Political will necessary in fight against HIV

Those numbers show an HIV infection rate in Saskatchewan that is twice the national average, 20.8 cases versus 9.3 cases per 100,000 people.

Allen started working in the field in the early ‘90s. She was one of many from the Prince Albert area involved in a 2002 provincial strategy called, At Risk: Recommendations for a Strategy on HIV, Blood-borne Pathogens and Injection Drug Use.

“It was very much like the strategy of today, except a lot really didn’t get done,” Allen said.

Injection drug use now accounts for 75 per cent of HIV transmission in Saskatchewan, and young aboriginal women are disproportionately affected.

Frank Regel, retired executive director of community services for the Prince Albert Health District, doesn’t disagree with Allen.

He also sat on that strategy’s provincial committee. Like many committees there were too many recommendations and the report was shelved, he said.

“Sometimes I think local strategies and pragmatic efforts trump all this work, by all these experts sitting around a table … without having the intricate knowledge of how it is to be someone living in the milieu,” he said.

His knowledge of the situation in Prince Albert started with a 1999 study called the, Seroprevalence and Risk Behaviour Survey, which looked at the patterns of HIV in the community. What they found was correlations between injection drug use, the correctional system and those moving to Prince Albert to be close to loved ones in the system.

“It became quite clear that Prince Albert had a larger opiate issue than we ever thought we had,” he said.

After that they realized something had to be done, he said. They launched several strategies including working in Saskatchewan Penitentiary, making inroads into First Nations communities, hiring an aboriginal outreach worker and increasing education around harm reduction and needle exchange, Regel said.

There was heavy publicity around Prince Albert being a hotspot in Canada for HIV infection, he said.

“At the time we brought it forward to the public, the government of the day wasn’t that terribly happy with us because it was controversial and showed that these things had to be addressed or should be addressed,” he said.

“The government of the day didn’t want to spend any more than they needed to, probably the same thing would happen right now, but we brought it to their attention.”

Tony de Padua, a nurse and assistant professor at First Nations University was among the first wave of the local response to the seroprevalence study. He started the anonymous testing outreach program at the Saskatchewan Penitentiary more than a decade ago and continues making weekly visits.

It’s hard to say if people did everything they could back then, he said. Sometimes research is done, results are put on the shelf and they just aren’t acted on, he said.

“For myself, I don’t think I’m that surprised to see what we are seeing now.”

While the local response started well, Regel said he’s not sure if that drive was seen across the board.

“I’m not sure if we (in Prince Albert) could have taken any other actions than we did at the time, to prevent the size of the population being identified now,” he said.

He uses the elimination of smoking in restaurants as an example where everyone worked together to make a change. There was a strategy to minimize second-hand smoke where, everyone got together, provincially and nationally, he said. Now it is just normal that there is no smoking in restaurants, he said.

“Whether the national strategy or the provincial strategy was effective (when it comes to HIV) … I’m not sure that it was paid the attention (that) it needs to be paid in order to have it register in the minds of the general public.”

In those years, when the early reports were coming out, the province knew there were issues around housing, poverty and education, said Judy Junor, former health critic for the NDP, but those issues required finances.

“The province did not have a lot of money in 2002 and it’s a different scenario now, where we have money that we could use,” she said.

The topic of HIV made an appearance in the legislature much earlier than that. In 1987, then opposition leader Allan Blakeney raked then Premier Grant Devine over the coals regarding a comment Devine is reported to have made about the effect of HIV on the aboriginal population.
According to Hansard, Blakeney was concerned about Devine’s statement, “If AIDS (Acquired Immune Deficiency Syndrome) ever gets into the native community, it will be hell on wheels.”

During the question period Devine defends that what he said was necessary to show the seriousness of HIV in the province.

“Because if it does hit Saskatchewan in any increased numbers, Mr. Speaker, quite frankly it will be extremely, extremely serious,” reads the Hansard.

A lot has changed since early arguments in the ‘80s, and the current government has a strategy in place.

However, Junor said she is skeptical that it is more than just lip service. There is not enough money for education or support for communities, she said.

There are still lots of challenges, but Don McMorris, health minister, said there has been more work done recently than in a long time.

“Yes sometimes people say, why put money into this population. I don’t look at it that way. We look at it as we absolutely have to, to help them make healthy life choices and get back into society and be a contributor as opposed to, perhaps, a taker,” he said.

He said he believes the strategy that has been put in place is the right strategy.

But there is still competition for health dollars.

“I started talking to people here and you can see that we have a huge problem … it is going to affect all of us because when so much of the health care dollars are spent on treating people with HIV and AIDS it does affect the population … because money could be used in other ways,” Junor said.

It can be difficult to find support for programming for HIV because of the pressure on finances, Allen said.

“The general population doesn’t really want to hear about this,” she said. Having a funded HIV strategy is a positive step, she said.

“I see it is totally different this time.”

See more in the series: The face of HIV in Saskatchewan

ahill@panow.com

This story is the first in a series about the face of HIV in Saskatchewan. Research for this project was made possible by a journalism grant from the Canadian Institutes of Health Research.

by Angela Hill

Political will necessary in fight against HIV

What's Trending