Because the HIV/AIDS care journey continues

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On Oct. 2, St. Joseph’s Infectious Diseases Care Program made a historic move from its stand-alone clinic on Oxford Street – home for the past 23 years – into St. Joseph’s Hospital. To mark this move, the team reflects on the early days of HIV/AIDS care and the pioneering role of St. Joseph’s, which will continue in the program’s new home in B3-030 (zone B, level 3).

Members of the Infectious Diseases Care Program team say good-bye to their home for the past 23 years on Oxford Street before moving into the new, central outpatient area, zone B, level 3,  at St. Joseph's Hospital. The program began operating out of their new location on Oct. 2.
(above: Members of the Infectious Diseases Care Program team say good-bye to their home for the past 23 years on Oxford Street before moving into the new, central outpatient area, zone B, level 3, at St. Joseph's Hospital. The program began operating out of their new location on Oct. 2.)

With a strong determination to provide the best services possible for people diagnosed with HIV/AIDS, internist Dr. Iain Mackie garnered support from the ranks within St. Joseph's Hospital and community partners and made a case to the Ministry of Health to request funding for what came to be known as the HIV Care Programme.

After gaining support from neighbours, the clinic opened in 1989 in a beautiful home at 448 Oxford Street East. The first comprehensive "one stop shopping" HIV clinic in Ontario, it became a model for others across the country. Founding medical director Dr. Mackie was an outspoken, passionate and sometimes controversial voice within the community. The clinic, now known as the Infectious Diseases Care Program, is now one of eighteen HIV outpatient clinics in Ontario. This network evaluates and develops best practice in the care of people living with HIV/AIDS.

Since 1991, a remarkable change in the medical treatment of our patients has occurred. Initially, treatment was for the complications of HIV and often palliative care. But in 1997, new classes of anti-HIV drugs were introduced which revolutionized our approach in management. With combination therapy (HAART), we were able to successfully suppress the virus and protect the immune system from being infected and impaired by HIV.

This advance resulted in fewer opportunistic infections and other complications, including the previously inevitable progression to AIDS. Subsequently, more anti-HIV drugs became available with better and more durable control of the virus and fewer side effects. Currently, patients with newly diagnosed HIV infection, with strict adherence to therapy, can expect to have a life expectancy approaching that of a non-infected individual.

What has not changed, however, is the need for education to strongly encourage prevention and early diagnosis of HIV to reduce the impact of this illness.

As we celebrate our history and move into our new ‘home’ we will continue to provide exemplary service to our patients, their family, our hospital colleagues, community partners and community.

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