Converstation with ………PWA Students

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Conversation with………….Students at PWA

Emily, Matt, Karen & Damla

 

Students on practicum are an essential ingredient to the future of any environment – and the learning process of each student who works alongside regular staff and volunteers. In conversation, we have a chance to hear what they are thinking as they approach the end of their time with the Toronto People With AIDS Foundation.

 

PD: Why did you want this internship? Why Toronto PWA?

 

Karen: I was excited about Toronto PWA’s holistic approach to care for clients. Nick came to my school and he was fun and very energetic. I was interested in sexual health care.

 

Damla: Actually, I didn’t choose Toronto PWA. I didn’t know what PWA was up until my placement coordinator chose it for me. So I decided to go in for the interview and see what PWA is all about. But I was supposed to do the research before going. I met with Bill Handley, Income & Community Liaison, for my interview. He told me a little bit about the organization and gave me a tour. I thought I would give it a try. It seemed very interesting. A population I’ve never worked with before. I didn’t even know a lot about HIV or AIDS. And that’s how I got introduced into it.

Matt: Initially I was drawn to work with the LGBT population and that kind of sub-factored into HIV/AIDS so I came in for a scheduled interview with Rachel Dickson, Interim Service Access Manager. Before that I did research and I thought it was super cool that there are multiple things PWA is – it’s not just one thing that offers one service. It’s a supermarket of different agencies. We’re connected to Fife House, Latino’s Positino’s, etc. And we have the Essentials Market. It’s a whole bunch of different things in one like the Circle of Care. So it’s good for networking as well and getting to know different HIV agencies in the process.

Emily: I got matched with PWA. I requested a couple big general sectors and the HIV/AIDS services was one of them, I found it interesting. I got my interview with Kevin Borden, Interim Food Programs Liaison, at the Essentials Market and he sold the place really well. He did a great summary of everything they do here like the programs and what I’d be doing. It sounded like a lot of fun, and a new population which I hadn’t worked with before, so I went for it.

 

PD: How are your University/Professors involved in your practicum? (Emily, Matt)

 

Emily: It’s different for third and fourth years. In fourth year we have a seminar class that we attend once a week and sometimes it’s really a place where we put theory into practice. We sometimes we do check-in’s: How is your placement going? What’s a good thing that happened? What’s a bad thing that happened? Describe your placement like the weather and that kind of thing. Our Professor comes in for one visit a year because that’s a mandatory minimum, and, if you need more visits they will come in for more . We do two evaluations,  a mid-term evaluation and a final evaluation.

Matt: It’s actually the same as what Emily said.

Emily: The presentations and papers are different.

Matt: We have to do one group presentation in the year. We do it in between other classmates in your group. You have to pick instances which happened in your agencies. You’ll talk about what happened in your incidents and the other two will talk about that situation. I did my presentation yesterday about what is happening at PWA, and then my classmates discussed it

 

PD: Have you previously been involved this closely with PHA’s? (Karen, Emily)

 

Karen: My placement before PWA was with Planned Parenthood so I was working with teen outsource so o I had experience talking about STI’s and some prevention. Through that I was introduced to the importance of sexuality with people who have STI’s and more complicated questions about consent and sexual health. One of the reasons I came to PWA was because I wanted to build on that knowledge. HIV is one of the areas where things get complicated in ideas about sexual health and relationship health. And what we do around disclosure. Because I was working with mostly teens I was really inspired by them taking on advocating for positive people’s sexuality and advocating for people’s rights in terms of making the choice to disclose or not disclose, trying to create safe conditions around that. Coming here I’m finding I am learning more about people who are HIV+ and are changing their lives and some of the things that get in their way of being able to doing that. Being HIV+ can complicate basic needs and at the same time meet your basic needs.

Emily: I haven’t been this closely involved. My last placement was a homeless drop-in. I was always circling around the perimeters of PHA’s but not this closely involved. So when I came here there was a good chance to try it out.

 

PD: Tell us about a good and bad experience you’ve had with a client. (Matt, Damla, Karen)

 

Matt: We had a client come in and he started reciting a performance piece which made a lot of people uncomfortable when he became loud. He asked to speak to the Executive Director and when Suzanne Paddock came out all the other staff members started circulating because he was  very loud. He was talking about the injustice, depression, and marginalization. And, a lot of the staff members, after at the debriefing mentioned they had a hard time with the situation. It was kind of a negative experience but at the same time it was a winning experience. And on the positive side of things just every single day getting to learn everyone’s different narrative is very interesting to me. I feel that that is the core of social work in general being able to have good listening skills and internalizing what other people are saying to you. That’s really positive for me.

