Healthy Living in the North

Taking aim at stigma: Northern Health offers routine HIV testing to everyone

Northern Health staff person stands in front of a display board for HIV project

As a member of the Blood Borne Pathogens team, Sam Milligan provides HIV/HCV education and consultation services to regional Northern Health programs and communities.

Northern Health is taking steps to reduce the stigma around HIV by introducing routine HIV testing for everyone, not just people at risk.

In addition to current risk-based testing guidelines, Northern Health has adapted the 2014 HIV testing guidelines developed by the British Columbia Office of the Provincial Health Officer. These guidelines recommend that everyone between 18 to 70 years of age, in both acute care settings and the community, be offered an HIV test every five years as part of routine health screening.

Preceding the release of the 2014 HIV testing guidelines, the University Hospital of Northern BC initiated the routine offer of HIV screening in December 2013 to all admitted patients who are having blood work taken for another reason while admitted.

“The Public Health Agency of Canada estimated in 2011 that approximately 25 per cent of people living with HIV in Canada are unaware of their HIV-positive status. Evidence also suggests that this 25 per cent account for up to 70 per cent of all new HIV infections,” says Bareilly Sweet, Northern Health’s Regional Coordinator, Blood Borne Pathogens Services.

“We also know that nearly 55 per cent of new HIV diagnoses in Northern Health are diagnosed late, with close to 20 per cent of new diagnoses fitting the criteria for advanced HIV. This means that over half of the people living within Northern Health’s region should already be on HIV treatment at the time of their HIV diagnosis.”

Historically, the reason for an HIV test has fallen into two categories: routine testing for women during pregnancy, and voluntary testing for everyone else. The problem lays in the second option — voluntary testing. For voluntary testing to occur, two conditions have to be met:

  • Health care providers need to ask their clients about risk and risk-related behaviour; however, current research evidence suggests such conversations are very difficult for health care providers to initiate with patients; and
  • Patients need to know they are at risk, recognize that risk, and be willing to disclose risk to their health care provider.

“Unfortunately, the current testing criterion stigmatizes testing. This discourages clinicians from offering an HIV test and discourages patients from seeking and/or accepting an HIV test,” says Sweet. “But that won’t stop us from continuing our work to normalize HIV testing, because routine testing will catch HIV infections in the early stages. And that’s what we need to do, because then we can improve the patient experience on every step of the HIV journey.”

St. John Hospital in Vanderhoof, Stuart Lake Hospital in Fort St. James and the Fraser Lake Health Centre began implementing the routine offer of HIV testing in the spring of 2014. Lakes District Hospital and Health Centre in Burns Lake and GR Baker Hospital in Quesnel are in the preparatory stages to begin offering HIV testing.

This article was originally published in September 2014 in Northern Health’s new internal magazine.

Sam Milligan

About Sam Milligan

Sam is the regional health systems navigator in Northern Health’s blood borne pathogens (BBP) services team. In his role, he provides education and consultation services to communities and programs across the north. Some of his responsibilities include improving community access to HIV & HCV treatment, increase testing for HIV/HCV, and provide current practice education to staff, physicians, and community members. If not at work or talking about work, Sam can be found in the realms of adventures with his two young sons or hanging out with the most gorgeous woman on the planet: his wife. (Sam no longer works with Northern Health, we wish him all the best.)