Healthy Living in the North

The story of HIV is changing

Stickers with HIV awareness messaging

You can live with HIV if you act to know your status and deal with it. Even if you don’t believe you are at risk, find out. Know for sure. Get tested.

Earlier this month, you may remember a news story featuring actor Charlie Sheen, who revealed that he is HIV-positive. With World AIDS Day upon us, Sheen’s revelation is a reminder that that the story of HIV is changing.

It used to be that a lot of heterosexual people thought they got a free pass on HIV because it was seen as something you only had to worry about if you were gay or an intravenous (IV) drug user.

The way people viewed HIV – and the way that too many still view it – is coloured by fear. We all want to be OK so we look for ways to spin our thinking: “If it’s transmitted through a kind of sex I don’t have, then I’m OK. If it’s transmitted through IV drug use, then I’m OK.” This spin, however, feeds into prejudice and discrimination against those believed to be at risk and it gives many of us a false sense of security.

It may be because of these false beliefs that one of the best protections against HIV infection is not used as often as it should be. According to Statistics Canada, in 2009-10, more than three in ten young adult Canadians (15 to 24 years) did not use a condom the last time they had sex.

The truth is HIV is unquestionably transmitted through heterosexual sex. According to the STOP Report published in 2015, in B.C. between 2010 and 2014, heterosexual transmission accounted for 25% of all new HIV cases. In northern B.C., 39% of all new HIV cases were among heterosexual people. Another truth is that while high-risk sex with multiple partners may increase the likelihood of contracting HIV, it only takes being unsafe one time.

There’s another important piece to Charlie’s story, though. In an interview, he said that since he was diagnosed four years ago, he has been consistently taking antiretroviral medications. His doctor verified that he has a suppressed viral load. The current state of HIV treatment has advanced to the point where someone who has achieved suppression and maintains treatment can look forward to living a normal lifespan and is not a risk to transmit HIV to others.

Charlie Sheen’s story shows that you can live with HIV if you act to know your status and deal with it. Even if you don’t believe you are at risk, find out. Know for sure. Get tested.


Editor’s note: This article was co-written by Andrew Burton & Sam Milligan. Learn more about our blog authors.

 

Andrew Burton

About Andrew Burton

Andrew is a Community Integration Systems Navigator for Northern Health’s HIV and Hepatitis C Care team and works to support healthy living practices in communities across northern B.C. Andrew is developing positive activity and diet practices for two reasons: to deal with his own health concerns, and to “walk the talk” of promoting healthy living. Building on his training and experience in creative arts therapy, Andrew founded and runs the Street Spirits Theatre program promoting social responsibility among young people. This work has been recognized nationally and internationally as a leading method of social change.

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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.)

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February 14th: Sexual and Reproductive Health Day

sexual and reproductive health dayThis Friday is February 14th. Do you know what day that is? Of course you do! It’s Sexual and Reproductive Health Day in Canada, as recognized by the Canadian Federation for Sexual Health. Sexual and reproductive health covers a wide range of topics, including awareness of sexually transmitted infections (STIs).

Over the past 10 years, Northern Health has seen and treated an increasing amount of STIs and this trend is likely to continue unless we take more precautions. Here are some facts about STIs in the north:

  • STIs affect both men and women
  • Almost half of STIs occur in people under the age of 25
  • There are at least 20 different kinds of STI
  • Some STIs are more common, such as chlamydia, gonorrhea and human papillomavirus virus (HPV)

An STI is not something that you want to deal with, so it’s important to know how to recognize their symptoms, how to prevent them, and where to get testing and treatment.

Symptoms can vary for each STI, but here are some of the general ones to look out for:

  • Sores or blisters on the genitals or around the anus or mouth
  • Irregular growths (warts) in genital area
  • Genital itching
  • Pain with intercourse, urination or having a bowel movement
  • Lower abdominal pain
  • Vaginal bleeding or spotting after sexual intercourse
  • Rash
  • Pain or swelling of glands in groin area

The best way to prevent getting an STI is to use a condom every time you engage in intercourse. Getting tested regularly is also important. You can do so at the health unit or at your doctor’s office. Regular testing is vital because some people have no symptoms at all. You should get tested if:

  • You have any symptoms
  • Your partner has been diagnosed with an STI or has symptoms
  • You have started a new relationship
  • You or your partner have not been tested in the last year

An HPV infection can lead to serious health problems, including genital warts and cervical cancer.