Damla: I’ve been here since September. I’ve had experiences with a client. One experience made me feel a little uncomfortable was – I was sitting at the front desk with Emily. A regular client came by and he had seen me sitting there and was curious about who I was which I have no problem with. It’s just the way people frame their words, he asked my name, my age, where I came from. I gave a very general answer of Toronto. He said “no where are you really from”. I said Canada. “No, where were your parents born or where were you born”? I told him the exact place and he said he figured that because I have an accent. And when he said that I just had nothing to say because that’s a common question I get.

 

PD: Was his expression flat? Cold? Negative?

 

Damla: It was very calm. It seemed like it was idle curiosity. But, every time somebody asks where are you really from, or, you have an accent it makes me feel like I am not a part of the agency, or I am not part of Canada because of others’ needs as an individual. I guess I would say that is the worst ones.  In terms of positive experiences a client came in to see my supervisor, Rajesh Pisharody, Income & Community Liaison. He was out at lunch and there was nobody else to see. And the issue that this client came with seemed very important. It was an emergency. She just wanted to see somebody. So, I decided to take her into my new office to see what the issue was about and to see if I could do something to support her. It was positive experience for me even though I didn’t tell her AB & C. It was the point that I spoke to her and made her feel validated. And told her I would pass this on to Rajesh and we will work with it and he will call you. It made me feel nice that I was able to support somebody without actually doing much for them. She left happy.  I was happy.

Karen: PWA has a very positive, happy vibe. And I feel really blessed to be here regularly and see how kind people are to one another. I see lots acts of love and kindness regularly and I think it makes my life feel better. It’s really important to see that. And a school my training tends to focus on what people don’t have and the effects of discrimination. A lot of talk about what people’ struggles look like and how that’s really complicated. So it’s nice to be in a space where some people might be experiencing those struggles but who are overcoming it and also supporting each other to overcome it. That’s been really important. I love that.

As far as negative experiences what I run into often is I look very straight and people often assume I’m straight and I’m not. And also sometimes people are really struggling, in a mood, and something is going on with them. It’s difficult to know how to support them and sometimes things get off on the wrong foot which leads to conflict. And that’s really hard. People are under a lot of stress sometimes when they come here. The first person they talk to is maybe the first they are able to talk to. And some are really in emotional pain  and stress, and they can lash out. I also see people working through that and it’s not a deterrent to that love and care. I think that’s really important.

 

PD: Some clients suffer from mental illness, challenges caused by the older HIV medications which were very powerful and hard on their system, and the environment and stigma they face every day.

 

Karen: Since PWA offers holistic care people are coming back for different issues in what they’re dealing with. If there was a problem they were trying to solve they don’t have another place to go to necessarily for solving all your problems in one place, sometimes I’m depleted at the end of my day.

 

PD: How do you feel about working alongside the PWA team? And the supervisors that are volunteers? (Emily, Matt)

 

Emily: I love it! I really do. Everyone is amazingly supportive of each other, of the students and of the volunteers. Of the clients that come in. It’s really nice to work in a place where you now that the other staff have your back regardless of the situation. Or what’s happening. I love it. It’s a great team.

Matt: Yes, it’s really cool that you can go and talk to staff members and volunteers who have absolutely nothing to do with you; don’t have to talk to you; but, will sit and talk with you. To get along with them it’s really nice to have the reassurance. Even if they don’t have anything to do with your work area they’ll take your problems very seriously as well. It’s a very inclusive environment. I’ve never been somewhere where I can connect with all the staff so well because everyone is so in-tuned with each other. It’s nice.

Emily: They’re really good about if you have questions, and then answering it without judgement. I mean about walking in here completely cold about ASO’s and all the related stuff, the staff, the volunteers and even the clients. You ask but you realize in hindsight you look dumb If you ask a straight forward question. They are amazing about answering it is just helping us learn more about living with HIV.

