Home care team serves as a crucial service within the multidisciplinary team in local community. The unique service is especially important for patients who have no access to other community services due to many inhibiting factors for seeking help. The service conducted by professional AIDS care nurses, aims to improve PLWHA’s management of medication adherence, ability in self-care and awareness of the importance of risk reduction. The service will commence as soon as a referral has been received. The initial assessment will be conducted at patient’s home and service commenced in home hospital and AIDS clinic. Besides care renders to PLWHA, education on HIV/AIDS and support are provided to their care-givers.
This unique service assists the care-givers to alleviate anxieties regarding HIV/AIDS and how to care for the patient at home. Our home care nurses, through intensive contact, fill in the gap where hospitals and clinics cannot cater for needs of PLWHA outside clinic hours. For those who need urgent consultation and assistance outside office hours, a 24-hour emergency service is provided. From our previous experience, it has been proven that the service has helped many PLWHA to handle urgent needs outside clinic hours and is especially important for the newly diagnosed and those who have started new regimen of HAART.
The SAC home care service provides 7 major service scopes including:
1) Medication supervision and administration
2) Safer sex and risk reduction education
4) Emotional support
5) Psychosocial support
6) Bereavement counseling for care givers
7) Collaboration with other health care professionals
Those services are aiming at improvement of their health status and well beings. Each case is seen as an individual and after assessment, a treatment plan and goal set will be established in accordance to the different needs of the individual patient. The treatment plan will be conducted in different stages but normally will start from physical intervention aiming for the final community re-integration.
At the initial stage of intervention, the target includes drug supervision, health knowledge education, safer sex education and related plan according to the health condition of the patient. In addition, ample emotional support with frequently home and hospital visits encourages the patients to work towards achieving their goals.
The close collaboration of home care nurse team and our Day Care Centre team has witnessed many successful cases. Many PLWHA, including singleton and family cases, managed to build up good support networks with other members. These positive interactions help them with better life adjustment and better prepared them for community reintegration.
Regular phone contacts, face-to-face interviews and training were provided to maintain communication with PLWHA and to provide immediate assistance in need. 100% of service recipients indicated improvement in their drug adherence, health care and self-care knowledge. 100% expressed that the home care service supported both their psychological and physical well beings after receiving the service. This in turn helped them to improve their coping capacity for the HIV/AIDS disease. We are really happy to witness successful achievement of some cases. For example, some cases who were very sick and with poor prognosis and now managed to go through the rehabilitation process and hoping for a brighter future with the possibility of job retraining.
The SAC physiotherapy service has been commenced since 1999. We target on providing rehabilitative services to people living with HIV/AIDS (PLWHA) and their care-givers according to their physical problems and clinical presentations. Immediate and appropriate physiotherapy services can help PLWHA to maintain their mobility and decrease the occurrence of irreversible physical damage. Better physical mobility enables them to achieve better quality of life, live independently and to integrate to the community.
PLWHA usually complicate with various physical problems which may be caused by their immunodeficiency and toxicity of the therapy (Highly Active Antiretroviral Therapy, HAART) they received.
Peripheral neuropathy is one of the commonest diseases that may occur in this population. PLWHA who suffered from peripheral neuropathy may manifest different degree of sensory and motor deficits. Sensory deficits include hypersensitivity, absence of jerks, allodynia and paraesthesia, while motor deficits involve muscle weakness and atrophy as well as joint stiffness. Poor balance and gait problem would be shown subsequently. Besides, other systemic diseases, which maybe induced by HAART or related to HIV, like weaken lung function, lipodystrophy, high blood cholesterol and blood sugar levels, are generally confronted by PLWHA where the symptoms may not be shown instantly.
