Machines that dispense HIV testing kits, clean needles and Naloxone launch in Canada
Machines that dispense HIV self-testing kits, clean needles and other harm reduction supplies have been installed in Atlantic Canada with plans for 100 in the next three years across the country, which continues to grapple with HIV cases and an opioid crisis.
Sean Rourke, scientist with MAP Centre for Urban Health Solutions, said the project started when he was working to get the first self-testing kit for HIV approved and available in Canada. Health Canada approved the test in November 2020 and Rourke said the next step was making it available to those who need it. MAP Centre is affiliated with Toronto's St. Michael's Hospital.
Rourke said 10 per cent of people in Canada with HIV don't know it. That's about 7,000 people. Those people aren't benefiting from treatment."
To help distribute the tests, the I'm Ready program was launched, which allows people to download an app on their phone to get the test delivered to their home or ready for pickup at locations across the country. Rourke said the program is working but it's not reaching everyone, including those without a phone or stable housing.
That's when the idea to launch Our Healthbox machines in communities that need it came to life. It's a smart machine with a digital screen that works like a vending machine with free HIV and COVID-19 self-testing kits as well as clean needles, Naloxone, crack kits with safe smoking paraphernalia, condoms and other things Rourke says we take for granted like feminine hygiene products, socks and mitts. Our Healthbox will also notify clients if there is a bad drug supply.
The federally funded Our Healthbox program will also feature educational videos accessible on the machine including on how to administer Naloxone for overdoses. The people monitoring the machines have the flexibility to put other items in it, too.
Our Healthbox will launch Monday in four communities in New Brunswick. One will be going to a front-line harm reduction service in Moncton called ENSEMBLE; another will be set up in the vestibule of a United Church in Sackville, the third will be stationed at a Guardian Pharmacy in Richibucto; and the fourth will be delivered to Woodstock First Nation.
Rourke, along with researchers at St. Mike's, plans to set up as many as 50 machines in Canada this year, and 50 more over the next three years.
Rourke said they are working with provinces and regions to find out how many harm-reduction dispensing machines are needed and where they should go. The group is also working with northern communities in Ontario and First Nations communities in northern B.C.
We want to really be in communities where there is the most need," Rourke said.
Canada continues to deal with a toxic drug crisis. According to the federal government, there were 3,556 apparent opioid toxicity deaths between January and June 2022 - about 20 deaths a day compared to 12 a day in 2018.
Our Healthbox is available to those 16 or older in Canada (18 and up in Quebec). The process to access Our Healthbox is anonymous, with clients confirming their age and then being provided with a code.
When they come back they use that code to sign in so that we can actually start to understand more about the need for each person," Rourke said, adding that the research gathered through the machine can also be useful for health-care decision-making in the province the machine is serving.
Debby Warren, executive director at ENSEMBLE in Moncton, said the organization tried out two of the machines during the pandemic, helped by federal funding.
That machine, once we turned it on back in December of 2020, it was unbelievable, the access to it - how people came from everywhere in our community to access it," Warren said. We could not keep up with the demand to keep the machines out."
To Warren, one of the key benefits is that they're accessible outside of business hours. Warren said 65 per cent of the machine usage took place during ENSEMBLE's off-hours, from 4 p.m. to 9 a.m.
We put Naloxone kits (in the Healthbox) and people come running down the street in daytime when we're open, bare feet in the winter, screaming for a Naloxone kit ... because we had the machine at night, they were able to still access it.
It could have been quite a different outcome if we didn't have Naloxone readily available 24/7."
The dispensing machines are funded by the Public Health Agency of Canada over the next five years. The Canadian Institutes of Health Research, the Canadian Foundation for AIDS Research, the St. Michael's Hospital Foundation and Even the Odds, a partnership between Staples Canada and MAP Urban Health Sciences, are also assisting with funding.
Rourke says the team is also working with health ministries for continuous funding.
CORRECTION - Jan. 23, 2023 - Debby Warren, executive director at ENSEMBLE, was misidentified in a previous version of this story.
Kelly Skjerven is a Toronto-based general assignment reporter for the Star. Reach her via email: kskjerven@thestar.ca