liv poz mag.qxd - Positive Living BC

Transcription

issue87_liv poz mag.qxd 2013-10-30 11:16 AM Page 1
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FIGHTING WORDS
Canada’s reputation for compassion is on the line
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GIRL TALK
From Toast to Toast with artist Peggy Frank
6
SPOTLIGHT ON THE UK
Still making progress despite economic downturn
8
FINGER ON THE PULSE
Getting older and better
11
NUTRITION
Cuckoo for coconut
12
ACTING UP
Take part in World AIDS Day
13
SURVIVING SANTA
Make self-care a part of your holiday
14
COVER STORY
Confronting the Ghosts of HIV Past, Present, and Future
16
REMARKABLE LOSS – REMARKABLE PROGRESS
AIDS Vancouver marks 30 years of service
19
CLASS IN SESSION
Why we need different combinations of meds to fight HIV
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SEX, DRUGS, AND HIV
Party drugs and HIV could be a dangerous cocktail
22
TRUTH AND RECONCILIATION
First Nations HIV epidemic is a legacy of our past
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DEALS AND DISCOUNTS
A resource for seniors in the Lower Mainland
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LAST BLAST
Classic song captures the season
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HEALTH PROMOTION PROGRAM MANDATE & DISCLAIMER
In accordance with our mandate to provide support activities and facilities
for members for the purpose of self-help and self-care, the Positive Living
Society of BC operates a Health Promotion Program to make available to
members up-to-date research and information on treatments, therapies,
tests, clinical trials, and medical models associated with AIDS and HIVrelated conditions. The intent of this project is to make available to members
information they can access as they choose to become knowledgeable
partners with their physicians and medical care team in making decisions
to promote their health. The Health Promotion Program endeavours to
provide all research and information to members without judgment or
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prejudice. The program does not recommend, advocate, or endorse the
use of any particular treatment or therapy provided as information. The
Board, staff, and volunteers of the Positive Living Society of BC do not
accept the risk of, or the responsibliity for, damages, costs, or consequences
of any kind which may arise or result from the use of information
d i s s e m i nated through this program. Persons using the information
provided do so by their own decisions and hold the Society’s Board, staff,
and volunteers harmless. Accepting information from this program is
deemed to be accepting the terms of this disclaimer.
NOVEMBER •• DECEMBER 2013
Funding helps Vancouver
researchers fight HIV
A $5 million project in partnership with
Genome BC will help Vancouver
researchers fight drug resistance and
develop personalized treatment.
Based on DNA sequencing technology,
the researchers are developing a test that
will detect drug-resistant HIV strains. As
well, the researchers will develop new
personalized tests – viral and human
genomic – to prescribe the best treatment
for each patient and minimize side
effects. They will also be creating a new
“early warning system” to map drug
resistance geographically to find out
where resistance rates are highest and risk
of transmission is greatest.
“We’ll be able to monitor the
emergence of drug resistance in real
time and identify patients with newly
acquired drug-resistant strains faster.
We can then intervene proactively
and preemptively so the resistance
doesn’t become widespread,” stated
Dr. Julio Montaner, co-leader of the
project, director of the BC Centre
for Excellence in HIV/AIDS, and the
director of AIDS Research and head
of the Division of AIDS in the UBC
Faculty of Medicine.
Source: Genome BC
HIV vaccine produces no
adverse effects in trials
The Phase 1 trial of an HIV vaccine,
conducted by University of Western
Ontario researchers with support by
Sumagen Canada produced no
adverse effects clearing the way for
more study.
The virus was given to asymptomatic
HIV-positive participants in a trial that
began in March 2012 and concluded
in August 2013. If successful, it will be
the f irst HIV vaccine based on a
genetically-modified killed whole virus
(SAV001-H) and is also the only HIV
vaccine currently undergoing clinical
trial in Canada. The vaccine also
produced a boost in antibody levels,
which indicates that it could prove
successful in preventing infection in
Phase 2 of the trial, which will measure
immune response. Phase 3, will measure
the efficacy of the vaccine.
Sumagen is seeking pharmaceutical,
government and charity organizations to
help it bring the vaccine to market.
Source: University of Western Ontario
Alberta studies partner abuse
of HIV-positive women
Alberta researchers found a high prevalence of intimate partner violence (IPV)
reported by HIV-positive women at a
major Southern Alberta clinic.
Forty percent of women reported
experiencing IPV and those women also
had worse health and quality of life
than HIV-positive women who didn’t
report IPV.
During routine visits between May
2009 and January 2012, 339 women were
screened. Of those 137 reported IPV and
20 percent of those reported the abuse
happened in their current relationship.
Eleven participants reported that it
occurred in their current and past
relationships. Twenty-two percent of the
137 women who reported IPV also
reported a history of childhood abuse.
Women who experienced IPV
“experience multiple barriers to
care, such as the immediate threats to
the safety of themselves and their
dependents, which in turn requires
less imminent threats, such as HIV
infection, to fall in priority,” reported
the researchers.
Source: CATIE
HIV diagnoses provoke US
porn moratorium
Two moratoriums on porn f ilm
production were issued after three
Los Angeles actors tested positive. A
fourth HIV diagnosis was reported,
but not conf irmed.
The first actor to test positive was
Cameron Bay leading to a five-day
moratorium that began on Aug. 22.
The second actor, Rod Daily, who
had been romantically linked to Bay,
disclosed on Sept. 4 that he had tested
positive. The second moratorium was
instituted after a third unidentif ied
person tested positive and was lifted
two weeks later on Sept. 20.
As a result, the Free Speech
Coalition, a trade association for the
industry, announced a 14-day testing
period for performers and an education program.
The AIDS Healthcare Foundation
successfully pushed for a law mandating
condom use on set in LA County,
which is now being challenged in court.
Meanwhile, the Foundation continues
to lobby for the law to be extended to
other areas.
Sources: Los Angeles Times, Free
Speech Coalition
continued on next page
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AIDS Walk raises $205,000
for people living with HIV
More than 500 walkers turned out to
show their support for people living
with HIV/AIDS on Sept. 22, and raised
over $205,000.
