IN THE NEWS| DRUG STRATEGY - Times Colonist Victoria - HIV amond addicts may double 03.12.2006 |
HIV among addicts may double -- doctor: Victoria expert condemns
government inaction
BY Louise Dickson, Times Colonist
Dr. Chris Fraser wants the "foot-dragging" on HIV prevention strategies
to end.
The AIDS expert, who has practised inner-city medicine in Vancouver's
Downtown Eastside and Victoria for the past 10 years, says that without
new strategies and services to help intravenous drug users, the rate of
HIV infection will double in that population.
"As long as there's foot-dragging by all levels of government in
implementing innovative prevention strategies, we're always fearful
we're going to lose control of the virus," said Fraser, who attends AIDS
conferences around the world.
The doctor leans back in his chair, taking a quick break from his work
at the Cool Aid Community Health Centre, to discuss the problem of AIDS
in Victoria. Fraser is on the front lines of the battle to prevent the
spread of HIV in an unstable population. Meanwhile, down the hall in the
crowded Swift Street waiting room, patients cough and shift nervously in
their seats.
In Victoria, HIV/AIDS is a bigger problem than one would suspect, Fraser
said. About 200 people acquired the virus in the 1980s and 1990s via
sexual transmission. When injection drug use took off in the mid-1990s,
so did the spread of Hepatitis C and HIV. Today, an estimated 20 per
cent -- one in five -- of the city's roughly 3,000 intravenous drug
users has HIV or AIDS.
"So there's about 600 injection drug users with HIV, and about one-third
either don't know they're infected or are not engaged in regular care,"
says Fraser.
Fraser worries that the percentage of injection drug users who are HIV
positive could increase to 30 or even 40 per cent if those infected with
the virus don't get proper care.
"There's a strong denial in Victoria about the presence of injection
drug use. And from that denial comes a lack of planning," Fraser said.
"We're at an important junction in community epidemiology, and if we
don't get people with HIV into more effective care, we could really lose
the handle on it."
Injection drug use has a higher rate of HIV transmission than sex. The
virus can spread rapidly among addicts, who may not know they are
infected and sometimes engage in unprotected sex. Injection drug
outbreaks can often drive sexual transmission outbreaks.
Cool Aid has approached the health authority about being more
accessible, staying open longer and being open seven days a week, but
these proposals are still waiting for approval, Fraser said.
They've asked for an outreach worker who would go into the community and
bring infected people to the community centre for care.
"I know 15 people who are infected with HIV who haven't had blood work
for more than a year," Fraser said. "And I know they are engaged in
behaviour that concerns me."
Cool Aid has outreach clinics with PEERS, the Prostitute Empowerment
Education and Resource Society, and AIDS Vancouver Island's lunch club.
"We go where they are," said Fraser, who brings a phlebotomist (a
technician who draws blood for tests) with him to the clinics.
Victoria's needle exchange is simply not enough to prevent the spread of
HIV/AIDS, Fraser said. The city needs mobile sites where addicts can
exchange their syringes. They also need a safe consumption site, he
said.
Fraser wants to see more reasonable housing and more treatment for
addicts.
"It's very do-able with the right willpower," he said.
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December 15, 2007
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