Harm reduction-based programming and services for people living with HIV/AIDS (PLHIV) in a novel clinical care setting: the opportunities and challenges for clinicians, clients, donors and fundraisers
Substance use significantly impacts the health and health care of many people living with HIV/AIDS (PLHIV), especially those dealing with additional medical, psychosocial, and economic complications. The need for comprehensive care for this population is particularly important given the current opioid overdose crisis in Canada. In response, harm reduction (HR) services (e.g., supervised injection, naloxone training, etc.) have been implemented to reduce drug-related deaths and harms. However, such services are typically not provided within hospitals/outpatient programs. Little is known about how HR services in these contexts may affect clinical care providers, complex service users, or broader organizational operations. This project provides a unique opportunity to examine the impacts of introducing HR services in a clinical care setting. The Casey House Foundation, supports a small community-based hospital which provides in/outpatient care to PLHIV with complex needs. This research will investigate the opportunities and challenges of implementing HR services from various unique perspectives (i.e., physicians, clinical and foundation staff, clients, donors) and collaboratively create a framework for evaluating these services. The foundation supports HR interventions to optimize safety and retain clients in care, and wishes to introduce these services in ways that also increase collaboration, expand clinical expertise, and engage donor support.