The annual Scotiabank AIDS Walk for
Life is the largest fundraiser of the year
for Positive Living BC’s Complementary
Health Fund, which helps people living
with HIV afford supplements, vitamins,
and other products and services not
covered by their healthcare plans.
Despite the rainy weather, spirits were
high. Participants took part in the firstever AIDS Walk Shoe Fashion show,
which featured celebrity judges Fiona
Forbes, host of The Rush on Shaw TV,
Kaitlyn Herbst, traffic reporter for the
Global BC Morning News Team, and
Conni Smudge a local drag performer.
The hosts were performer Symore and
Jonny Staub of the Beat 94.5 FM.
Source: Positive Living BC
Reinspire raises $26,000
Positive Living BC’s special event,
Reinspire, was a success with $26,000
raised. Net proceeds went to support
the Society’s Complementary Health
Fund (CHF).
The 62 guests in attendance at the
Sept. 5 event viewed displays of sections
of the NAMES Project – Canadian
Memorial AIDS quilt and the momentous
“One World – One Hope” quilt created
by the late Doreen Rennschmid based on
the work by Joe Average.
Special guests included Average who
explained that his design, which was
commissioned for the International AIDS
Conference in Vancouver in 1996, signifies
the interconnectedness of the world’s
population affected by HIV/AIDS. The
quilt weighs 350 pounds and measures
29 by 32 feet. Also in attendance were
former NAMES Project director, Judy
Weiser, and long-time Positive Living BC
volunteer, May McQueen. Both Weiser
and McQueen created panels that were
shown at the event. The sections of the
NAMES Project displayed were selected
for their local connection.
Source: Positive Living BC
STOP HIV/AIDS
continues rollout
After a successful pilot project in Vancouver
and Prince George, STOP HIV/AIDS
began to be rolled out in the Interior.
The program seeks to reduce the spread
of HIV/AIDS through early detection by
making HIV testing a regular part of
routine medical screenings.
At press time, Merritt was launching
its program to be followed by Vernon
and Trail. The cities were chosen because
they are spread out in all three of
Interior Health’s service areas. Interior
Health says it will take three years to
completely introduce the program at all
of its sites.
Late diagnosis can lead to the
transmission of HIV because, not only
are people less likely to take precautions
if they don’t know their status, but the
use of highly active antiretroviral
therapy (HAART) has been shown to be
effective in reducing transmission in
serodiscordant couples.
Sources: Merritt Herald; BC Centre
for Excellence in HIV/AIDS
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BC-CfE calls for
national strategy
Researchers are calling for a national
strategy to fight HIV/AIDS based on
British Columbia’s Treatment as Prevention strategy.
In an article published in September’s
issue of HIV Medicine, researchers
analyzed Health Canada data from 1995
to 2011 and found that BC saw the
largest decrease in HIV diagnoses during
the time period.
BC’s rate of new infection declined
from 18.05 to 6.49 per 100,000 population.
Ontario, Quebec and the provinces saw
smaller decreases, while Saskatchewan
and Manitoba experienced increases.
Rates were constant in Alberta and
the territories.
“The consistent and sustained
decrease in new HIV diagnoses in
British Columbia reinforces Treatment
as Prevention as a highly effective
approach in the fight against
HIV/AIDS,” said Dr. Julio Montaner,
senior author and director of the BC
Centre for Excellence in HIV/AIDS
(BC-CfE). “The evidence should now
be absolutely clear: Treatment as Prevention
is the best way to achieve an HIV and
AIDS-free generation. It’s time for
Canada’s leaders to emulate the government
of B.C. and adopt this as the national
strategy to stop HIV/AIDS.”
Source: BC Centre for Excellence in
HIV/AIDS 5
Compassionate Canada?
Cuts to refugee health care put Canada’s reputation to shame
By ◆ Romari Undi ◆
any of us living here in Canada may be thankful for the
access to care and support we have, but the disparity
in accessing that care is an unfortunate reality.
While historically, Canada has enjoyed a sense of pride in its
“universal health care,” we must recognize there are many flaws
and exclusions within our system.
One such particular set of exclusions is highlighted by recent
changes to the health care provided to refugees seeking asylum
within our borders.
HIV testing is mandatory for all newcomers. New immigrants
and refugees represent an increasing proportion of people living
with HIV in Canada.
M
New beginnings
One would hope that, after surviving the horrific experiences
refugees and their children have faced, asylum in Canada would be
the beginning of a new life of hope and health. However, years of
trauma have an incredible effect on people, and these cannot
be wiped clean from their embattled spirits upon arrival here.
Landing in a strange new country, already traumatized from years
of war, violence, or famine, they now have the additional fear and
uncertainty caused by the knowledge of their positive HIV status.
They face complex and confusing demands, including a strange new
culture, lifestyle, and food. The stress of settlement, access to
housing, etc., places further demands on their health, which
may be fragile physically, mentally, and emotionally.
On June 30, 2012, the Canadian government implemented new strategies, including cuts to its Interim Federal Health Program (IFHP) that
have further added to newcomers’ sense of fear, anxiety, and confusion.
Depending on the category they fall into (government-assisted
or privately sponsored), refugees have different entitlements to
benefits and service access, and some are without any coverage
for health care. Still others may be entitled to limited medical
coverage. These cuts most dramatically affect those who are
seeking asylum after arriving in Canada (inland refugees).
Limited coverage
While a person may be covered for their antiretroviral drugs, they
may not be covered for medication required to treat a condition
resulting from their HIV illness. In such circumstances, for example,
a person who may need a drug to prevent blindness from a condition caused by HIV is denied coverage for that drug.
P5SITIVE LIVING
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This causes confusion for health care providers about a
patient’s entitlement and causes further anxiety and confusion
to the refugee claimant.
There is also a loss of psychological support services for
refugees who are survivors of torture, rape, and genocide, and
medications that may be needed for those suffering from
trauma and suicidal thoughts.
People fleeing from years of persecution, violence, and
famine are not travelling to North America to take advantage
of our health care system; they are coming here to build a life
for themselves and their children.
Long considered a country of compassion, Canada is not living
up to its reputation with its new immigration policies. In fact, the
latest measures are in addition to the Conservative-led defeat of a bill
that would have made it easier for Canadian generic drug companies
to produce and ship HIV/AIDS drugs to developing countries.
