Reflections on World AIDS Day and Indigenous AIDS Awareness Week

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Each year, December 1 marks World AIDS Day, as well as the start of Indigenous AIDS Awareness Week, a time to honor those who have lost to the disease and raise awareness of the inequalities that still have a profound impact on the fight against HIV/AIDS 40 years after the virus was discovered. Photo by the US National Institute of Allergy and Infectious Diseases (NIAID).

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 that followed, more than 36 million people died from the disease. Today, there are approximately 38 million people living with HIV (PLHIV).

Significant progress has been made in 40 years: Current HIV treatments are unlike the limited and toxic treatments of the past. In fact, they often consist of one pill a day. Medications have fewer side effects, leading to greater compliance. And in 2020, the first long-acting injectable treatment for HIV was approved by Health Canada, giving people living with HIV more options. People living with HIV now have the tools they need to live long and healthy lives.

Furthermore, evidence tells us that a person living with HIV who is on antiretroviral therapy (ART) and has an undetectable level of the virus in their blood cannot sexually transmit it to someone else, with or without the use of a condom (‘Undetectable= Non transmissible’ or ‘U=U’). In Ontario, over 97% of people on ART have undetectable levels of HIV.

The National Institutes of Health in the United States states that: “U=U is a game-changer because it transforms the social, sexual and reproductive lives of people living with HIV. It allows people living with HIV and their partners to be in a relationship without fear of transmitting HIV. People living with HIV say they no longer feel “outcast” or “contaminated”. Moreover, it changes the way healthcare professionals, the public, employers and policy makers view and make decisions about people living with HIV.

The biggest danger with HIV is not knowing your status. Data suggests that up to 14% of people living with HIV are unaware of their status. Therefore, access to easy, non-judgmental testing is crucial. The COVID-19 pandemic has limited patient access to sexual health screening. Fortunately, HIV self-testing is now available in Ontario. The self-test involves a simple finger prick with results available within minutes.

For HIV-negative people and members of populations facing a higher incidence of HIV infection, pre-exposure prophylaxis (PrEP) is a complement to other HIV prevention strategies. PrEP is a pill taken daily that is more than 99% effective in preventing HIV infection.

Breakthroughs in HIV treatment, testing and prevention have benefited countless people, but left too many behind. Africans, Caribbeans, Blacks and Aboriginals are overrepresented 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 occurring simultaneously: COVID-19, HIV/AIDS and drug poisoning. What they have in common is that the greatest impacts are felt by the most marginalized and stigmatized people in our community. Although COVID-19 has resulted in one of the fastest government and health responses in history, making large-scale testing and vaccination available in record time, this sense of urgency has not been enforced. to end HIV and drug poisoning crises. We must confront the stigma that causes us to value some lives more than others.

COVID-19 has exacerbated the already unfathomable number of deaths from drug poisoning. The message of COVID is that it is best to keep your distance and self-isolate; during a drug poisoning crisis, the greatest danger is that people use substances alone. COVID has worsened the illicit drug market, driven people to use in isolation, and reduced access to vital services.

According to BMC Public Health: “In British Columbia, overdose is the leading cause of death among an underserved cohort of people living with HIV (PLHIV) in British Columbia, Canada. Public health efforts to end the HIV epidemic and support the health and well-being of PLHIV are thwarted by persistent health inequalities and the enormous and persistent risks faced by people who use drugs. Integrated low-barrier primary care is essential to support underserved PLHIV, and a secure supply of medicines is needed to support PLHIV who use drugs.

December 1 is World AIDS Day and the start of Aboriginal AIDS Awareness Week. As we pay tribute to the lives of those we have lost and work to improve the lives of those living with HIV and who are at risk, let us also take this opportunity to redouble our efforts to fight the ignorance and stigma and fight against the inequalities that continue to poison our society.

Gilles Charette
Executive Director, HARS (Regional HIV/AIDS Services)
kingston


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