Q&A with Casey Wigg, nurse practitioner at Sunnybrook’s HIV Clinic

Written by Monica Matys

Sunnybrook is home to one of Canada’s first and oldest HIV Clinics. For over three decades, clinic staff have proudly provided leading care to a diverse patient population. Casey Wigg is a nurse practitioner at the clinic and offers a snapshot of the critical health services provided.

What is the history of Sunnybrook’s HIV Clinic?

Dr. Anita Rachlis is the pioneer behind the clinic. She started working at Sunnybrook as an infectious disease specialist and quickly recognized the need for a multidisciplinary clinic dedicated to the treatment of people with HIV. That clinic opened here at Sunnybrook in 1989. Today, it has grown to include eight staff members serving more than 1,000 patients. The core team includes two infectious disease specialists, two nurses, two nurse practitioners, a social worker and a receptionist. Over the years our team has grown to include the outpatient pharmacy team, a nephrologist, a malignant hematologist and an obstetrician with a special interest in supporting our population.

Tell me more about your role and the patients you see.

The Anita Rachlis Clinic is home to Sunnybrook’s most diverse population. We serve over 1,000 patients that come from all over the world, from across socioeconomic lines and from diverse racial and sexual backgrounds. Some have just been diagnosed with HIV and are full of questions and fears. Others bring with them stories of trauma they have escaped. We have highly successful and prominent patients that are thriving, and others who are living in a shelter and trying to maneuver a complicated health and immigration system with limited English. Everyone’s story is truly unique, but the one unifying trait is that they are incredibly grateful. Whether it’s having access to life saving medications, or having a safe place to ask questions and celebrate even small victories, this clinic means so much to people.

I am unbashful in stating that I have the best job in the world. As one of the nurse practitioners at the clinic, I work with those with the most complex health and social issues. It may be those struggling with substance use, co-infected with Hepatitis C or those with complex mental health issues. We manage those requiring post-exposure prevention. Due to stigma, we have patients who struggle to find a primary care provider so we need to provide wrap-around care while working with community partners. Through all the highs and lows, it’s  such an honour to walk this journey with our patients.

How does the work of this clinic help fight against the stigma and myths around HIV/AIDS?

The one thing we want for every patient who comes with a brand new diagnosis of HIV, is for them to leave the clinic knowing that all their dreams and hopes are still within reach. There is an adjustment period people experience as they incorporate an HIV diagnosis into their story.  For some, that period is long and difficult and they benefit having a clinic that can provide trauma-informed care.

When a patient first comes in carrying their own stigma and myths, they often can’t imagine a day could go by when they will not be consumed by their diagnosis, but that day does come. Our patients go on to pursue lofty educational and career opportunities, have healthy relationships, bear children who are not HIV positive and live long and happy lives. When the clinic first opened, this was not the reality. Because of pioneers like Anita Rachlis and others who work in the field, we can tell patients to hold on to their dreams because they are still within reach.

What role does the clinic have in research?

The Anita Rachlis Clinic has been involved in conducting clinical research in HIV/AIDS since 1987. This includes clinical drug trials, studies looking at social and behavioural issues related to HIV infection and the validation of new lab tests to name a few.

Most recently we have been involved in the first injectable treatment for HIV.

For patients who used alarms to take multiple pills a day and had to coordinate meals with medications, an injection every two months is beyond what they expected to see in their lifetime.

A diagnosis of HIV was once considered a death sentence. Now, 40 years from the first diagnosed HIV case in Canada, we have a growing HIV positive geriatric population. We are pleased to be involved in the CHANGE HIV Study that is studying aging in the HIV population.

We have come a long way from the days Anita Rachlis first envisioned this outpatient clinic, but there is still so much work to be done. We witness courage every day as our patients show up despite the stigma and trauma they continue to face.  They show up and so we show up and all of us are grateful for having this space at Sunnybrook.

About the author

Monica Matys

Monica Matys is a Communications Advisor at Sunnybrook.

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