Given compassionate treatment, support, and the medical
help they so desperately need, the resilience of refugees in
Canada is demonstrated time and time again as many go on to
become healthy, strong, vital, and valuable
leaders in our community. 5
Romari Undi is a member of ViVA, a board member
of Positive Living BC, and a volunteer with Vancouver
Island Persons Living with HIV/AIDS Society.
Where to find help
Rainbow Refugee Committee (RRC) A Vancouver-based
community group that supports and advocates with people
seeking refugee protection because of persecution based on
sexual orientation, gender identity, or HIV status.
Visit www.rainbowrefugee.ca or email [email protected].
Mosaic A multilingual non-profit organization dedicated to
addressing issues that affect immigrants and refugees in the
course of their settlement and integration into Canadian society.
Visit www.mosaicbc.com or call 604.254.9626.
Pivot Legal Society Jane Doe Network If you are a woman
who has experienced violence and need legal help, the Jane Doe
Legal Network may be able to provide you with confidential
legal advice. Call 604.255.9700.
drag queen towered
over us at a soirée
fundraiser; no less
impressive than her size
was the impact of the
message she delivered.
We had hoped
for another stop in
Northern Ontario, but
stretched staff in several
places couldn’t reach
out to “one more
thing.” In many small
communities, a handful
of people, or even a
single soul, is trying to
do a small-scale version
Artist Peggy Frank with the “This is Not a Cocktail
of everything a large
Party” sculpture in Victoria.
organization like the
Canadian AIDS Society (CAS) does. “Very few people come to
visit us over here,” we were told more than once. Is it surprising
that silence is what we hear about HIV in much of rural Canada –
a silence that intensifies isolation?
Our Northern Ontario route allowed us an adventure on
Manitoulin Island – fulfillment of a life-long dream for Cathy
and me. This bonus created unique opportunities to discuss
HIV with curious passersby, who were anxious to know more
about the cocktail glass in the blue party truck.
We were blessed with royal treatment across the country. Billets,
meals with friends, and gas and coffee gift cards took us from
Victoria to Fife House in Toronto, where an intimate group watched
the Legal Network’s moving film on the criminalization of nondisclosure. Alarming! Appropriately, the weather changed. After
days of sun, torrential rains and blankets of fog hit the windscreen.
We celebrated a late Mother’s Day dinner in Brockville with
my mom and dad before heading north to the nation’s capital.
In Ottawa, we visited the Canada Science and Technology
Museum because one of the curators had asked to have the
sculpture incorporated into the collection to document medical
research on HIV and AIDS. Back on Parliament Hill, Cathy
dropped me off, then caught a lot of attention as she drove in
spirals in search of parking! I set up shop as close to the hill as
permitted – at the Parliament Pub. Although MPs were busy
passing bills prior to summer closure, their young, interested,
and enthusiastic assistants engaged in conversations about HIV.
Clients and staff at two Montreal venues warmly greeted us
and curiosity about our journey continued to open conversations.
In the Quebec City area, a couple of days’ stay at my sister’s
P5SITIVE LIVING
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place meant time to dry out the truck and contents, which
were sodden after the Highway 401 downpours. I even managed
a presentation, en français, to a wonderful group of friends
who had been following our journey east online. Anger and
tears reflected that our message had been clear.
In New Brunswick, I reconnected with friends from my
pre-infection, graduate student days in Zimbabwe thanks to a
local CBC interview. In Prince Edward Island, we received a
warm reception from the AIDS PEI folk and learned more
about challenges faced in rural Canada.
On day 29, we arrived at our destination, St. Andrews, NB.
When the patron of the sculpture show remarked, “This is the
piece I’ve heard so much about,” I realized that social media
attracts diverse attention, and I reflected on our journey as we
installed my piece. We had dreamed of raising awareness on
our cross-Canada tour, and it felt like we’d succeeded.
To write this tale focusing only on HIV is impossible. Sharing
the country with a dear friend was a big part of this journey.
Cathy drove most of the 8,792 kilometres we put on the dragonflyblue truck we called Babe. Cathy cried listening to stories about
individual struggles; she laughed when things were funny; we sat
together in stunned silence when the unbelievable happened.
Cathy has encouraged me for almost three decades, yet her
repeated remark on this trip surprised me: “I had no idea.”
After 27 years of living positively, my biggest concern is that
too many people live in isolation because of the very politicized
reaction to this disease. If it is “just another manageable disease,”
then treat us as though we have equal status to those who make
the laws in this stunningly beautiful country. Senators could try
living on a disability income!
My greatest inspiration comes from others
who live positively. Thank you, and bless us on
our journeys. 5
Peggy Frank is a Victoria- and Southern Gulf
Islands-based biologist, artist, and activist who
has been living with HIV for much of her adult life.
Read Peggy Frank’s blog at peggyfrank.blogspot.ca or visit the
Facebook page at Cross Canada Cocktail Tour - Toast to Toast.
About ViVA
ViVA is a collectively organized group of HIV-positive women who
strongly believe in respect, equality, the Greater Involvement of
People with HIV/AIDS (GIPA), the Meaningful Involvement of
Women with HIV/AIDS (MIWA), and healthy, empowered lives
for all HIV-positive women. To join or for more information, email
[email protected].
late stage of the disease, when CD4 cell counts are below 350
study will examine whether people using PrEP change the number
cells/mm3, which is when antiretrovirals are less likely to be effective. of partners they have sex with, if they change, how often they
As a result, most AIDS-related deaths in the UK occur because of use condoms, and whether PrEP leads to higher rates of other
late diagnosis.
sexually transmitted infections. This two-year study, started in
Public knowledge of HIV and AIDS is declining in the UK.
November 2012, aims to recruit 500 participants.
