Theme: Models of Care Year: 2019
Background:
ACE was created in response to an identified high risk population living with HIV/AIDs, who weren’t
accessing health care other than through the correctional system or in emergency rooms (ER). Many
were co-infected with hepatitis C (HCV) and engaged in high transmission risk behaviors, but due to
poor adherence and engagement in care they weren’t considered or connected for HIV or HCV
treatment.
Description of model of care/intervention:
The ACE Team utilizes pharmacists, a nurse and outreach worker to provide daily outreach to 38
clients. They outreach to shelters, clients’ homes, or the street to provide medications, health and
social interventions. ACE works to secure housing, food access, funding supports and manage acute
health concerns, chronic diseases, optimize or initiate therapy, and connect individuals to care. Since
its conception in 2016 ACE received over 120 referrals. At referral, 61% are homeless, 50% have
AIDs, 54% are HCV positive, 100% have active addictions, 48% inject drugs, and 24% work/worked in
the sex trade.
Effectiveness:
ACE intervention improves medication adherence from 0-50% to over 80%, HIV viral suppression in
86% of patients and retention in care from 0% to 79% of active patients. ACE has successfully treated
35% of HCV co-infected engaged patients with a virologic cure in all. These patients weren’t
considered for treatment due to their poor adherence and unmanaged HIV. ACE reduces ER visits
and hospitalizations through daily contact with a healthcare provider and progressing patients to
greater stability.
Conclusion and next steps:
ACE is effective in engaging and stabilizing hard to reach individuals and those experiencing multiple
barriers to care. The ACE model of outreach is currently Alberta Health government funded for 2
years as a demonstration project and opportunities exist to scale the model provincially by applying
it to HCV, addictions/detox, remote and First Nation communities.
Disclose of interest: none