Last but not least, conditions such as osteonecrosis, various arthritis and tendinitis are also frequently reported by PLWHA. It implies that there is a strong need of physiotherapy interventions among our clients to help them alleviate those disabilities and impairments. The SAC physiotherapy service operates with a referral basis. SAC receives physiotherapy referrals from public hospitals and private general practitioners, as well as from the three HIV clinics in Hong Kong. Once a client was referred, the physiotherapist would then determine whether home-based or center-based physiotherapy interventions should be arranged. A tailor-made treatment plan and goal would be set for each client during the initial physical examination. SAC maintains good communications between SAC physiotherapy service and clinicians by providing progress reports to corresponding HIV clinics.
There are different training apparatuses and electrical modalities in SAC center which allows more varieties and choices for physiotherapy treatments. The decision of modalities use depends on the service recipient’s need and condition. Individual care plan and intervention will be reviewed and updated frequently to maximize their recovery.
A series of therapeutic groups will be held each year on both regular and irregular basis. A designated objective is assigned to each group, like core strengthening and cardiovascular training. Participants enjoy the time as all the groups are fun and energetic, they encourage each other during exercise, enabling good, supportive relationships.
SAC Center is a multi-integrated day care center for people living with HIV/ AIDS (PLWHA). It provides diverse therapeutic services conducted by professional staff to meet the different needs of PLWHA using multi-professional approach. The center serves as a path to full rehabilitation. Although numerous efforts have been placed to promote acceptance of PLWHA in Hong Kong, PLWHA still face discrimination and stigmatization in the community. The vivid discrimination leads to fear of disclosure of their HIV status and thus poses a lot of obstacles in seeking mainstream social service in the community.
The SAC center provides a non-judgmental and supportive environment for members to participate in different recreational and therapeutic programs. Facilitation of peer support programs is especially vital as service recipients are more willing to share their feelings with their peers in the same situation more readily. SAC also takes an active role in improving their physical and psychosocial well-being. Numerous targeted programs and goals set help PLWHA to prepare well before community reintegration.
Diverse targeted programs are implemented in the center to meet the different needs. All members agreed that the center programs, including both regular and special target programs, helped building up their social network. Members showed good sense of belonging towards the center and they were very keen to pick up different tasks. They learned different skills during the process and built up their capacities and therefore enhanced their self-esteem. They were also more willing to outreach to the public and promote acceptance on HIV/AIDS issues.
The Society for AIDS Care is the only organization that provides 100% successful Prevention Mother-to-child Treatment (PMTCT) of HIV in Hong Kong. Mother-to-child transmission (MTCT) is when an HIV-infected woman passes the virus to her baby, so called vertical transmission. This can occur during pregnancy, labor and delivery, or breastfeeding. Without treatment, around 15%-30% of babies born to HIV-infected women will become infected with HIV during pregnancy and delivery. A further 5%-20% will become infected through breastfeeding.
Therefore, additional prevention measures are necessary to reduce the risk of transmission of HIV. We implement a series of key interventions as a component of overall maternal, newborn and child health services. Initially we offer appropriate counseling and support to women living with HIV to enable them to make informed decisions about their reproductive lives. Then earlier initiation of antiretroviral therapy for HIV-positive mothers is recommended. As long as their quantity of HIV antibodies is undetectable, delivery could be given. Followed by the birth of child, we recommend the avoidance of breastfeeding and prolonged use of ARVs to reduce the risk of mother-to-child transmission of HIV to the rate of 1%.
The aim of SAC counseling service is to provide remedial and protective service to people living with HIV/AIDS (PLWHA) and their families in crisis. It also promotes healthy lifestyle, positive mental and sexual health to the PLWHA. The service covers all geographical regions in Hong Kong.
In view of the diverse nature of our cases in terms of age, family background, health condition and nationality, the counseling service adopts a flexible approach. The counseling intervention includes parent-child relationship, couples’ relationship, safer sex bargaining skill and emotional problem for those in needs.
All service recipients are referred by the clinics of Department of Health and other NGOs. Prior to the formal intake of new referred case, the case will be assessed by our professional service worker and followed by case meeting with supervisor and other service team members. In the beginning, most of the new clients are lack of confidence and hesitate on sharing with our counselor. This situation is very common because of poor self-perception and bad experiences in the past. Thus, careful monitoring is essential to minimize the negative feeling of clients. When the client builds up a mutual reliance with our counselor, treatment goal will be set.