 

PD: What are your future goals once graduated? (Damla, Karen)

 

Damla: I’ve thought long and hard about my future after graduation. I’d eventually like to get my Master’s in Social Work. But, I don’t know if that’s something I’ll do as soon as I graduate. I’m in fourth year now, however, I am taking another year. So, I’m not graduating until 2018. After I do graduate I’d like to get a secure job; work full-time for a couple years. Gain some experience. Hopefully go back to school to do my Master’s. In the meantime try to get myself into counseling because that’s my dream and goal- to become a counsellor for youth, potentially youth at risk. And it’s to work with students, whether it’s at a hospital setting or a school setting. I do a lot of work with students now so I feel like the experience I’m gaining can really add on to my future and kind of pave the way for me. And I’d eventually like to open a Woman’s Shelter down the road. That’s always been something on my mind. Specifically for a woman who faces domestic abuse.

Karen: This is kind of a scary question for me I guess in that. I kind of allowed myself to not plan ahead because I’m in school presently. I’m thinking of getting my Master’s in Social Work but I’m also not really enjoying being in school.

 

PD: What year are you in?

 

Karen: I’m almost finished my program, I’m in my final year and my last Semester. I would love to work at a place like PWA. It’s great to see how kind and excepting everyone is here at PWA. Being able to talk to anyone and get help. That’s rare to find. My goal is to find places that have a work environment similar to PWA and to model that for myself in how I interact with people at work and in general.

 

PD: What has been your most memorable experience at Toronto PWA?

 

Emily: It was the Holiday Food Hamper program. It was so much fun! Decorating, especially hanging those snowflakes. It was just so much fun hanging out with the volunteers all day and seeing all of our clients in a place that’s not this office. It was such an intimate environment. Everyone knew exactly what they were supposed to do packing all those Holiday Hamper bags. It was amazing. I loved every second of that 12 hour day.

 

PD: Everyone is focused that day. It’s an efficient machine.

 

Matt: That’s the best answer obviously. I guess I’m going to say I really like doing volunteer interviews, placing volunteers with Roy Schuurhuis, Interim Engagement Coordinator Dreaming & Opportunities. Usually he leaves me to do the interviews and after they’re done he and I will sort out where to place each volunteer. But when I do the interview one-on-one it’s a really an intimate experience to learn all about this person. And they are usually very open to talk about their whole lives. It really opens my eyes a lot, it’s not only one particular experience but multiple, I’m grateful.

Damla: I’m going to have to agree with Emily because it was my most memorable time here at PWA.

 

PD: Holiday Hamper Day?

 

Damla: Yes. Not just the day itself but the whole process of it Emily was given a different task and I was given a different task. Most of them were big projects that we can bring forward to our future work places because they were huge. We were dealing with large amounts of money. They gave those tasks to students which is very empowering to me and the whole process of it, going back-and-forth, asking for support and asking a bunch of questions. It made me feel very connected to everyone that works here, even the times where it was getting very exhausting and very tiring, there are always staff like Rachel Dickson and Rajesh Pisharody who you could just go into their office and cry and not feel ashamed about it. And then the day of the Holiday Hampers I felt like one of Santa’s Elves. Everything was in order and everyone was so happy. Their happiness eventually affects you. Waking up that morning and being there for 9am, I thought this is going to be a long day. But then the day and time just flew by, I actually didn’t want it to end. Even the cleaning up process afterword was fun for me and that was weird I loved decorating with Emily.

Emily: The decorating committee of two!

Damla: Yes! I can now add that to my resume. The staff was kind enough to order us all lunch, I thought that was kind of them.

Karen: My most memorable experience was actually the day after the Holiday Hamper Day. I loved the Holiday Hamper Day. But, the next day there was, Starry Night, the staff and volunteer Christmas party at Flash. It was fun. And everything was donated, and volunteers put so much work into everything. We shared all the food. There was drag performances and dancing. I got to meet a lot of volunteers on the dance floor. It was a lot of fun.