Fewer people in the UK understand that HIV can be transmitted
Even in the UK, people living with HIV still experience
by heterosexual sex and, as a result, the number of people infected persistently high levels of stigma and discrimination and are more
through sexual transmission in the UK is rising. Between 2002
likely to struggle and live in poverty. A recent survey revealed
and 2011, new HIV diagnoses
that one in three people living with
One of the biggest challenges HIV said they had experienced
almost doubled among the over
50 age group. As well, new
in the UK is shared with Canada: discrimination based on their HIV
HIV diagnoses among MSM
up to a quarter of people living status. In response, the UK is the
in the UK have been on the
with the virus don’t know it. first country in Europe to undertake
rise since 2007, and in 2011
a full rollout of the People Living
reached an all-time high of 3,010 new infections in this population. with HIV Stigma Index initiative. The index aims to increase the
understanding of how stigma and discrimination is experienced
The economic struggles in the European Union are impacting
by people living with HIV and then use the evidence gained to
HIV/AIDS services in the UK. In 2011, HIV organizations in
London (where most of the epidemic is centred) were hit with a 20 shape future programmatic interventions and policy changes.
These include improving workplace policies, informing debates
percent reduction in their funding for prevention services. The
about the criminalisation of HIV transmission, and promoting
UK’s national strategy for HIV and sexual health came to an end
in 2010, and a new strategy to address problems and make progress the realization of human rights.
in responding to the HIV epidemic has not yet been created.
Finally, despite the European financial crisis, the UK is leading the way by committing 0.7 percent of its national income in
2013 to international development. These funds are focused on
Looking forward
Africa, and will help reduce new HIV infections, especially in
The UK recognizes the importance of testing in reducing
children; strengthen human rights and fight stigma; address TB;
transmission and in 2010, an estimated 2.1 million HIV tests
were performed. The National Health Service is trying to expand and fund scientific research. The UK will be the first member of
the G8 and the sixth country to meet or exceed the 0.7 percent
testing outside the clinical setting, by working with community
target, joining only Denmark, Luxembourg, the
organizations to develop local strategies and rapid HIV tests.
Netherlands, Norway, and Sweden. 5
Evidence-based and culturally appropriate testing and prevention
campaigns target MSM and African communities. These prevention
campaigns are supported by parallel activities to reduce HIVassociated stigma and discrimination in these groups.
The UK is piloting an innovative Pre-Exposure Prophylaxis
Chrystal Palaty is a Vancouver-based technical
writer who translates science into English.
(PrEP) trial to prevent HIV transmission among MSM. The
“
There are many different ways to get involved!
Volunteer
@
1) Volunteer weekly helping out with our many programs
& services (Mon-Fri)
2) Volunteer at special events, AccolAIDS Gala,
Pride Parade, AIDS Walk for Life
3) Volunteer on projects, in meetings or with Positive
Living Magazine
POSITIVE LIVING BC
To find out about all volunteer opportunities, contact Marc > 604.893.2298 or [email protected]
P5SITIVE LIVING
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Cuckoo
for coconut
Do the health claims hold water?
By ◆ Jenn Messina ◆
ou’ve probably noticed a new canned beverage at the
grocery store lately and heard some buzz around
coconut water. With sales skyrocketing worldwide, you’re
probably asking: What’s all the hype about coconut water?
Coconut water is the clear juice inside a young, green coconut
and is a common drink in Southeast Asia, Africa, and the Caribbean.
One coconut can produce two to four cups of coconut water. In the
United States and Europe, canned or packaged coconut water outsells
milk in some convenience stores and is often promoted as a healthy
and natural source of electrolytes for rehydration. Other health claims
include lowering blood pressure, boosting metabolism, aiding
in weight loss, and containing anti-aging properties. It sounds like
a miracle drink, but let’s check out the real deal with these claims.
Y
Coconut water and exercise:
Coconut water can be used to replace water lost during endurance
exercise as a natural alternative to sports drinks as it has some
nutrients like sodium, magnesium, and potassium, which help
maintain water balance in the body. It also has natural sugars,
as well as small amounts of other vitamins and minerals. However,
for the average gym go-er or active person who drinks water and
eats a healthy diet throughout the day, it may be of minimal benefit.
Coconut water isn’t more hydrating than water. Recent studies
done on athletes found little difference in hydration or exercise
performance when coconut water and sports drinks replaced water.
Coconut water and anti-aging properties:
While being adequately hydrated does help to make you
look and feel better, as mentioned earlier, coconut water
is no more hydrating than water. No research to date has
shown a beneficial effect of coconut water on human
cell growth.
Bottom line:
Though it may be one of the latest health booms, coconut
water is not necessary for a healthy diet and can be expensive.
The vitamins and minerals in coconut water can be found in
larger amounts in foods such as fruits and vegetables. Eating a
variety of foods is always the best way to get all the nutrition
you need! Drink regular water to quench your thirst! Aim for
eight to 12 cups of liquid every day. If you want to buy
coconut water, look for those that are 100 percent natural and
without added sugars or sodium. 5
Jenn Messina is a registered dietitian who
works with people living with HIV in the
Immunodeficiency Clinic, with inpatients at St.
Paul’s Hospital, and in an addictions clinic in the
downtown eastside of Vancouver.
Mix it up
While it is true that potassium can lower blood pressure, our body
cannot distinguish the potassium in coconut water from that in other
food sources, like bananas, tomatoes, oranges, or potatoes. Coconut
water can also increase potassium to dangerously high levels for
some people, such as those with kidney problems, so make sure
you discuss this with your doctor first before drinking large quantities.
Coconut water can lower fat when used in cooking and
added to soups and sauces instead of using coconut milk or
cream. It is also a low-sodium option for increasing the
flavour of your meals.
Add this fresh, tropical flavour to your food in a variety of ways:
◗ Freeze some in an ice cube tray, then add to your
favourite drinks for a hint of cool coconut
Coconut water and weight loss:
◗
Add coconut water to smoothies in place of other juices
◗
Use plain coconut water in place of regular water when
cooking rice or oatmeal to create a sweet, nutty flavour
◗
For a tropical twist on a dessert recipes, add coconut
water in place of other juices
Coconut water and health:
Any food or drink will temporarily increase the body’s metabolism as it takes energy to break it down. However, no food or
drink can permanently boost metabolism to help with weight
loss. One tried and true method to increase your metabolism is
with regular exercise! So if you want to lose weight and keep it
off, enjoy a well-balanced diet and regular physical activity.