Successful implementation of the service helps to alleviate pain, build up positive attitude and serve an important role of promoting the importance of safe sex in preventing secondary infection of HIV/AIDS.
The empowerment project facilitates PLWHA to develop their potentials, and aims to encourage self-development, enhancement of social/communication skills and improvement of knowledge in HIV/AIDS. Participants will be trained to become volunteers at the SAC center and provide voluntary services to other PLWHA in the community. Volunteers expressed their improvement in their perceived capabilities and self-esteem, which get them ready to go back to the community.
The comprehensiveness and diversity of the services can provide more opportunities to volunteers with different abilities. The service has gained good reputation among the service providers and recipients. Volunteers expressed that their self-esteem were enhanced and they have managed to develop better understanding of HIV/AIDS. The skills they gained from the program enabled them to recognize their limitations, hence preparing themselves to be more equipped for the future.
All of the volunteers agreed that the empowerment project bring them more chances to help others and their lives had become more meaningful. Furthermore, they also gained friendship and improved communication skills after attending the training sessions. SAC center advocates the importance of the spirit of volunteering to serve the less privileged.
SAC seeks funding from government and other funding bodies to sustain our Food Bank, a patient support program aiming to meet tangible needs. Our Food Bank and other support items provide necessities for PLWHA, including food, oil, etc. This program is tailored especially for low-income family, cases under social welfare benefits or those unable to support themselves.
Please click here to download the donation form to support our Food Bank service.
Four years ago, I was diagnosed with HIV. Since then, I had never bought a bottle of Coca-cola in that store across the road.
“Uncle Wong, one Coca-cola, please. No bottle deposit and keep the cap for me!” Without waiting for me to finish my sentence, Uncle Wong had already opened the sliding door of the fridge, popped the crown cap with an opener and stuck the smoky bottle on my hand. The big prize below that bottle cap was always waiting for me. Another hot summer, another young guy.
Who knows? The store was far away from me, not even existed in my world…..two sharp stings made both my physical and mental health burst like bubbles, torturing me and crucifying me on a sickbed.
One of the stings was AIDS. It caused the collapse of my immune system thoroughly and distorted my life. Complications, opportunistic infections and side effect caused by HAART weakened my body mechanism and self-care ability. As a result, although being a young man, I became vulnerable like a fragile old man and suffered from frequent headaches and diarrhoea. I could barely take off my jacket even on a blazing hot summer day.
Another sting is emotional disorder. On one hand, depression crushed my rationality, trampled my confidence, and tempted me to commit suicide; on the other hand, panic disorder imprisoned me in the cage of fear:
going out alone drives me into anxiety attacks. Streets, pedestrians, and even the sky are threatening me. Thereafter, I won’t leave home without my mum’s companion. No matter it was having a follow-up consultation or buying groceries in the supermarket.
“The Valley of the Shadow of Death” depicted my life at that moment: no light, no way-out, no bottle cap and no dreams. All was about desperation flowing in my blood vessels, marking a dead end for me. Without work, social life and faith to survive, I was stuck. Even worse, I became a burden to my family with no contribution but a liability comprised of life-long medication and living expense. How could I childishly reach out my hand to request my mum to “buy me a Coca-cola in glass bottle and remember to keep the bottle cap.”? The two stings drowned me.
The Society for AIDS Care relieved me from this ocean of pain. My doctor advised me to have counseling aside from medication so I was referred to SAC, where a professional team of social workers, nurses and physiotherapist unplugged the deep-rooted stings on my heart. Social workers, like the dawn, swept away the cloud by conveying a positive message and facilitating peer support; nurses were like a shower, moistening my soul by dismissing my doubts on health problems and on HIV/AIDS; physiotherapist, as a solid base, provided nutrition and strengthened my body mechanism via physical training.