Chlamydia and gonorrhea and are both treatable. Treatment is free at sexual health clinics throughout the north. Treating HPV depends on the type of infection (there are over 100 kinds). For more information on treatment and testing, please visit your local health unit.

Fortunately two vaccines are available in Canada to prevent HPV infections, Gardasil™ and Cervarix™. They are provided at no cost to many girls and women. You can get them at your local health unit, doctor’s office, and many pharmacies. For more information on HPV and other vaccines and eligibility, please visit Immunize BC.

Kim Garrison

About Kim Garrison

Kim is the Public Health Communications Liaison Nurse and works out of Mackenzie. She has a background in public health, and is a graduate of UNBC. She was born and raised in Prince George, and recently moved to Mackenzie with her young family. Her favorite thing about Mackenzie so far is Morfee Lake, which is about five minutes away from her house! She keeps busy chasing after her little ones, and enjoys getting outside when it’s not too cold out!

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Tales from the Man Cave: Sex Happens

Request the HIV test

Visit hiv101.ca for info.

Sex happens, doesn’t it? Unfortunately, so does HIV.

There are many songs celebrating the “inebriated Celt” – “I am a rambler and a gambler a long way from home,” as Bob Dylan says.  Many girls and many episodes of sowing wild oats are espoused as songs, television shows and movies boast of great exploits and adventures.

Celebrating the act of living is great, but what’s wrong with this picture? The problem with this male fantasy is of course well known. Living like this means there is bound to be trouble. But, sex happens to all of us and is a beautiful thing; most adults have had sex even though we may not have the exploits of the mad Celt, off in his ramblings.

That brings me to my point: if I have had sex with someone, who else has that someone had sex with?

Imagine someone with the flu sneezing on their hands and then shaking hands with you. Can you see the virus? Did you touch your face after that – mouth or nose? Thankfully it’s just the flu (which does, however, kill its fair share of people each year, so get your flu shot) but you get my point – viruses cannot be seen!

What if you’ve had too much to drink and meet someone at the bar… they’ve had too much too obviously. Can you see that virus coming?

So why not take the test for HIV? Is that too scary? It might be a hard sell… But it can save lives, maybe yours.

I know when AIDS arrived on the scene it scared the crap out of all of us and seemed like a death sentence. Thus, it became very difficult to deal with and people were very frightened. Now, the recommendations are: if you have had sex, take the test.

I remember coming across a poor chap in Glasgow in 1985 (the year Rock Hudson died of AIDS) who was admitted with AIDS to the hospital I worked at. Back then, there was so much uncertainty around the disease, and admittedly, some fear, due to the ignorance.  Information did not travel via the internet yet and one had to find a book to explain things or some other scientific source.  I’m not sure there were that many, if any, books written on the topic at that time and the press became an information source – there were some good articles and some terrible ones.

Today we know better. We now know that basically anyone can get it so, if you have had sex, get the test.

HIV treatment is very good these days and the scientific medical community has done really well in researching and treating the infection and disease. Since nobody is perfect and we all fall down at times, like the medieval nursery rhyme says, it’s time to get rid of the stigma and moralizing and treat the disease like any other infection.

Get the test.

Visit hiv101.ca for more information.

Jim Coyle

About Jim Coyle

Jim is a tobacco reduction coordinator with the men’s health program, and has a background in psychiatry and care of the elderly. In former times, Jim was director of care at Simon Fraser Lodge and clinical coordinator at the Brain Injury Group. He came to Canada from Glasgow, Scotland 20 years ago and, when not at work, Jim plays in the band Out of Alba and spends time with his family.

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World AIDS Day 2013: A time to reflect and move forward in the fight against HIV

HIV testing

HIV testing will be offered as part of regular hospital care. Our aim is to reduce the spread of HIV throughout northern B.C.

December 1, 2013 marks World AIDS Day, the day that we annually honour those living with HIV, and commemorate those that we’ve lost to AIDS. It’s also a time to salute Northern Health’s community partners who work so diligently to support persons living with HIV/AIDS. They include Positive Living North, Northern BC First Nations HIV/AIDS Coalition, Central Interior Native Health Society, the Cedar Project, and the Northern HIV and Health Education Society. These organizations, and the world at large, have seen great changes since the first reported AIDS cases in the mid-1980s. Admittedly, many people still react with fear, shock and stigma when the topic of HIV/AIDS comes up. But due to great medical advances in HIV treatment, HIV is now considered a manageable chronic disease — not an automatic death sentence.