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HIV and Rehabilitation

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HIV and Rehabilitation: What’s it all about?
By Kelly O’Brien, Physiotherapist &  PWA  Board Member

For those with access to antiretroviral therapy the life expectancy for people living with HIV is now approaching that similar to the general population (Weber et al 2013). HIV is increasingly considered a chronic illness as people are living longer and now aging with HIV.  As a result, more individuals may be living with an increasing number of concurrent health conditions related to HIV as well as the normal effects of aging.  For instance, over 34% of people living with HIV in Ontario were living with at least one other physical condition, and 39% were living with a mental health condition (Kendall et al, 2014).   In the HIV, Health and Rehabilitation Survey, an online web-based survey with adults living with HIV in Canada, 72% of respondents stated they were living with two or more health conditions in addition to HIV; the most common conditions included mental health issues (42%), muscle pain (33%), and joint pain (30%). Collectively, these health-related challenges associated with HIV and concurrent health conditions may be termed, disability.  The Episodic Disability Framework was derived from the perspectives of people living with HIV as a way to think about the health-challenges experienced by adults living with HIV.  Episodic disability can include any physical, cognitive, mental and emotional symptoms and impairments, difficulties carrying out day-to-day activities, challenges to social inclusion, and uncertainty or worrying about future health that can fluctuate on a daily basis and over the entire course of living with HIV (O’Brien et al, 2008).

Rehabilitation is recommended to address or prevent the health-related challenges of HIV and multi-morbidity and improve health for adults aging with HIV.  Rehabilitation can be defined as any services or activities that address or prevent impairments, activity limitations, or participation restrictions experienced by an individual (Worthington et al, 2005).  Rehabilitation services such as physiotherapy and occupational therapy can help to address side effects of medications, fatigue, pain, cognitive problems, and issues related to income and vocational support and have the potential to improve health and quality of life for people living with HIV.  The E-module for Evidence Informed HIV Rehabilitation was developed by realize (formerly the Canadian Working Group on HIV and Rehabilitation) to provide a comprehensive overview about up-to-date evidence and overview of the role of rehabilitation for people living with HIV.  Nevertheless, few people with HIV access formal rehabilitation services through the health system.  Only 17% and 6% of respondents in the HIV Health and Rehabilitation Survey accessed a physiotherapist or occupational therapist in the past year respectively, leaving individuals likely to access complementary and alternative therapies and services offered at community-based organizations, as well as take up individual self-management or wellness living strategies to deal with their daily health challenges.

Exercise is one strategy that can be individually employed by people living with HIV in order to address or prevent disability.  Results from a systematic review comprised of 24 randomized controlled trials concluded that exercising at least three times a week for at least five weeks is safe and can lead to improvements in cardiopulmonary fitness, strength, weight and body composition, and quality of life (O’Brien et al; 2016).  Adults living with HIV who attended a twice weekly physiotherapy-led group exercise and self-management sessions in the United Kingdom demonstrated improvements in mobility, cardiorespiratory fitness, strength, flexibility and health-related quality of life (Brown et al, 2016).

The Canadian Physical Activity Guidelines (CPAG) state that adults aged 18-64 years should engage in at least 150 minutes of moderate to vigorous aerobic physical activity per week in bouts of 10 or more minutes and that it is beneficial to incorporate bone and muscle strengthening activities with major muscle groups at least twice weekly (Canadian Society for Exercise Physiology, 2017).  However, few routinely engage in exercise (Schuelter-Trevisol et al, 2012) placing people living with HIV with lower cardiorespiratory fitness levels at risk for cardiovascular disease and mortality (Vancampfort et al, 2016).

Community Based Exercise (CBE) is an ideal strategy for enhancing the health of people living with HIV within a self-management framework.  CBE can foster social interaction, support and encouragement to exercise, and promote emotional, cognitive and behavioural self-management strategies to help independently manage health challenges associated with chronic conditions.

The Toronto PWA Foundation and Casey House, along with the Toronto Central YMCA are actively involved collaborating with the Department of Physical Therapy at the University of Toronto on research examining community-based exercise for people living with HIV.  A group of MScPT students examined readiness to exercise by conducting 14 one-on-one interviews with adults living with HIV in Toronto. Results indicated that readiness to exercise can involve a dynamic and fluctuating spectrum ranging from not thinking about exercise to routinely taking part in daily activity (Simonik et al, 2016). Tailoring exercise to individual goals, preferences, and abilities of the individual, offering a combination of individual and group-based exercise that can provide social interaction and support, offering accessible places to engage in exercise, and providing access to knowledgeable health care or fitness professionals can help to promote participation in CBE for people living with HIV (Li et al, 2017).  A current research study is underway funded by the Canadian Institutes of Health Research, HIV/AIDS Research Initiative examining the impact of a CBE programme with adults living with HIV in Toronto (O’Brien et al, 2016).

