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HIV clusters linked to injection drug use in families

Nov 15, 2011 | 5:18 AM

While 20-year-old Alyssa, who lives in Saskatoon, doesn’t remember the exact day this year that she found out she was HIV positive, she remembers all the other details.

“I got really sick. I ended up in hospital, I was in hospital for about a month … I found out I got it from my mom, from sharing drugs,” she said.

She is not alone. Throughout Saskatchewan, there is a trend emerging that sets this province apart from the rest in Canada — and not just because of an infection rate that is twice the national average — HIV is attacking families.

The government once said in a report that HIV is moving in clusters, said Margaret Poitras, the CEO of All Nations Hope AIDS Network, a Regina-based organization that supports people who are HIV positive.

“To us those clusters were our families. They were the parents, the grandparents, the children,” she said.

“It’s the nature of drug use in our communities: they share, they share the drugs, they share the equipment … so we see clusters as in families.”

This is something Alyssa learned at an early age. When she was younger, she said, she didn’t know anything about HIV and AIDS. So at around age 13, she began using injection drugs with her family.

“I wanted to fit in with my family. I wanted them to stop ignoring me.”

This need to be part of something seems to supersede what injection drug users hear through public-health education.

“They know not to share with new people, but when it comes to their cousins, their brothers, their partners, their moms and their dads, they’re willing to share with those folks because there is a particular level of trust,” said Nicole White, executive co-ordinator of AIDS Saskatoon.

When public health starts following the contacts after someone tests positive they are likely finding seven or eight more people who are also positive — and a lot of times they’re finding familial clustering around the cases, White said.

Contact tracing is part of the Public Health Act, so public health professionals can try to control the spread of disease, said Dr. Moliehi Khaketla, the deputy medical health officer for the three northern health authorities.

They don’t give out people’s names because maintaining confidentiality is important, she said.

But when it turns out to be family members, it gets complicated.

Robert was a student when he found out he was HIV positive and told public health that he was using injection drugs with his family.

“As a result of the health nurses getting into my family, there are six of us in my family that turned out to be HIV positive,” he said.

“When I did inform my family about it, they kind of pushed me aside and everyone was pissed off because I informed the public health department.”

Saskatchewan’s Ministry of Health realizes that there are unique aspects to the epidemiology of HIV in Saskatchewan, including increasing issues around drug use in families, said Jim Myres, director of disease prevention with the ministry.

“It is unique and to be very honest it’s a very delicate (topic) and I don’t know if we’ve fully tackled that piece, but we’re working on it,” he said.

It’s delicate because indicating to anyone that you are sharing needles with your son or daughter, “those are very difficult conversations to have,” Myres said.

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

ahill@panow.com

This story is the third 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.