P5SITIVE LIVING
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Acting up
Take part in
World AIDS Day
By ◆ Rheanna Chisholm ◆
orld AIDS Day, Dec. 1, is a time for action and
ref lection on the epidemic of HIV/AIDS. The
Canadian AIDS Society has chosen “Do
Something” as this year’s theme, recognizing that knowledge
is power and awareness of HIV will ultimately lead to its
eradication. World AIDS Day is a time to remember those
who were taken by the disease, celebrate the continuing
progress of new medications and treatments, and close the
chapter on decades of tragedy caused by a powerful virus.
Becoming the first-ever global health day, World AIDS Day
was started in 1988 and continues to recognize the 34 million
people in the world who suffer from HIV. Since the first World
AIDS Day, much more is known about the disease and better
treatments and protection opportunities are available. This
does not, however, mean the work is done. The fact that new
victims of HIV are diagnosed every day is enough proof that we,
as a society, need to do more: act, teach, inspire – do something.
This World AIDS Day is the perfect opportunity to let yourself
be heard. Whether you live with HIV, know someone who does,
or just know a thing or two about the pandemic, challenge
yourself to make a difference. If you do not know a thing or
two, find out more. Ask your peers or find ideas on the web;
do whatever you can to get people talking about HIV.
Small actions speak loud, but countless small actions speak
louder. No matter what day of the year it is, simple, courageous
acts can help in the battle against HIV. Display your efforts
through a YouTube video explaining the effects and challenges of
HIV. Make a Facebook status or tweet relating to HIV facts. Wear
a red ribbon, the international symbol for HIV, and take the time
to tell people what it stands for. Hold a bake sale and donate
your profit to the Global Fund to Fight AIDS. Come up with
other fundraisers to hold at your local school or work. Whatever
you do, do it with pride in knowing that you are part of the cure.
W
P5SITIVE LIVING
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Without the courageous acts of others, the cure for HIV
would be a lot farther away. Reflecting on the honourable
achievements of others to end this disease is an inspiring way to
develop ideas for making your own mark. For women, a huge
milestone in history was the formation of the International
Community of Women living with AIDS founded in 1992. In
1994, scientists developed a way to reduce the risk of motherto-child HIV transmission, allowing people with HIV to have
their own healthy family. In 1995, highly active antiretroviral
therapy (HAART) was approved for use in the United States. In
2007, 31 percent of people living in low- to middle-income
countries who needed treatment received it. Simple acts from
numerous people turn into world history. Together, we can
stop the transmission of HIV and find a cure.
This Dec. 1, or any day for that matter, remember those who
have fought before you, act with those are currently fighting,
and support future activists. Recognize how far we have come
to conquer this disease, but remember to keep fighting until its
eradication. This World AIDS Day, pass on your knowledge of
HIV and inspire them to fight along with you.
What will you do? 5
Rheanna Chisholm is a second-year community
studies student at Cape Breton University.
Resources
www.worldaidscampaign.org/world-aids-day/history-ofworld-aids-day/
www.worldaidsday.org
www.cdnaids.ca/wad
night all I could do was curl up on my bed in a fetal position overcome
by the full horror of what might be, the specter of this silent killer
possibly attacking me while I lay there. I knew I was “at risk” given my
sexual activities. One of the men I was dating had swollen glands, a
symptom associated with HIV disease. Years later, I realized that a bout
of weird flu I had during this time was my body reacting to being
infected by HIV; it was a visitation from the Ghost of HIV Past.
The HIV test became available in 1985 and with it came a host of
issues to weigh up. Reports of people being rejected, fired, and evicted
on the mere suspicion that they had HIV were already circulating. The
fear of being outed, not only as gay but as someone infected with HIV,
was huge. My belief that knowledge is power motivated me to go to the
clinic offering the test.
The virus was silently circulating It was a cold, dark,
and wreacking havoc on the rainy evening when my
immune systems of so many world changed forever.
of the wonderful, dynamic, The person in the white
vibrant people I was meeting. lab coat sitting across
from me delivered the
verdict in a clinical, dispassionate manner; I had tested positive, and it
was unknown what the result indicated in terms of my long-term future
health. All I could think was, “I have it and it is going to kill me.” My
rising panic about my own mortality shifted when I thought of the
woman I was living with: “Please, not her too!” Fortunately, I was spared
the anguish of infecting a person I loved.
“
The Ghost of HIV Present
One of the first articles ever written in a major
newspaper about what was to become the
HIV/AIDS epidemic appeared in the New York
Times on Aug. 29, 1981.
Testing positive pushed me off the sexuality fence I was straddling, and
I landed with both feet into the gay life. My circle of gay friends
expanded as I embraced my homosexuality. It was a circle that started
to diminish as quickly as it had grown. The virus was silently circulating
and wreacking havoc on the immune systems of so many of the wonderful, dynamic, vibrant people I was meeting. Friends and acquaintances
would seem fine and then suddenly sicken and die. Others were coping
with disfiguring and debilitating infections: purple lesions on their skin
from Kaposi’s sarcoma, loss of sight from cytomegalovirus, chronic
diarrhea, and wasting, mouths and throats so sore from thrush that it
was impossibly painful to chew or swallow anything. AIDS-related
dementia was another destroyer. I would pass familiar faces on the street
but their expressions and behaviours were those of someone moving in
another world seen only by them.
Knowing I was infected with HIV presented challenges when it came
to meeting people and dating. I was cautious about who I told and
when. Over the next few years I was lucky enough to meet people who
were in the main not terrified by HIV, people who didn’t run in the
opposite direction when the topic came up. A few actually felt comfortable
enough to start dating and to find out how compatible we were or
weren’t. It was during this time that I met a man who would become
my life partner and, when the laws allowed, my husband. We forged a
life together, creating our shared world and choosing to live in the present
with hope for our future. We both had tested positive and together
faced the challenges of living with HIV.