As more individuals age with HIV, rehabilitation interventions, including exercise can offer ways to enhance health outcomes for people living with HIV.

Take Home Messages:


Kelly O’Brien
is a physical therapist and Assistant Professor in the Department of Physical Therapy University of Toronto. Her research focuses on disability and rehabilitation in the context of HIV and chronic disease. Currently she is working with a team to examine the translation of a community-based exercise intervention for people living with HIV in the community. Kelly is also a founding member of the Canada-United Kingdom (now International) HIV and Rehabilitation Research Collaborative (@cihrrc).  She is also Board Member of the Toronto PWA Foundation.

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The Spirit of Giving

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The Spirit of Giving

Our choice in life to give has many significant benefits not only for those that receive but for those that give. Rewards of health and happiness, and strength of entire communities are a result of donating time, talent and treasure to charities.

Giving often results in joy, charity, a greater sense of community, caring, and a strong feeling of self-worth. When volunteers and donors are asked why they give, the common answers are,” It’s the right thing to do”, “Because there is a need”, and “I feel better about myself.”

It’s been proven that when people give, it activates regions of the brain associated with pleasure, social connection, and trust, creating a “warm glow” effect. Giving is good for our health, giving to others has been shown to increase health benefits in people with chronic illness, including HIV.

Giving promotes cooperation and social connection. When you give, you’re more likely to get back. One’s generosity is likely to be rewarded by others at some point. This can sometimes be by the person or organization you gave to, sometimes by someone else.

Giving evokes gratitude, whether you’re on the giving or receiving end of a gift, that gift can elicit feelings of gratitude. It can be a way of expressing gratitude which is integral to happiness, health, and social bonds. Giving is contagious, when you give, you not only help the immediate recipient of the gift it can inspire others to give to our community.

Significant observances, such as GivingTuesday and World AIDS Day, are often the triggers and serve to remind us of opportunities to donate and support.  When we give we share with others in so many ways. PWA is very fortunate to have many volunteers, donors and community supporters who give. These community partners keep PWA front of mind and truly understand the meaning of “Giving”. Joining together to participate in events, donating money, or volunteering of time helps form long-standing relationships and build strong communities.

In the weeks leading up to the Holiday Season some amazing fundraisers were organized by our community partners. These individuals find great pleasure in giving back to PWA, which was evident in the effort that went into hosting these  great events.

We’re so grateful for the passion and energy that went into each event bringing holiday cheer and opportunities for engagement for all, and funds raised in support of people living with HIV/AIDS.. Thanks to all the following organizers for their hard work and dedication:

Flash, Maria Delmonte and Druscilly DuBarry for Starry Nights

TICOT for the Night of a Thousand Stars and Purse First Events

Heroine Marks for the Jingle Belles Event

Shake it Up/ Michael Pez for the Santa Baby Event.

Spearhead Holiday food Drive

This wonderful spirit carried on into 2017 with an event in honour of Chris Edwards, Chris Edwards, an icon in the community, tirelessly raised funds for PWA. His signature event – an ensemble cast of character impersonations – was an annual blow-out event of the best drag in Toronto. Toronto Legends  Donnaramma and Amanda Roberts  orchestrated The Stars Reach Out to PWA held on January 26 at Blyss Nightclub. With incredible community support from cannabis Culture, Blyss Nightclub, Woody’s, O’Gradys, Church St. Garage, Buddies in Bad Times Theatre,  TICOT, and of course thirteen remarkable Drag performers, the event raised $10,110 for PWA. It was truly a fantastic night and exemplified the spirit of giving. PWA’s long-standing community partner, Scotiabank joined in to support this incredible initiative – Thanks to Jeffrey Erhahon and the team for their ongoing support.

Chris Edwards had a deep and very impactful relationship with PWA. Chris’s dedication and commitment to people living with HIV/AIDS has changed lives and to this day his legacy continues to inspire. Chris’s influence had no boundaries which was so evident through his commitment to PWA.  The community continues to fundraise in his honour and his memory.

 

“It is remarkable that so many people came forward tonight and gave more than asked. Out of remembrance. Toward future programs. Embracing the positive in all of us.”-
-Volunteer Participant

 

 

 

 

 

 

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