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Hey Doctor, why aren’t you prescribing the abortion pill?

The newly available abortion pill (Mifegymiso) is everywhere in the news these days. Based on all the media coverage, you would think the World Health Organization’s “gold-standard” would be widely available, but so far, only a few doctors seem to be offering it. What gives?

The drug is already available and used safely in over 60 countries, and is an effective way to terminate a pregnancy by using medication rather than surgery. It can be used early in a pregnancy (up to 7-weeks gestation in Canada) and is finally available on the Canadian market.

The thing is, many physicians and pharmacists who want to begin prescribing and stocking Mifegymiso don’t know where to locate the training or order the medication. Here’s a handy roadmap for all the doctors and pharmacists looking to provide medical abortion, but simply don’t know where to start.

Are you a physician?

You can access the training here. Click on “Accredited Medical Abortion Training Program” and then “Register Now.”  Fill out the form, and check your email for confirmation. Completing this course will make you eligible to be a Mifegymiso prescriber. Upon completion, you will be asked to enter your physician license number and be contacted by the manufacturer (Celopharma) to order and stock the medication.

Are you a pharmacist?

You can access the training here. Click on “Accredited Medical Abortion Training Program” and then “Register Now”. Fill out the form, and be sure to click the box that says “I am a Pharmacist.” Completing this course will make you eligible to stock Mifegymiso. Upon completion, you will be asked to enter your pharmacist license number and contacted by the manufacturer (Celopharma) to order and stock the medication.

Note: the non-accredited version of the training can also be selected if you do not require or wish to receive Continuing Medical Education credits. The accredited version costs $50.00 and you will receive a certificate upon completion. The non-accredited version is free. Anyone can take the non-accredited version but only practicing physicians and pharmacists will be contacted by Celopharma to order and stock the medication upon completion.

Completing the training will make physicians eligible to dispense Mifegymiso (and stock it, if they wish to do so at their clinics) and pharmacists eligible to dispense Mifegymiso to physicians. For physicians who do not wish to stock the medication at their clinics, or lack the existing infrastructure to do so, they will need to find the nearest clinic or pharmacy that is trained to dispense Mifegymiso and receive it from them.

Start the Conversation

Doctors and pharmacists have been slow to take the training. And those that have are largely existing abortion providers. This is a huge opportunity for existing providers and other physicians, like family doctors, to help close the gap in access to reproductive choice in Canada.

So let’s start the conversation! Ask questions – if you’re a health care provider, talk to your colleagues, if you’re a client/patient, talk to your providers. We’ve got a long way to go until all people in Canada truly have access to all of their pregnancy options but together, we can break down barriers.

Are you a health careprovider? Click here to download the SRH2017 handbook for quick tips on talking about abortion in a non-stigmatizing way.

 

 

Hot pillow talk: new and fabulous sex news

Ready for some pillow talk?, the theme of this year’s Sexual and Reproductive Health Awareness Week, couldn’t have arrived at a more opportune time when it comes to HIV and safe sex.

You bet we want to talk! And sexual partners who are serodiscordant – one HIV-positive, the other HIV-negative – have every reason to interject a little celebration with that pillow chat. That’s because the science of HIV transmission is now declaring that with or without a condom, if someone with HIV is on treatment, engaged in care, and has an undetectable viral load, they do not pass HIV to their sex partners!

The “fabulousness” of this news cannot be overstated. We are now at an historical moment, celebrating the most significant development in the HIV world since the advent of effective combination therapy 20 years ago. A person taking antiretroviral treatment who has an ongoing undetectable viral load can declare “I’m not infectious!”

How did we get here?

The research on treatment as prevention has been slowly accumulating for many years. In July 2016, two large studies (PARTNER and HPTN 052) published final results showing that not a single HIV transmission occurred between serodiscordant sexual partners when the person living with HIV was on treatment, had an undetectable viral load and was engaged in care. With these results, “we now have 10,000 person years (of follow-up) with zero transmissions from people who are suppressed,” acknowledged Dr. Myron Cohen (principal investigator of HPTN 052).