As treatments were explored, many of us were offering ourselves up
as guinea pigs in drug trials in the hope we would help find a cure and
P5SITIVE LIVING
17
continued next page
survive. Our hopes were repeatedly and brutally dashed; the
silver bullet that would stop this disease was yet to be cast. By
1995, I was still kicking after ten years of living with HIV, but
not anywhere near as high. My immune system was badly
weakened and recurring opportunistic infections increasingly
compromised my quality of life. I had stopped working in
1993, unable to cope with the physical, mental, and emotional
demands of my career. I experienced a period of HIV-related
dementia, a time I refer to as my Cosmic Adventure. It was a
hard landing when I returned to earth after that journey, but at
least I returned.
dramatic, unpleasant health events as my immune system
rebounded. More drugs were required to battle latent opportunistic infections. At one point in time I was taking up to 30
pills three times a day to fight a plague of infection. As tough
as it was at the time, the drugs were working and I was returning
to the world of the actively living, albeit somewhat altered in
appearance by drugs that caused lipodystrophy.
Over time, new classes of drugs and improvements in earlier
drugs have made ARV regimens easier to adhere to and more
tolerable. I now take just a few pills twice a day, which fits in
nicely with my routine. I rarely miss doses and my blood work
is comparable to, if not better than, that of many people who
are not living with HIV. My viral load has been undetectable
for years now. My current health issues are primarily related to
the natural processes of aging, although possibly aggravated by
HIV and ARVs. Not that I’m in the clear, for the Ghost of
HIV Present still hovers next to me. Were I to stop taking my
medications, my HIV would rebound with a vengeance and
once again I would be engaged in a battle for my life, a battle
that I would still lose.
The Ghost of HIV Future
Michael Connidis at Positive Living BC’s Reinspire event on Sept. 5, 2013.
An omnipresent sense that something sinister was going to
take me down, grab me like the boogey man from under the
stairs, haunted me. I felt my life light dimming as the dark
cloud of the virus moved across the landscape of my body. Yet
my appreciation for the gift of life intensified and my attention
to what was important became more focused; my time to be with
the people I loved and cared for and who shared their love and
care for me was limited. My family and friends became all the
more dear to me, being alive that much more precious.
In 1996, the triple cocktail bullet of Anti-Retroviral Therapy
(ARV) that could shoot down HIV was announced at the
International AIDS Society conference in Vancouver. The
drugs were harsh, and some I simply couldn’t tolerate.
Debilitating side effects, like diarrhea, vomiting, and fatigue,
were in some respects worse than what I had been experiencing
before treatment. The long-term effects of the drugs were
unknown. Still, against the approaching certainty of death from
HIV disease, I was prepared to do my utmost to manage and
make the most of this visitation by the Ghost of HIV Present.
Coming back to life like the biblical Lazarus rising from the
dead, fighting back from the diminishment of years of active
HIV infection has been a slow process. I experienced some
P5SITIVE LIVING
18
It has been over 30 years since I became aware of HIV and 28
years that I’ve known I am living with HIV in my body. What I
thought was going to be a shorter-than-expected life has been
much longer and fuller than I could ever have dreamed it to be
that fateful day when I tested positive. I look forward to a
future shared with my husband, family, and friends with a
healthy appreciation for our individual “natural” mortality,
valuing the time we have together.
I continue to live with this virus that has incorporated itself
into the genes of my cells; it is not just in me but a part of me.
I have my own unique population of HIV and I am utterly
selfish about it and do not intend to share it with anyone else.
I await a visitation from the Ghost of HIV Future that will
show me a time when HIV is no longer a part of me, no longer
a plague upon this world. I look forward to HIV being but a
memory I will recall as I would a dream that was sometimes a
nightmare, but that I have at last awoken from. 5
Michael Connidis is still writing and able to
contribute articles to Positive Living Magazine
thanks to the top-notch ARV treatment, medical
health care, and support services like PLBC that
are available in Vancouver.
Class in session
Why we need different combinations of meds to fight HIV
By ◆ R Paul Kerston ◆
you find yourself in a room with a small, wounded (but
here, let’s say, not dangerous) animal that needs medical
attention, approaching the animal may be necessary, but if
there are, say, two doors and a window the animal might
escape the room through, you’d be wise to seal those exits
before tackling the animal. Depending upon how small the
animal is and its mode of travel (say, a hamster versus a bird)
there may even be other ways the animal can escape your
attempts to deal with it in that room. If it escapes the room,
you may need to try and find it in another room and repeat
the process, and it also may have learned how better to defend
itself from its first encounter with you!
Treating HIV is not entirely dissimilar: The human immunodeficiency virus must be approached to be dealt with, and it
can “escape” our efforts by taking over our own human cells
and, once inside there, multiply or replicate itself – then leave
the room (or cell) and find other rooms (or cells) to continue
its process. If we don’t stop it from escaping that human cell,
or from even getting into that cell in the first place, it can
continue to do whatever it wants as long as the host – as long
as we – are alive. And if, accidentally, we let the virus escape
via lowered levels of the medications that work, we must repeat
the process… and our original methods/medications may no
longer work.
If
Sealing off the escape routes
To understand how any medication works is to comprehend a
very complex matter. But in its simplest terms, medications
cause chemical interactions and changes, the end result of
which can make things happen or make things stop happening.
In the case of antiretroviral medications used to treat HIV, the
proper use of medications causes the virus to be unable to
replicate itself in order to continue its existence. The way the
meds do this is by individually sealing off several avenues
the virus needs to use in order to do that. This can include
stopping the HIV from going into the human cell it seeks or
from exiting that human cell once its process inside is complete,
and there are many intermediate steps involved that now can
be stopped by different groups – or classes – of medications.
The thing about HIV, though, is that while it’s such a small
entity – “only” a virus – it’s enormously resourceful: It can
adapt, as with most creatures, and that adaptation makes it like
a hamster that can find a small hole and burrow, making you
think it’s left the room… but it’s only hiding.
We’ve been successful in preventing HIV from multiplying
itself by finding several places – and the fact of its being
P5SITIVE LIVING
20
several places is important – in order to stop the viral replication
process. Over roughly a decade of discovery, we found that if
we only attack one step in what we know HIV must do in
order to get into the human cell and multiply itself, then HIV
can find other ways to get in, do its damage, and then escape
our cells and produce more of itself in our bloodstream. Each
time that happens – and it can occur millions of times in a day
– the level of virus in the blood (called the viral load) climbs
higher. The higher the viral load, the more dangerous the
situation because, eventually, our bodies can no longer deal
with the situation, and we lose our ability to reproduce our
own human immune cells – which HIV targets – fast enough to
overcome the damage that HIV is doing. That’s when we lose
the fight if we are not properly treated.