A person addicted to drinks in glass bottles can barely adapt to those in cans or plastic bottles. Likewise, others are unlikely to understand the pain that people living with HIV/AIDS suffered. Whilst the stress doubled due to discrimination, my heart was eventually consoled and my wounds were healed by love and care. My weight was increased by 8 lbs; instead of being suffocated because of walking, I can go jogging easily. And of course, getting to the store across the street, SAC Day Centre or any places farther away, is a piece of cake to me now.
Recently, Coca-cola stopped the production of 6.5oz glass bottle. From 6.5 oz to 8oz, I am now ready to fight for what I have lost.
Uncle Wong passed me the freezing 8 oz coca-cola, but my eyes will resemble my warm heart from now on.
When I was young, I liked travelling to different countries for experiences. My life was quite crazy, playing for fun, joining sex parties, without protecting myself. I knew something is wrong there, but I lack self-control. I didn’t care anything and I thought I could do anything.
I was admitted to hospital because of herpes zoster infection and drug intoxication. There, I discovered I am HIV+. During my three months stay in hospital, I felt unwell without identifying the reasons and was frustrated.
I was totally stunned when I knew I am HIV positive. I didn’t know what to do. I didn’t want to tell anyone even my family. I started to hate when people sit near me and I hated myself. My disease is real, but I never feel that living with this disease is as bad as others’ imagination. I really hoped that I could die immediately to make me feel easier. I believe I still have a long way in my life, therefore I worried about how to continue my life. I felt I would lose my future.
The medical treatment always causes discomfort, loss of energy and motivation. I was very active in the past but now I don’t have passion to do anything. Even if I want to go to faraway place, my body can’t stand the activities with more than four hours and will be overtired. I deeply understand what chronic disease is. Once I had to change the treatment plan and medications make my skin turns darker with marks that could not be removed.
Doctor asked me why I’m unhappy and convinced me to eat more. I didn’t want to blame anything or anyone, but I really lost the interests and enjoyment in life. I believe it is immoral to spread my sadness to others.
Though I get used to be alone, coming to SAC Center allows me to speak with other people. Days have gone slowly and I am much more relaxed now. But I still insist not to tell anyone about my positive status.
At the beginning, I thought that I coughed for months and got eczema because of insufficient exercise. I tried both Chinese and Western medicine but was not fully recovered. I was very upset. My friend hinted that I should do a HIV test. I told myself to be prepared for the worst result, but I could not hold my panic when I was informed for being HIV positive.
I have a good relationship with my family, but they do not know that I am homosexual. I do not plan to tell them the truth. I was very unhappy when the doctor asked if I had a history of practicing casual sex. Are you suggesting that I deserve this illness? At that time, I suffered from pneumonia and had to stay at hospital. My body was getting thinner quickly and exhausted.
My job industry was quite sensitive towards HIV/AIDS. When my boss came to visit me at hospital, I felt that he had suspected my HIV status. I was scared and have no choice but resigned. I changed to a night shift job. One night, I suffered a stroke which left me partly paralyzed. I stayed at hospital for more than a month. I was very scared and upset. I did not have much savings and was worried about my financial situation. I always felt that the practitioners looked at me through prejudice and bias, and therefore I always cry with emotion.
The stroke affected my legs movement ability. I was referred to SAC Center and took the physiotherapy treatment for more than a year. I did exercise hard to recover my pain. I participated in the activities at Center and met some new friends. My heart opened gradually and tried not to get into a dead end. Two of my closest friends know my HIV status. Their companions and supports allow me to unburden my grievances and loneliness. Now, I do not feel so much pressure and somehow understand my future development, though I still keep my secret of having AIDS from my family, and that still makes me uncomfortable.
I am a relatively shy person. In the past, I just dropped in to the SAC Centre occasionally because I was scared of spending time with strangers. Since last year, I have been getting on well with other members in SAC Center. As long as I have had emotional problems or headache, I always share my feelings with them and SAC staff. My stress and pain are relieved after the sharing.
