withdrawal management centers, hotels, parks & streets
🎯In July 2024, the MB HIV Program launched the “Program to Access Treatment for HIV and Support” (PATHS)
🎯PATHS delivers comprehensive services and offers intensive case management to people living
with HIV (PLWH) who are not linked to or retained in HIV care
🎯PATHS delivers comprehensive services and offers intensive case management to people living
with HIV (PLWH) who are not linked to or retained in HIV care
December 1, 2024 at 8:28 PM
🎯In July 2024, the MB HIV Program launched the “Program to Access Treatment for HIV and Support” (PATHS)
🎯PATHS delivers comprehensive services and offers intensive case management to people living
with HIV (PLWH) who are not linked to or retained in HIV care
🎯PATHS delivers comprehensive services and offers intensive case management to people living
with HIV (PLWH) who are not linked to or retained in HIV care
📊There were 151 people referred to the MB HIV Program who have not been successfully linked to HIV
care
📊Only 66% of people referred to the MB HIV Program have a suppressed viral
🎯Innovative and meaningful efforts are needed to successfully engage & retain
people living with HIV in care
care
📊Only 66% of people referred to the MB HIV Program have a suppressed viral
🎯Innovative and meaningful efforts are needed to successfully engage & retain
people living with HIV in care
December 1, 2024 at 8:28 PM
📊There were 151 people referred to the MB HIV Program who have not been successfully linked to HIV
care
📊Only 66% of people referred to the MB HIV Program have a suppressed viral
🎯Innovative and meaningful efforts are needed to successfully engage & retain
people living with HIV in care
care
📊Only 66% of people referred to the MB HIV Program have a suppressed viral
🎯Innovative and meaningful efforts are needed to successfully engage & retain
people living with HIV in care
📊A total of 2,301 people have been diagnosed with HIV and referred to the MB HIV Program as of Nov. 8,
2024.
📊Many people diagnosed with HIV are linked to HIV care, but are not then successfully retained in HIV
care
2024.
📊Many people diagnosed with HIV are linked to HIV care, but are not then successfully retained in HIV
care
December 1, 2024 at 8:28 PM
📊A total of 2,301 people have been diagnosed with HIV and referred to the MB HIV Program as of Nov. 8,
2024.
📊Many people diagnosed with HIV are linked to HIV care, but are not then successfully retained in HIV
care
2024.
📊Many people diagnosed with HIV are linked to HIV care, but are not then successfully retained in HIV
care
📈Between 2021 and 2023, there was a 130% increase in the # of people newly diagnosed with HIV & referred to the MB HIV Program
📈In 2023, the incidence of HIV in MB (26.4 HIV diagnoses/100,000 people) was >5 times higher than the incidence of HIV in Canada in 2022 (4.7 HIV diagnoses/100,000 people)
📈In 2023, the incidence of HIV in MB (26.4 HIV diagnoses/100,000 people) was >5 times higher than the incidence of HIV in Canada in 2022 (4.7 HIV diagnoses/100,000 people)
December 1, 2024 at 8:28 PM
📈Between 2021 and 2023, there was a 130% increase in the # of people newly diagnosed with HIV & referred to the MB HIV Program
📈In 2023, the incidence of HIV in MB (26.4 HIV diagnoses/100,000 people) was >5 times higher than the incidence of HIV in Canada in 2022 (4.7 HIV diagnoses/100,000 people)
📈In 2023, the incidence of HIV in MB (26.4 HIV diagnoses/100,000 people) was >5 times higher than the incidence of HIV in Canada in 2022 (4.7 HIV diagnoses/100,000 people)
Reposted by Lauren MacKenzie, MD, MPH, PhD
🎯Ultimately though, a lack of stable housing is at the crux of many of these barriers to care, and a Housing First strategy is likely be the most impactful intervention possible
November 25, 2024 at 4:33 PM
🎯Ultimately though, a lack of stable housing is at the crux of many of these barriers to care, and a Housing First strategy is likely be the most impactful intervention possible
🎯PATHS delivers comprehensive services to and offers intensive case management to people living with HIV who are not connected to care
🎯Service is offered in non-traditional settings such as community spaces, agencies and drop-ins, shelters, encampments, correctional settings, parks and streets
🎯Service is offered in non-traditional settings such as community spaces, agencies and drop-ins, shelters, encampments, correctional settings, parks and streets
November 25, 2024 at 4:33 PM
🎯PATHS delivers comprehensive services to and offers intensive case management to people living with HIV who are not connected to care
🎯Service is offered in non-traditional settings such as community spaces, agencies and drop-ins, shelters, encampments, correctional settings, parks and streets
🎯Service is offered in non-traditional settings such as community spaces, agencies and drop-ins, shelters, encampments, correctional settings, parks and streets
🎯 Interventions should consider holistic, person-centered, and trauma-informed care options to address the barriers found in this research & appropriately serve PLHIV
🎯To this end, this year the Manitoba HIV Program developed & launched the “Program to Access Treatment for HIV and Support” (PATHS)
🎯To this end, this year the Manitoba HIV Program developed & launched the “Program to Access Treatment for HIV and Support” (PATHS)
November 25, 2024 at 4:33 PM
🎯 Interventions should consider holistic, person-centered, and trauma-informed care options to address the barriers found in this research & appropriately serve PLHIV
🎯To this end, this year the Manitoba HIV Program developed & launched the “Program to Access Treatment for HIV and Support” (PATHS)
🎯To this end, this year the Manitoba HIV Program developed & launched the “Program to Access Treatment for HIV and Support” (PATHS)
Facilitators to HIV care included:
✅Successfully stopping substance use
✅Perception of caring service providers particularly during HIV diagnosis
✅Welcoming healthcare environments
✅Social opportunities & integrated supports
✅Supportive social networks
✅Successfully stopping substance use
✅Perception of caring service providers particularly during HIV diagnosis
✅Welcoming healthcare environments
✅Social opportunities & integrated supports
✅Supportive social networks
November 25, 2024 at 4:33 PM
Facilitators to HIV care included:
✅Successfully stopping substance use
✅Perception of caring service providers particularly during HIV diagnosis
✅Welcoming healthcare environments
✅Social opportunities & integrated supports
✅Supportive social networks
✅Successfully stopping substance use
✅Perception of caring service providers particularly during HIV diagnosis
✅Welcoming healthcare environments
✅Social opportunities & integrated supports
✅Supportive social networks
Barriers to HIV care included:
⛔️Navigating the initial shock of receiving HIV diagnosis
⛔️Mental health challenges & inaccessible supports
⛔️Substance use
⛔️Violence
⛔️Discrimination by primary care service providers & social networks
⛔️Lack of preventative &
social supports
⛔️Lack of accessible housing
⛔️Navigating the initial shock of receiving HIV diagnosis
⛔️Mental health challenges & inaccessible supports
⛔️Substance use
⛔️Violence
⛔️Discrimination by primary care service providers & social networks
⛔️Lack of preventative &
social supports
⛔️Lack of accessible housing
November 25, 2024 at 4:33 PM
Barriers to HIV care included:
⛔️Navigating the initial shock of receiving HIV diagnosis
⛔️Mental health challenges & inaccessible supports
⛔️Substance use
⛔️Violence
⛔️Discrimination by primary care service providers & social networks
⛔️Lack of preventative &
social supports
⛔️Lack of accessible housing
⛔️Navigating the initial shock of receiving HIV diagnosis
⛔️Mental health challenges & inaccessible supports
⛔️Substance use
⛔️Violence
⛔️Discrimination by primary care service providers & social networks
⛔️Lack of preventative &
social supports
⛔️Lack of accessible housing