This year, Northern Health is marking World AIDS Day by introducing a new health care initiative that complements our current strategies to reduce the spread of HIV throughout northern B.C.

Request the HIV testThe initiative — which will see medical staff offer HIV testing as part of regular hospital care — will be introduced at the University Hospital of Northern B.C. beginning Monday, December 2, 2013. This new initiative is being undertaken in efforts to reduce the impact of HIV/AIDS through effective screening and early detection, and to provide timely access to high-quality and safe HIV/AIDS care and treatment.

All patients over age 14 admitted to hospital will be offered an HIV test as part of their admission blood work. As with all medical interventions, every patient has the right to refuse an HIV test. This initiative is expected to be implemented in other Northern Health acute care facilities through 2014.

Why are we introducing routine HIV testing in hospitals? It’s because HIV is an important health issue with 300 to 400 new diagnoses made in BC every year. The number of new infections is not declining — and people are not being diagnosed early enough. Sixty per cent of HIV patients are diagnosed after they should already be on treatment. Evidence also shows that 25 per cent of people living with HIV are not aware of their status.

The routine offering of HIV testing has already proven successful in the Lower Mainland where Vancouver Coastal Health introduced the initiative in October 2011. Up to 94 per cent of Lower Mainland patients who are offered an HIV test as part of routine hospital care say ‘Yes’, because they appreciate knowing that they’re not being singled out to take the test.

Knowing your HIV status is so important for your health care. As health care providers, knowing our patients’ HIV status affects how we treat infections, cancers and even which vaccinations to consider. If you are tested and are diagnosed with HIV, you should begin treatment as early as possible. Why? Because early HIV treatment prolongs and improves people’s lives. People on HIV medications can now have healthy lives, relationships, and children.

hiv101.caThe routine offering of HIV testing initiative is funded by BC’s Ministry of Health. It’s part of the From Hope to Health: Towards an AIDS-free Generation initiative, formerly known as the STOP HIV/AIDS pilot project. Many of you are familiar with Northern Health’s STOP HIV/AIDS education and awareness campaign; one of our main goals was and is to normalize HIV testing, by urging everyone who was sexually active or using injection drugs to make the time to get an HIV test.

We’re hoping that our new routine offering of HIV testing initiative will finally take us to that next step, where HIV testing becomes the norm in health care, not the exception. But we need your help. Talk to your friends and family and encourage everyone to take an HIV test. Explain that routine HIV testing of all patients reduces stigma and improves early detection.

As we approach World AIDS Day, help us work towards an AIDS-free generation. Help us spread the word about HIV — not the disease. For more information, visit HIV101.ca.

 

World AIDS Day events in Prince George

World AIDS Day Candlelight Vigil and Dinner:

  • Date: Friday, November 29, 2013
  • Time: 3:00 – 5:00 p.m.
  • Place: The Fire Pit Cultural Drop-In Centre – 1120 – 3rd Ave., Prince George

Blood, Sweat, Tears & Laughter project — Play Creation Workshop, sponsored by Prince George and District Community Arts Council. This workshop is directed towards youth in and around Prince George and will engage them on their thoughts, feelings and stories concerning HIV/AIDS. These shared stories will be used by the local youth theatre group, Street Spirits, to generate a play entitled, Blood, Sweat, Tears & Laughter. The play will be filmed and turned into a resource for agencies who also wish to engage in HIV/AIDS research through theatre.

Workshop:

  • Date: Saturday, November 30, 3013
  • Time: 10 a.m. to 2 p.m.
  • Place: 1148 – 7th Ave., across from Prince George City Hall

Play performance:

  • Date: Sunday, December 1, 2013
  • Time: 7:30 p.m.
  • Place: ArtSpace, 1685 – 3rd Ave (above Books & Company), Prince George, BC
Dr. Susan MacDonald

About Dr. Susan MacDonald

Susan is the Chief Medical Officer for Northern Health and has responsibility for matters of quality and patient safety in medical practice across the north. She has been the medical lead for the STOP HIV/AIDS project since 2010. Susan received her medical degree at McGill University and has certifications in International Health and Tropical Medicine and a Masters in Infectious Diseases. She practiced as a GP Anaesthetist in Quesnel and as a Family Physician at St. Paul’s Hospital in Vancouver for over 20 years. She has also worked and trained in China, Nepal, Kenya and Peru. Susan has taught global health internationally and is the author of several health care publications including a chapter on Infectious Diseases in Asia.

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