Despite the fact that new cases of HIV have largely levelled off across Canada, Saskatchewan has a surging infection rate. Over the next few weeks, the Sheaf will examine why this is the case and what can be done about it from the perspective of people dealing with the situation.[box type=”info”]This week: a look at how the provincial government treats patients and how they plan to curb new infections.[/box]
With the number of new HIV cases in Saskatchewan going up steadily each year since the early 2000s, the provincial government has taken a keen interest in reversing the trends that have made Saskatchewan the site of the newest HIV epidemic in Canada.
Saskatchewan Chief Medical Officer Moira McKinnon says HIV prevention and treatment has become a high priority for the Saskatchewan government. The government expects to spend about $12 million on its four-year HIV strategy, which will significantly reduce what it currently spends on treating HIV-positive patients.A study by the Chief Medical Health Officer of Ontario guesses that HIV costs the Saskatchewan health care system upwards of $40 million per year. This is a “conservative estimate,” though, because many people do not realize they are infected and that they are experiencing HIV/AIDS-related health problems.
The province’s strategy has four main areas of focus — community engagement and education, prevention and harm reduction, clinical management and surveillance and research — within which goals have been set. Some of the goals are to reduce the number of new infections and to increase the number of people who are accurately diagnosed and then remain on treatment.
One of the most important goals the strategy sets, McKinnon says, is to reduce the discrimination and social stigma that surround HIV. This will encourage people to come in for testing and treatment more regularly.
“Anecdotal reports indicate that many HIV-positive people live in unsupportive environments and therefore choose not to disclose their HIV status due to the discrimination they might otherwise encounter,” the strategy says.
Peer groups for various at-risk and infected groups of the population — injection drug users, HIV-positive mothers and HIV-positive teens are the groups mentioned in the strategy document — are expected to provide people with enough support to be open about their condition and to seek treatment.
McKinnon stressed the importance of decreasing discrimination in the medical community as well as in the general community “so that people can access their health system without being discriminated against.”
Many patients must go to the same pharmacy for their medication every time, and there are volumes of paperwork that need to be filled out. These patients also have trouble getting in to see addictions and mental health professionals when they need to or are able to, which can set back their treatment in that area.
“Often, they’re given an appointment that’s two months away and they can’t wait,” McKinnon said.
The portion of the population that has suffered exponentially more than anyone else from the uptick in HIV cases in the province is injection drug users, a fact the government acknowledges. In an effort to combat this, their strategy calls for increased access to needle exchanges. There is already one in both Saskatoon and Regina, though hours of operation are limited.
“Increased access” could mean longer hours but it could also mean taking it on the road to find the people who need it, according to McKinnon. She added that at present there are no plans to open a safe injection site like Insite, which operates in Vancouver’s Downtown Eastside.
“We consider that a ways down the line, if at all,” she said. “Our epidemic is a bit different from B.C.’s, and whether the people will actually use it” is something the government has not yet determined.
Injection drug users in Saskatchewan often, according to McKinnon, use drugs in tight-knit groups like families, gathering in someone’s house. They may not need a safe space in which to use drugs.
While the government still has two years left on the deadline it imposed with its strategy, McKinnon says there has already been some important progress. A few years ago many HIV-positive women were showing up at hospitals in labour who were not on medication, leading to the “completely preventable” birth of HIV-positive babies.
“We’ve already seen a reduction in the number of women who come in for labour off their medication,” McKinnon said.