Deadly Record: Inside Saskatchewan's HIV crisis
Something as simple as the common cold could kill Lauren Cardinal.
A friend of hers died because he refused to see a doctor and get an abscessed tooth removed.In Saskatchewan, this is her reality as one of the nearly 1,500 people who’ve been diagnosed with HIV in the province in the last decade. “I think some people don’t hear about AIDS and some people just don’t want to know,” Cardinal said, sitting on the couch inside a small room that serves as Prince Albert’s only drop-in centre focused on HIV/AIDS.Experts say Saskatchewan is one of the few places in the industrialized world where people are still dying from AIDS and HIV infections.
This province’s rate of new HIV cases is twice the national average. In the last decade, more than 200 people have died while living with HIV. The crisis is hitting First Nations communities and people hardest. Aboriginal people represented 71 per cent of new diagnoses in 2014, according to the provincial government.“We are a first-world country with third-world rates,” said Katelyn Roberts, the director of Sanctum, Saskatchewan’s first AIDS hospice. Roberts and others like her are speaking out, saying this province needs a new and effective approach to treating a growing epidemic.“I think people need to wake up and realize we are the HIV hot spot for North America,” said Jason Mercredi of AIDS Saskatoon.Cardinal is one face of the growing epidemic.
The 32-year-old mother of two is outgoing and funny. Sitting in the Gate drop-in centre, she knows almost everyone who walks by. They come to the drop-in centre where she works every day, for a quick meal or some coffee. Many of them are also HIV-positive, but unlike her, they are shy or unwilling to talk about their illness. She says her biggest mistake was trusting someone too much. Seven years ago, she was an addict living on the streets, using cocaine and opiates regularly.“I was using — just basically doing what people out there are doing,” she said, pointing out the drop-in centre’s door to P.A’s streets. “Trying to survive every day, day to day.”She says she tried to be safe and didn’t share needles with strangers. Her boyfriend at the time, however, was not so careful. After contracting HIV from someone else, he gave it to her.
“He wasn’t as safe and cautious as I was, and I was a little too trusting,” she says.For the past seven years, she’s lived with HIV. Every day she takes medication that helps control the disease. Sometimes is makes her nauseous and dizzy, but like millions of people worldwide, she lives with HIV and manages it, thanks to advances in drugs and treatment. Others in Saskatchewan have not been so lucky. She has personally known at least 15 people who have died after contracting HIV/AIDS. Two of her brothers are infected. Countless friends and acquaintances live every day with HIV.
In 2015, the number of new HIV cases rose to 160 — 48 more than the year before.Between 2005 and 2014, 1,458 people were officially diagnosed with HIV, according to the province. At least 203 of them died, 44 within a year of diagnosis. It’s not clear, however, that all 203 people died because of AIDS or HIV infection.While many parts of the world have taken an aggressive stance against the spread of HIV — rigorous testing and treatment has led to steady declines in most parts of Canada in the last two decades — Saskatchewan continues to see an increase. The AIDS hospice in Saskatoon just opened, while others across the country are closing or transitioning their services.Two people have come to die in Sanctum’s palliative beds since it opened last year, according to Roberts, but there may be many more who simply don’t get help. “It’s appalling. I think it’s appalling that we live in a first world country where people are dying of a chronic illness, that shouldn’t be dying from this,” she says. Most of her clients are under the age of 45. Unlike other chronic and fatal diseases, HIV infections are often hidden, affecting marginalized people who already have a mistrust of the health care system and government. “You don’t see people dying in back alleys of cancer,” she says.
Saskatchewan was thrust into the spotlight this summer, when doctors from across the world met in South Africa for an annual AIDS conference. Saskatchewan, the conference heard, has HIV rates among indigenous people comparable to or above many developing countries.“It’s a socio-economic disease. It will affect where you don’t have good health care and medical coverage,” says Saskatoon Tribal Council Chief Felix Thomas.STC runs a busy harm reduction clinic in Saskatoon’s inner city. Thomas says his staff see a client every three or four minutes. He says people come to STC’s clinic because the staff there are non-judgmental about addictions or HIV status.“We don’t attach a stigma to them. We know HIV is colour blind. It doesn’t matter what race you are,” he said.Mary Bear knows the statistics and the fear of HIV all too well. The 33-year-old mother contracted the disease while living on the streets of Saskatoon seven years ago. She was an addict, using cocaine and morphine when she contracted HIV from her then-boyfriend.
“I knew it was out there … but I wasn’t educated. I didn’t know the repercussions. In a way I didn’t care. I didn’t love myself,” she said, sitting in her back yard, her son Kyle playing nearby.She says she was high when she received her diagnosis and it wasn’t until she began receiving treatment for drug addiction that the reality set in.Since those days, she’s moved to Prince Albert and has received help with her addictions and HIV. Her doctor is based in Toronto, but she has her personal cellphone and can call or text with any questions. She met her husband, who is also HIV positive, and she now speaks regularly and openly about her experiences.He son, who will turn three next month, was born without HIV — something she says she is grateful for every day.Living with HIV and being open about it isn’t easy.“When I go speak to people, I can pinpoint the people who are disgusted by me. Like, put yourself in that position. It hurts,” she says.
She knows people — mostly other aboriginal people — who won’t go to the hospital or see a doctor because they fear the stigma attached to drug addiction and HIV. That fear of coming out as positive is a contributing factor to her community’s increasing rates, she says.She takes her medication before bed and often wakes up nauseous. Aside from that, she lives a relatively normal life thanks to advances in medication and treatment. On a sunny afternoon, she and her husband John play with Kyle around their house. They are in the middle of house training a new puppy.
“In the beginning, it was hard, but now that I have been living with it for seven years it’s become a normal day to day thing,” she said.Provincial officials have said part of the reason why the rates are climbing is because more extensive testing is now done in certain communities.People like Chief Thomas, however, believe more needs to be done and that the province needs to step up.“The buck does stop with the health ministry,” Thomas said. Saskatchewan has been without an official HIV/AIDS strategy since 2014, and aggressive anti-HIV strategies like those proposed by the United Nations have not been adopted.Mercredi, sitting in his AIDS Saskatoon office hours before it becomes a bustling place, says it’s about more than the provincial government, it’s about changing attitudes toward harm reduction strategies like needle exchanges and even safe-injection sites.“Harm reduction is the only way to go with people who are marginalized,” he said.Cardinal, who got her diagnosis in prison while serving time for robbery, says far too many people who are especially vulnerable to contracting HIV — addicts on the street with little or no support system — feel left out of mainstream society. That sense of isolation is only amplified when they are HIV positive.“A lot of people are afraid to disclose because they are afraid to be judged, afraid they will be shunned from their community or their family,” she said.That kind of judgment is wrapped up in the fact that the majority of new HIV cases are IV drug users.
Published: September 16th, 2016
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