I have also learnt lots of health tips from the workers and the members in SAC Centre. Every week, I enjoy the internet service, badminton group, dance class, stretching exercise and health workshop held there. Whenever SAC Center organizes activities such as Mid-Autumn Festival Party, Christmas Party and birthday party, etc, I volunteer to give a helping hand in the preparation work. I am fond of all services provided by SAC Centre. Every time I return home from the centre, I can have a sweet dream.
I joined SAC Centre in 2003 through referral from Nurse Chung. At the beginning, I was not willing to open up myself. I got to know Nurse Lau at first and she is a very considerate and caring person. She always consoled me on my health and provided advice on my living conditions. Time went by and I got to know many good friends there. I felt my life had broadened immensely and my social life expanded.
A glowing angel Nurse May Ko appeared when I developed severe depression in 2005. She is an extremely kind-hearted person and she treated me like a family member. She has saved me by pulling me out from my dark valley. With her full support, I have regained my confidence and now I am a much happier person. I wish to give my heartfelt thanks to SAC Center.
When I was younger, I never used condoms when having sex. I found out I am HIV positive when I went to government clinics to treat my sexual transmitted disease. I was greatly shocked and felt the world collapsed. I did not know what to do but only thought of how to die. I neither cried on anyone’s shoulder, nor anyone could have straightened me out. I dared not tell my family, friends and colleagues about it as I knew that I would be excluded then. Doctor required me to attend the next consultation but I rejected. I did not mind as I thought I am going to die anyway. Since then, SAC nurse contacted me but I never took a look of them. Sometimes, I even treated them rudely.
Several years later, I was suddenly experiencing short of breath and felt dizzy. Nurse Ko, SAC nurse, accompanied me to the hospital. I was critically ill and my sister was informed of my HIV status by the doctor. She was very concerned about me. Her comfort and care had driven me to keep up my treatment.
A lot of illusion occurred at the beginning of my treatment. Without any reasons, I turned on the television and radio loudly and wandered at home. I could not sleep and had bad temper. But my sister and Nurse Ko never gave up on taking care of me. I know that they had such hard time. I once forgot to take medicine on time and wandered on the street, fortunately Nurse Ko found me and took me home. Relied on her endless reminders and care, my leg movement has totally recovered now.
I always want to be the number one and feel that men only weep when deeply grieved. Facing my HIV infection, I could not help to shed tears. Right now, I just want to tell people: Don’t reject treatment! Practice Safer Sex and always use Condoms!
Hello, everybody! I am an AIDS patient, thirteen years old. I love blue colour. My hobby is drawing. My dream is to become a painter. Also, I like swimming, playing badminton and soccer. Although I am short, thin and weak, I have a clever mind.
When I was one year old, my mother was infected with HIV unfortunately. Death took her life quickly soon after. HIV/AIDS is detestable like a terrible parasite. After sucking my mother’s blood, it pounced upon me and tried to stick its sharp poisoned teeth into my body. I was tested positive for the virus too and was sent to Queen Mary Hospital for treatment. In a very long time I can only rely on medication to control my illness.
When I was three, my father took me to Kunming, capital of Yunnan province in China. From then on, I started my new life there. Although I live in China with my dad, I need to continue my treatment and consultation in Hong Kong. Since then, I received endless support from staff of SAC. They helped me and other children living with AIDS.
When I went to the clinic, they came to see me!
When I was sick, they cared about me!
When I was unhappy, they accompanied me!
When I was boring, they played with me!
When I had difficulties, they helped me!
They took every care of me, especially the nurse Ms. Yim. She greeted me every hour, every day. I am very grateful for her care and help. They have also specially raised some special funding for me to support my traveling and living expenses when my dad and I are in Hong Kong.
When I was three and a half years old, I went to kindergarten. Every kid liked to play with me. I spent a happy childhood there. When I was six and a half years old, I went to study primary one. The time in primary school seemed to draw a starting line for me. Going to Hong Kong for treatment became a routine in my life.
From primary one to primary three, my study was bad and I always received the lowest ranking in school. My school result became worse and worse. Later on, I changed to another school and my ranking improved a little.
