Positive Life NSW

Lance Feeney looks at the issues around access to S100 dispensing services for working people with HIV and where to go to get your meds after 5pm.

HIV medication works extremely well for most of us with HIV. The days of carrying spare sets of underpants in your briefcase, anti-diarrhoea capsules as well as nausea, analgesics and, various other pills and potions for the mitigation of unwanted side-effects, has mercifully declined, if not disappeared. Manufacturers - who had a vested financial interest in reducing ‘these horrors’ – have incrementally eliminated or improved side-effect profiles. Many people have not only been able to suppress viral activity, but also reclaim their health and wellbeing and re-engage with their working lives.

Analysis of data from the Sydney Gay Community Periodic Survey (2007) reported that 60.1% of positive respondents were working full-time and 10.8% working part-time (that’s approximately 70%). We suspect that when the most recent data is available, these percentages will be higher. In an environment where treatment success is dependent on strict adherence, it is also logical that S100 dispensing services are convenient and easy to access.

Analysis of data from the Sydney Gay Community Periodic Survey (2007) reported that 60.1% of positive respondents were working full-time and 10.8% working part-time (that’s approximately 70%). We suspect that when the most recent data is available, these percentages will be higher. In an environment where treatment success is dependent on strict adherence, it is also logical that S100 dispensing services are convenient and easy to access.

Some of the issues
Getting to and from a hospital pharmacy when you’re working full-time can be challenging to say the least. If you’re lucky enough to work in an industry where your employer is flexible and understanding, and your work colleagues are worldly and not homophobic, you still have to take time-out from work and travel to your nearest hospital pharmacy, wait for the meds to be dispensed, and then travel back. This procedure can take hours; depending upon where you work and how suspicious work colleagues can be a difficult and challenging process. Explaining regular absences from work can lead to anxiety and in some cases pressure to disclosure. This decision is often later regretted, but the damage is done.

A mechanic, who works in a suburban Sydney garage, recently, talked to me about his monthly medication drama. His work colleagues don’t know he has HIV, let alone hepatitis C. Just dealing with the ‘gay thing’ is a challenge for some of them. Every month it takes him two hours to get to his nearest hospital pharmacy, collect his meds and return to work. His fellow-workers constantly ask him questions about where he goes and what he’s up to. Finding answers to this ongoing probing makes him anxious and stressed.

Advocacy
In response to the increasing numbers of people who have gone back to work, Positive Life and ACON have been advocating for improved access to S100 dispensing services. This includes access to S100 dispensing out-of-business hours and three months supply of medication, where clinically appropriate. Ideally, we would like to see an HIV community pharmacy dispensing service. This would, to some degree, resemble the ‘community pharmacy pilot’ that was run some years ago. In this scheme, a small number of community pharmacies dispensed HIV medication supplied by a local hospital pharmacy. These could be located in areas with the greatest HIV population densities such as Darlinghurst, Newtown and North Sydney.

Working people would then be able to get their prescriptions dispensed either in the evenings or at the weekend – like they do for all their other dugs. This would not only be a convenient and better fit in peoples’ lives, but also maintain confidentiality. Assumptions about an individuals’ HIV status are easily made when you’re sitting in a hospital pharmacy waiting room. This potential exposure of HIV status is problematic and embarrassing for some.

Available Service
Selected metro hospital pharmacies have progressively moved to meet the needs of working people and opened the dispensary after normal working hours one evening a week. This extended service has been increasingly used by many.

You can get your meds after 5pm, Monday to Friday:

• St. Vincent’s Hospital (SVH) Pharmacy: Thursday – till 7pm
• Royal Prince Alfred Hospital (RPA) Pharmacy: Tuesday – till 7pm
• Albion Street Centre Pharmacy: Thursday – till 6.45pm

Currently no S100 dispensing service is available at the weekend, except from hospital Accident and Emergency Departments. If you need to use this service you may be triaged as a low priority so, we suggest you take some interesting reading material and settle in for a long wait.