HIV needs to attach to our cells first, and we presently
know of two attachment points and have a medication to help
stop the replication process via one such attachment. Maraviroc is an attachment inhibitor that prevents the virus from
connecting with the CCR5 receptor located on our own CD4
cells – CD4 cells being the target of HIV and its replication
cycle. HIV also needs to get inside certain parts of our CD4
cell to finish its replication and we have medications to stop
these processes, including a fusion inhibitor (T-20) that prevents
one part of insertion into our cells, as well as raltegravir and
other integrase inhibitors that do similar things at different
parts of the process of the virus getting inside our cells.
“
In the case of antiretroviral
medications used to treat HIV,
the proper use of medications
causes the virus to be unable
to replicate itself in order to
continue its existence.
Lost in translation
HIV needs to convert its form of building blocks (called singlestranded RNA) into the human building blocks (called doublestranded DNA) and this is like somebody speaking Russian to
somebody speaking Portuguese. The Russian needs a translator
when starting the conversation. That’s why we have medications
such as AZT, 3TC, FTC, abacavir, tenofovir – and other meds
called nucleoside reverse transcriptase inhibitors (NRTIs).
Reverse transcriptase is an enzyme that HIV brings with it and
which helps it translate what it wants into what our cells can
Truth and reconciliation
First Nations HIV epidemic is a legacy of Canadian history
By ◆ Paul Goyan ◆
Truth and Reconciliation Commission of
Canada has now concluded its hearings into
the history and legacy of Indian residential schools in
Canada. A number of large Truth and Reconciliation
marches have taken place. Chief Commissioner Justice
Murray Sinclair is busy working on the f inal report. How
does the truth and reconciliation process f it within our
understanding of the HIV/AIDS epidemic as it has affected
First Nations peoples, especially in British Columbia? The
great harm caused by church-run residential schools for
more than a century is but one thread in a tapestry of
pain and suffering that tells the story of how the colonization and assimilation of First Nations, Métis, and Inuit
peoples is linked to the near obliteration and cultural
genocide of our land’s f irst inhabitants.
The impacts of the colonizers can be seen in the health
outcomes of the indigenous peoples. HIV/AIDS is a
current example of how First Nations peoples experience
inferior health outcomes, in large part ref lected in the
social determinants of health. Fifteen years ago, the Royal
Commission on Aboriginal Peoples carefully investigated
the historical record of Canada and its relationship with
First Nations peoples. In its f inal report, the Commission
minced no words, summarizing its f indings in a single
sentence: “There can be no peace or harmony unless there
is justice.” Since that time, much of government efforts
have been consumed by land treaty negotiations and the
burgeoning awareness of the harm caused by the Indian
residential school policy which captured the government’s
two main objectives regarding First Nations peoples:
assimilation and cultural genocide.
The
The History and Impact of Indian
Residential Schools
Ambivalence is defined as “the state of having simultaneous,
conf licting feelings toward a person or thing.” It describes
how many Aboriginal and non-Aboriginal Canadians feel
about each other. The impact of this countr y’s long
history of Indian residential schools can also be seen in
the dynamics of the HIV/AIDS epidemic among the First
Nations, Métis, and Inuit peoples. Multiple generations
of Aboriginal children and youth were removed from
their families and communities as part of a governmentP5SITIVE LIVING
24
sanctioned policy of forced assimilation through cultural
genocide. “These schools rearranged and eroded our
traditional ways of life, and our entire family structure for
generations. They left a legacy of unresolved grief, trauma,
and loss on many levels. People try to cope with that pain
by turning to drugs, alcohol, and abuse,” Cathy Baylis, the
daughter of a residential school survivor, told the Tyee
website in 2004.
Sinclair writes in the interim report that: “All Canadians
should be made aware of the sorry chapter in their country’s history.” He goes on to conclude that, “Canadians
have been denied a full and proper education as to the
nature of Aboriginal societies, and the history of the relationship between Aboriginal and non-Aboriginal peoples.”
Telling the truth about the forced assimilation and
cultural genocide which resulted, in large part, from the
Indian residential school system comprises the f irst step
toward reconciliation. More than 150,000 First Nations,
Métis, and Inuit students attended residential schools
between 1840 and 1996. There are 35,000 present-day
sur vivors living in British Columbia, the largest number
of any province or territory. The residential schools constituted
an immediate and ongoing assault on Aboriginal children
and families, Aboriginal culture, and “self-governing and
self-sustaining Aboriginal nations.”
Pathways to Health and Healing
The continuing impact of colonization, the government’s
assimilation policy, and the legacy of the residential school
system is evident when considering the comparative
performance of Aboriginals in relation to non-Aboriginal
populations with respect to the social determinants of
health, as follows:
◗ Poverty, income, and social status
◗ Educational attainment, unemployment and parental incomes
◗ Quality of overall health
◗ Addictions and mental health
◗ Homelessness and housing quality
◗ Food security, safety, and nutrition
◗ Infant mortality and healthy child development
◗ Prevalence of chronic diseases, quality of seniors’ health,
and life expectancy
◗ Violence, family violence, and suicide
The inter-generational effects of abuse and family fragmentation found among Aboriginal families and communities
can largely be attributed to the history of residential
schools and colonization. Increasing rates of HIV, HCV,
and HIV/HCV co-infection are the result of complex effects
of addictions, social dislocation, discrimination, and
poverty. AIDS service organizations recognize the importance
of “culture as intervention,” stressing the need for more
community-based addiction programs while incorporating
indigenous values and healing strategies. Many First
Nations people living with HIV have diff iculty obtaining
access to basic, specialist and community-based healthcare,
addictions and mental health services, and culturally-sensitive
HIV prevention education.
In 2007, the Provincial Health Off icer released his
annual report, “Pathways to Health and Healing,” which
focused on the health and well-being of BC’s First Nations
people. First the good news: There have been some
improvements in overall health status and outcomes for
individuals of First Nations ancestry in the province.
Mortality is decreasing while life expectancy is increasing.
