"This could become a national initiative in HIV/AIDS education," said Dr. Gerry Bally of the unit. "HIV education is bringing out issues that are burning in health care right now, such as how to service the underserviced and how to reach hard-to-reach populations."
Dr. William Rowe, director of the School of Social Work at McGill University, said the HIV/AIDS pilot project for medical students could also be used in other professions. "It's a wonderful concept to dedicate an all-class day and get all levels of your trainees to address and respond to an important topic. It's exciting because it allows you to bring many layers of activity and action together at once."
The three videotapes shown during the all-class day featured the talents of Newfoundland actor Greg Malone. They were produced by CODLESSCO and Memorial's Division of Educational Technology and included interviews with people involved in all aspects of AIDS in St. John's, Montreal, Toronto and Vancouver.
Mr. Malone also gave the keynote address on the topic What's so funny about HIV/AIDS and sexuality? Dedicating his work in HIV/AIDS education to actor Tommy Sexton, who died of AIDS, he challenged his audience to see the word as it really is, suffused with judgement.
"Prejudice leads to judgment, which leads to fear, which stops all understanding," he said. "The purpose of this exercise is to shake out our fears."
Some of the panelists talked from personal experience about the fears and prejudices they have encountered as patients with HIV/AIDS. Rick and Greg, a gay couple, said they have been refused services, for example from a dentist, because of their illness. Robin, an HIV infected woman with two children, was diagnosed in her eighth month of pregnancy. "The doctor literally pushed me out the door," she said. "I had the feeling there was nobody there for me -- there was discrimination from friends, family and doctors."
Gerard Yetman, director of the AIDS Committee of Newfoundland and Labrador, said working with HIV/AIDS infected individuals can be tremendously stressful for caregivers. "We're constantly coping with death -- counsellors, doctors and nurses are reaching burnout. Being a limited and small group, we have to be part of the whole dying process. My advice to you, as medical students, is to keep yourself healthy and make sure you have your supports so you'll be around for a long time."
Dr. Rowe and Dr. Bill Ryan, Batshaw Child and Family Services, Westmount, Quebec, introduced medical students to the concept of harm reduction as a strategy for dealing with diseases such as HIV/AIDS. Dr. Rowe said a main principle of harm reduction is to focus on the problem and take a value-neutral view of both the activity and the person. "Don't moralize and don't take the high road," he said.
Dr. Ryan described how the HIV prevention program at his clinic uses components of harm reduction and health promotion in a project to provide social support for gay, lesbian and bisexual youth. To counteract the isolation, loneliness, homelessness, depression and violence that affect these young people, they are introduced to other gays and lesbians. "We let them know there are other people in the world like them," he said. "I don't think we can underline enough what isolation does to these youths. There is a strong suicide risk."
The materials for the all-class day on sex, drugs and HIV -- including videotapes, student guides, facilitator workbooks and a course manual -- are being made available to other medical schools in Canada.