More cases of HIV/AIDS have been reported in Kenora, Ont., in the past 12 months than in the past eight years, and a community practitioner says a safe eating place is needed to help address the problem.
In 2022, the Northwest Health Unit (NWHU) reported nine confirmed cases of HIV/AIDS in the northwestern Ontario city. In the previous eight years, there had been only eight confirmed cases, according to NWHU data.
Dr. Johnny Greck says that number could be much higher — he’s seen 15 new cases reported in the past nine months — and said the health unit’s figures lag behind what he’s seeing on the ground.
“Our numbers are from street field tests that are then followed up with a lab-validated test — and so far there have been no false positives from the field tests,” Grek told CBC News in an interview.
NWHU health officer Dr. Young Hoon did not dispute Grek’s numbers, but said NWHU must follow provincial case reporting standards and cannot rely on preliminary tests or other clinical information to confirm them.
Greck practices family medicine at Kenora’s Paterson Medical Center and provides outreach and street medicine through the Sunset Country Family Health Team. He has seen many fights on the streets of Kenora since he came to the area 4 1/2 years ago.
The attitude and feeling on the streets here is one of, I would say, desperation upon desperation.- Dr. Johnny Greek
“The attitude and the feeling on the streets here is one of, I would say, desperation upon desperation,” he said.
It works closely with people who may be more vulnerable to viruses, including those who use drugs, are homeless or homeless, or work in the sex trade.
Being a street doctor means Grek literally meets people where they are. Sometimes they may feel more comfortable doing a consultation at a homeless shelter or the Kenora Scholarship Center.
HIV (human immunodeficiency virus) attacks the immune system, or its ability to fight disease. If left untreated, HIV can lead to AIDS (acquired immunodeficiency syndrome), which can be controlled by various treatments.
In Ontario in 2020, more than 22,000 people were estimated to be living with HIV, according to the Ontario HIV Epidemiology and Surveillance Initiative.
The virus is primarily spread through bodily fluids, including blood and semen. Young Hoon said unprotected sex and sharing needles or drug-making equipment are the most common ways people contract HIV/AIDS.
Officials in Kenora recently held a special council meeting where members of the public shared their concerns about public safety downtown.
Greck, who was at the meeting, said there was a collective agreement that there needed to be talks about these issues – but there was also a lot of anger and resentment about the situation.
He said he would like to see more empathy for people who use drugs instead of judgment and fear of them.
Sites for safe consumption
As part of tackling the opioid crisis, there have been calls for safe use sites – where people have the legal right to bring drugs for use in a clean, safe environment and can also receive addiction support from healthcare workers.
There are 26 safe eating locations in Ontario. But the closest to Kenora is Path 525, at 525 Simpson St. in Thunder Bay, Ont.
In the second half of 2022, NWHU is working with LBCG Consulting for Impact Inc. to conduct a feasibility study of controlled consumption services. The study looks at whether controlled consumption services are needed in Kenora, Dryden, Fort Frances and Sioux Lookout and what form they might take.
“The main goal is to prevent [opioid] overdoses, but it has the ability to increase access to clean needles and drug preparation equipment, and that will of course reduce the spread of HIV,” Young Hoon said.
NWHU is currently reviewing drafts of the report, with the hope of finalizing and publishing the results in February.
Drug paraphernalia is displayed at Molson’s overdose prevention site in Vancouver’s Downtown Eastside on September 10, 2019. Kenora doesn’t have a safe place to use, but the rise of HIV/AIDS in the Ontario city is prompting a call for one. (Ben Nelms/CBC)
According to Grek, the safe consumption site “would mean everything” to Kenora.
“We’re past the point where we can stop people from using drugs. We are past the point of being able to control or stabilize even the dangerous … toxic supply of drugs that are on the market right now,” he said. “But what we haven’t gotten past is showing that people who use drugs are human beings.”
And when — not if — Kenora recognizes that’s the right approach, he said, it needs to be more than “just a drop-in place where you go and do drugs and then leave.”
He encourages people to challenge their viewpoints by having open conversations, like the one held at last week’s Kenora council meeting.
“We all get healthier when we learn more, especially if it means being a little more open to people,” he said.
Step up testing, prevention programs
Anyone who thinks they are at risk of contracting HIV/AIDS can get a blood test by contacting their primary health care provider or going to a community health center, primary care, or clinic. Some NWHU offices also offer testing, Young Hoon said.
Dr. Kit Young Hoon, NWHU Medical Officer, says, “Early detection and treatment of HIV means that people with HIV can live with it for a very, very long time and live with it in a healthy way.” (Submitted by Lindsey Koch)
Young Hoon emphasized that conversations with health practitioners are confidential.
“Many years ago, when less was known there, too [were] fewer treatment options for HIV, a diagnosis really seems like a death sentence, but it’s not anymore,” she said. “Early detection and treatment of HIV means that people with HIV can live with it for a very long time, a very long time time and live with it in a healthy way.”
But treatment should start as soon as possible.
Testing helps prevent the spread of HIV, as does access to clean needles and a protective barrier like condoms during sex. A list of needle distribution sites can be found on the NWHU website. Many clinics also give out condoms for free.
Making these services available to vulnerable populations — people who are homeless or poverty-stricken — is critical, Young Hoon said.
The health unit is closely monitoring the number of HIV/AIDS cases to see what further action may be needed.
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