Even so, the First Nations’ mortality rate remains two-tofour times higher than that of the general population. The
Provincial Health Off icer has also expressed concerns about
“the widening gap between Status Indians and other residents
for HIV/AIDS disease, which is ref lective of increased
vulnerability and the lack of proper access to Highly Active
Antiretroviral Therapy (HAART).”
“
Telling the truth about the
forced assimilation and
cultural genocide which
resulted, in large part, from
the Indian residential school
system comprises the first
step toward reconciliation.
Success in curbing the raging injection drug use (IDU)
epidemic in Vancouver’s Downtown Eastside through
harm reduction programs such as the Insite clinic and the
implementation of “Treatment as Prevention” (TasP) both
reduced community viral load and dramatically decreased the
number of new HIV diagnoses. This leading-edge research on
TasP is of great interest to global partners in the fight against
HIV/AIDS. The high percentage of persons living with HIV
who identify as First Nations in BC have also benefited from
these successes.
The “seek and treat” model employed by the STOP
HIV/AIDS project under the auspices of Vancouver Coastal
Health and the BC Centre for Excellence in HIV/AIDS has
been implemented under “real world” conditions in Vancouver
and Prince George. Provincial funding for STOP HIV/AIDS
has now been extended to all provincial health authorities.
Unfortunately, the same success has not been experienced
in many other jurisdictions, most notably in Saskatchewan
where the number of new HIV diagnoses reported has
quadrupled over the past several years, in particular among
the growing Aboriginal IDU population.
continued next page
P5SITIVE LIVING
25
Social science research into groups such as at-risk youth
who use illicit drugs has discovered strong connections
between drug and alcohol addiction and early childhood
experiences. For example, the Cedar Project conducted by St.
Paul’s Hospital, the University of British Columbia (UBC),
Carrier Sekani Family Services, Positive Living North, and
other organizations between 1998 and 2005, determined that
almost 60 percent of all prevalent HIV infections among
Aboriginal people resulted from injection drug use. Onethird of those infected were under the age of 30.
The Cedar Project investigated HIV infection in over 500
Aboriginal people (ages 15 – 34) who had recently smoked or
injected illicit drugs (i.e., crystal meth, crack, cocaine, and
heroin) in Vancouver’s Dowtown Eastside (DTES) and Prince
George between October 2003 and April 2005. HIV prevalence was much higher in Vancouver (17 percent) than in
Prince George (7 percent); whereas hepatitis C prevalence
was higher in Prince George (62 percent) than Vancouver (57
percent).
The groups in both location shared numerous similarities
in early life experiences. Almost two-thirds had been taken
from their biological parents when they were four or f ive
years old. Almost half had been forced to have sex and/or
had been molested by age six (70 percent of the females
versus 25 percent of the males). Slightly under 40 percent
of participants had attempted suicide. Between 35-40 percent
of participants were involved in survival sex work, beginning
at age 16. The participating youth had experienced high
rates of incarceration, although the rate was somewhat
higher in Vancouver (72 percent) than in Prince George
(60 percent). The median age at f irst incarceration was
between the ages of 15 and 16. These weren’t “bad kids,”
but unfortunate victims.
Crime and Punishment or Harm Reduction
and Healing?
The Harper government’s ‘war-on-drugs’ mentality infuses
the 2007 National Anti-Drug Strategy. The vast majority of
funds are allocated to law enforcement, although the policy
framework also includes prevention and treatment. Harm
reduction is the missing fourth pillar, despite overwhelming
scientif ic evidence that it keeps people alive until they are
able to enter treatment. Unsurprisingly, the strategy is cool
towards condoms, silent on clean needle distribution, and
actively opposed to safe injection sites. Vancouver’s Insite
clinic remains open only because the government was
so directed by the Supreme Court of Canada. It is worth
noting that one study published in 2008 estimates that
Insite’s operation will avert 1,191 new cases of HIV
infection over a ten-year period.
The incarceration rate of Aboriginal people is a national
disgrace, especially in the western provinces and northern
P5SITIVE LIVING
26
territories. For example, Aboriginal offenders in Ontario make
up only eight percent of incarcerated males and 13 percent of
incarcerated females. In Saskatchewan, Aboriginals make up
77 percent of incarcerated males and 90 percent of incarcerated
females. British Columbia also has a high rate of incarceration
(about 21 percent), although it is much better than that found
in the three Prairie provinces. Aboriginal adults make up 22
percent of prison admissions in Canada, despite comprising
only 3.6 percent of the Canadian population (2007/08). Onethird of incarcerated females are Aboriginal.
In 2009, Michelle Mann was commissioned by the Off ice
of the Correctional Investigator to produce an independent
report on Aboriginal offenders. She determined that the
high rate of incarceration among Aboriginal offenders is
primarily the result of the former residential school system,
although poverty, social exclusion, substance abuse, and
discrimination are contributing factors.
The rate of HIV infection among prison inmates is
seven-to-ten times higher and the rate of Hepatitis C infection
is 30-to-40 times higher than the Canadian average. Nevertheless, inmates are denied access to life-saving harm reduction
tools which are readily available in the community. In
February 2010, the Truth in Sentencing Act was proclaimed
as part of the Harper government’s “get-tough-on-crime”
agenda. The rate of incarceration among Aboriginal Canadians
is nine times the Canadian average, a clear indication
that Aboriginals will be impacted disproportionately by
these measures.
A New Beginning?
The current approach by the Harper government is incompatible
with the “truth and reconciliation” process. Canadians
need to understand the truth of our colonial past and the
terrible injustices suffered by First Nations, Métis, and Inuit
peoples. Regardless of what Harper may wish, harm reduction
is an essential part of any comprehensive solution. Similarly,
the war against HIV/AIDS cannot be won without addressing
the socio-economic and cultural determinants of health.
First Nations peoples, in particular those who are most
marginalized, such as women, children, youth, and elders,
have been forced to carry a disproportionate share of the
burden imposed by the HIV/AIDS epidemic. Aboriginal and
non-Aboriginal Canadians need to join together in solidarity
to f ight for a better future. In reality, the tr uth and
reconciliation process is not at an end. But at least it holds
out the promise of a new beginning to those who are willing
to listen and act. 5
Paul Goyan is the past treasurer of the board
of Positive Living BC.

liv poz mag.qxd - Positive Living BC

Transcription

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