Every time when I came to Hong Kong, I was not obvious as carrying a small bag. However, when I went back to Kunming, my luggage was doubled and was fully packed with my bottles of medicine. I thought my father’s life is shortened by helping me to carry the luggage day after day, year after year in all these years.
When I came for treatment early this year, I was told to take pills instead of liquid medicine. Oh! That means I do not have to carry a heavy luggage full of bottles anymore. My luggage is much lighter! I was so happy and crazy! I want to thank Ms. Yim and all SAC staff once again. It’s their sweat and pains taking effort that make me stand here today. I would like to thank Dr. Chiu at Queen Mary Hospital as well. I will never forget your care and support!
About a year ago, one night, I sat on the edge of balcony window, swinging one leg outside of the window, decided to commit suicide. I could not believe that I was diagnosed with lymphomas when I went to the hospital because of stomach pain. After the surgery, the doctor informed me that I am also infected with HIV/AIDS. I could not believe it and wished to commit suicide by jumping down from my apartment. “What if this does not cause my death, but just makes my legs or arms broken, what can I do?”, when I thought that my body would be badly mutilated…… Don’t laugh at me. I am an aestheticism. I wish I can die perfectly.
Living with confusion and frustration, I started the HIV/AIDS treatment in Kowloon Bay clinic after leaving the hospital. Their social workers transferred my case to SAC Centre. At the beginning, in fear of getting infection in the community, I stayed at home mostly. Ms. Yim, SAC nurse, frequently visited me. She taught me the knowledge of HIV/AIDS and the information of medicine for the treatment.
I am not a highly educated person. My life relies on hard labor working. Because of my illness, I become jobless and relied by social security assistance. I am the youngest one in my family, having one brother and one sister. I asked the doctor to tell them I have HIV. Fortunately, they do not discriminate against me but greatly support and take care of me, especially my sister, who always encourages and visits me. Her feeling is consoled by nurse as well. My sister’s anxiety is much relieved after she receives SAC’s service and learns the knowledge of HIV/AIDS. The only thing made me unhappy is my most trusted friend left me after he knew I was infected. He did not even give me a call. But I do not blame him.
After taking one year of chemo-treatment, my health, as well as my mood, improves a lot. Sometimes, I work as a volunteer in SAC Centre. Currently, I start the body training program and frequently visit my sister. I wish that I can re-integrate the society as soon as possible.
In 2000, my health condition was so worse and I had been living in hospital for more than 3 months. The disease made me so painful that I had ever thought of committing suicide. Indeed I understand everyone will die once in a lifetime, but I would prefer to die naturally. With this thinking, I gave up the thought of suicide. However, my health was very poor that my mother had to take care of my daily living. Although I knew that my mother would not be infected by the virus through daily contacts, I still worried and felt uneasy. Sometimes, I would have emotional outburst, which made us feel sad. Fortunately, my mother kept on taking care of me whole-heartedly.
My life had changed after joining SAC Center through Nurse Yim. I started regular physiotherapy service for physical training. I also joined the center activities, such as BBQ and parties, which made me regain the happiness. With the guidance of the social worker, I had learnt how to use internet and utilize the searching tool to explore many interesting and updated information. My social life has been expanded a lot through participating in different activities and I became much happier.
As time goes by, I have been growing up a lot, both physically and psychologically, for the past 8 years. I learn about what is HIV/AIDS and I accept myself as a person with chronic disease. I have to take proper medication and undergo rehabilitation exercise regularly. Now, I can even live independently and take care of myself. In order to prevent myself from depression again, I have learnt how to keep calm while facing problems. I always remind myself by saying “Just Try My Best”. During these 8 years, SAC Center had been relocated with personnel changes. I still take the regular physiotherapy treatment service, and sometimes join the outdoor activities, birthday and festival parties to have fun with other members.
Although I am still worrying about the problems I need to face in the future, I believe I could overcome them with my faith. All in all, I hope all people should love themselves and prevent the spreading of HIV/AIDS by practicing safer sex!