From Zimbabwe to Canada: Rethinking HIV Care with a Trail-blazing Model

On my recent trip to Zimbabwe, I stepped into a clinic and discovered a trailer for HIV testing. At first, I was fascinated as I believed that this is something that could potentially revolutionize the system back home in Canada. What seemingly was a simple visit to a community clinic opened my eyes even further to a healthcare model worth sharing.

The clinic operated with a streamlined approach. It began with group pre-counseling sessions, not just to inform but to listen and gauge understanding about HIV. Then, in private, individuals could speak freely with the nurse about their personal reasons for testing, and choose the type of test they preferred, either a finger prick or an oral swab.

After the test is completed, clients are asked to wait for the result. The nurse uses this time to assess their mood,predict possible reactions, and offers them a chance to think if they would like to hear about their results. Results are shared only if individuals are ready to hear their test result. If not, they are free to leave the clinic. This is followed by harm reduction counselling.

In Canada, the journey from testing to treatment can be burdensome...

The nurse also informs the client that this result does not necessarily indicate your partner’s status. Clients are encouraged to bring their partner. The nurse does not notify the partner but leaves it to the client to determine if they want their partner to know about their status or not.

Immediate Care: The 'Test and Treat' Model

When it comes to HIV care, timing is everything, and the clinic's 'test and treat' model is a game-changer. Here, patients with positive results are given a week's supply of medication right away before a confirmatory test.

Canada's social workers, peer supporters, and outreach staff are untapped community resources in HIV care. They are the bridge between people and the healthcare system.

This contrasts greatly with Canada's system. While Canadian healthcare excels in many areas, when it comes to HIV care, the journey from testing to treatment can be burdensome—a series of referrals and appointments that delays treatment and can increase patient’s anxiety.

A Call for Change

The lesson from Zimbabwe is clear: simplify to amplify care. This means reducing the complexity from testing to treatment and empowering frontline workers to deliver care promptly. By doing so, we could see an increase in testing and a reduction in the stress and cost associated with care.

Some Recommendations...

Canada's social workers, peer supporters, and outreach staff are untapped community resources in HIV care. They are the bridge between people and the healthcare system. These professionals excel at connecting clients to services, and shifting tasks of counseling, testing and prevention to them could be important in providing immediate care. Enhancing their training could lead them to deliver a more cohesive care experience.

Creating welcoming and supportive healthcare settings is critical.

To fight HIV effectively, we must engage more people in getting tested. Creating welcoming and supportive healthcare settings is critical. Adopting Zimbabwe's patient-focused methods could transform Canada's HIV care for the better.

And always know that right here on the I-AM website, everyone is always welcomed to find support and resources surrounding HIV self-testing and connecting to care, as well to get free HIV self-tests.