The following is a submitted Op/Ed. The views and opinions expressed do not necessarily reflect those of Kingstonist.
In June 1981, the world received the first reports of what would later be known as HIV/AIDS. In the forty years since, over 36 million people have died from the disease. Today, there are about 38 million People Living with HIV (PLWH).
Significant advancements have been made in 40 years: Today’s HIV treatments are not like the limited, toxic treatments of the past. In fact, they often consist of one pill a day. The medications have fewer side-effects, leading to greater adherence. And in 2020, the first long-lasting injectable HIV treatment was approved by Health Canada, providing people with HIV with more options. People living with HIV today have the tools to live long healthy lives.
In addition, evidence tells us that someone with HIV who is taking antiretroviral treatment (ART) and who has an undetectable level of the virus in their blood cannot transmit it to someone else sexually, with or without the use of a condom (‘Undetectable=Untransmittable’ or ‘U=U’). In Ontario, over 97 per cent of people on ART have undetectable levels of HIV.
The National Institutes of Health in the US indicate that: “U=U is a game changer because it transforms the social, sexual, and reproductive lives of people with HIV. It enables people with HIV and their partners to be in a relationship without fear of transmitting HIV. People with HIV report no longer feeling ‘like a pariah’ or ‘contaminated.’ Furthermore, it changes the way health professionals, the public, employers, and policymakers see and make decisions related to people with HIV.”
The greatest danger with HIV is not knowing your status. Data suggests that up to 14 per cent of people living with HIV are unaware of their status. Therefore, access to easy, non-judgemental testing is crucial. The COVID-19 pandemic limited patient access to sexual health screening. Thankfully, HIV self-testing is now available in Ontario. Self-testing involves a simple finger prick with results available in minutes.
For people who are HIV negative and members of populations that face higher incidence of HIV infection, Pre-Exposure Prophylaxis (PrEP) is a complement to other HIV prevention strategies. PrEP is a pill taken daily which is over 99 per cent effective at preventing HIV infection.
The breakthroughs in HIV treatment, testing and prevention have benefited countless people, but leave too many behind. African, Caribbean, and Black people and Indigenous people are over-represented in the number of HIV infections in Canada. As a society we cannot end HIV/AIDS without confronting anti-black racism and doing the work of reconciliation with Indigenous peoples, dismantling the systems that continue to oppress and marginalize people.
Today, three global health crises are happening simultaneously: COVID-19, HIV/AIDS and Drug Poisoning. What these have in common is that the greatest impacts are experienced by our community’s most marginalized and stigmatized. While COVID-19 has resulted in one of the fastest governmental and healthcare responses in history, making widespread testing and vaccination available in record time, this sense of urgency has not been applied to ending HIV and the drug poisoning crises. We need to confront the stigma that causes us to value some lives more than others.
COVID-19 has exacerbated already unfathomable death tolls from drug poisonings. The messaging from COVID is that it is best to keep distance and isolate; in a drug poisoning crisis, the greatest danger is for people to use substances alone. COVID has worsened the illicit drug market, pushed people to use in isolation, and decreased access to life-saving services.
According to BMC Public Health: “In British Columbia, overdose is the leading cause of mortality among a cohort of under-served People Living with HIV (PLWH) in BC, Canada. Public Health efforts to end the HIV epidemic and support the health and well-being of PLWH are being thwarted by persistent health inequities and the enormous and persistent risks facing people who use drugs. Integrated low-barrier primary care is essential for supporting under-served PLWH, and safe drug supply is needed to support PLWH who use drugs.”
December 1st is World AIDS Day and the start of Indigenous AIDS Awareness Week. While we honour the lives of those we’ve lost and work to improve the lives of those who are living with and at risk of HIV, let us also use this opportunity to redouble our efforts to fight ignorance and stigma and address the inequalities that continue to plague our society.
Executive Director, HARS (HIV/AIDS Regional Services)
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