Convinced by this body of evidence, CATIE recently endorsed the Consensus Statement of the Prevention Access Campaign, celebrating the fact that “undetectable equals untransmittable”. This revolutionary statement, pushed forward by a dedicated group of people living with HIV, has prompted CATIE to adjust our messaging on this topic. It’s important for all frontline service providers working in HIV to understand the evolution in language so they can convey accurately these new revelations concerning HIV transmission.

In the spirit of ‘starting a conversation’ for the best possible care during Sexual and Reproductive Health Awareness Week, let’s unpack this message of “undetectable equals untransmittable,” or “U=U” in its familiar short-hand.

Can we really say that the risk does not exist?

Yes! We can and we must. While research has reported “zero transmissions,” the idea of “zero risk” is uncomfortable to many because it is impossible for research to ever conclude that a risk is zero. Statistically, we cannot rule out that a very small risk may exist, no matter what the data show us. However, focusing on the possibility of a very rare event can also be misleading. In this case, a large body of evidence is telling us that people with undetectable viral loads do not transmit HIV, and in research jargon we say that the risk is negligible (meaning insignificant or not worth considering).
But what does negligible mean to the average person? It certainly does not convey the excitement that people living with HIV are feeling about this amazing news. Negligible may be an accurate word but it is not a suitable message. If the risk is negligible then we must be willing to accept that it is not important.

HIV- negative and HIV-positive people need to hear this message

HIV-negative people need to know that an HIV-positive person who is on treatment and engaged in care, and maintains an undetectable viral load, is a very safe sexual partner because their HIV is diagnosed and the virus is controlled. This is counter to what prevention messaging said for years, where the HIV-negative partners of people living with HIV were considered to be at highest risk. We now know that the majority of HIV transmissions come from people who are living with HIV and don’t know it (the undiagnosed). This paradigm shift requires us to take up new messages that clearly communicate where the risk actually lies – not with HIV-diagnosed people who have and maintain undetectable viral loads.

It is also important for people living with HIV to hear this message so they can be confident in their ability to have healthy sex lives. People living with HIV continue to face stigma that affects their lives in many ways. By continuing to focus on a risk that is negligible, we do nothing to combat HIV-related stigma. The U=U message can reduce HIV stigma by removing the fear that people living with HIV are “infectious” and “risky” sex partners.
We need to ensure that our HIV prevention messages help, rather than harm, the people to whom we are speaking. With a little creativity and boldness, these messages can be meaningful to the communities we serve while remaining strongly grounded in the science.

More information can be found at the CATIE web site section entitled Undetectable Viral Load and HIV sexual transmission. You can also see prevention resources on catie.ca and add your organization’s name to the Consensus Statement of the Prevention Access Campaign. Let’s get the word out! Get tested, get on treatment, become undetectable and have lots of great sex!
By Camille Arkell, CATIE’s Knowledge Specialist, Biomedical Science of Prevention, and Laurie Edmiston, CATIE’s Executive Director. 

SRH Week 2017 is just around the corner!

This year, Sexual and Reproductive Health Awareness Week (SRH Week) will take place from February 12-18 with the theme: Ready for some pillow talk?

The 2017 campaign will build on last year’s “What’s Your Relationship Status” campaign by asking health care providers and clients/patients to “start the conversation” for the best possible care.

Open communication between health care providers and clients/patients is crucial to sexual and reproductive health.

On February 12th, we’ll be launching a quick reference book for health care providers and a blog series spotlighting health care providers making a real difference. We’ll be on Facebook and Twitter too! Find us @srhweek or download our social media kit (coming soon!).

The new campaign and material will be available on www.srhweek.ca as of February 12. Can’t wait until then? Check out campaign material from last year!
Of course, any campaign needs strong voices to really make a difference. Help promote sexual and reproductive health this SRH Week by displaying the posters, following @SRHweek on Twitter and Facebook, visiting www.srhweek.ca and helping to spread the word!

Want posters? No problem! If you would like to order copies of the poster, click here and fill out the poster order form. We’ll be happy to send you posters at no charge. For campaign graphics, social media tools, PDF copies of the poster and much more keep visiting www.srhweek.ca!

Now let’s start the conversation!