'It does scare me': New HIV strains highlight need for more testing, less stigma, says man living with virus

For an Indigenous man with HIV who is living in Saskatchewan, news of mutating strains of the virus circulating in the province came as a shock.

"It does scare me," said Cote First Nation resident Darryl Caldwell, who has been living with HIV for seven years.

His reserve is near the town of Kamsack as well as other neighbouring reserves see more than 10 times the national average of HIV, rates that were on his mind when he heard news about recently discovered immune resistant strains.

"So that's very disheartening, because a lot of the people from my community, a lot of my relatives, could be having this strain."

Dr. Alex Wong, an infectious disease specialist in Regina, said the mutated strains can explain some of what Saskatchewan physicians have been seeing on the ground recently.

Ordinarily, individuals with normal healthy immune systems infected with HIV might see their symptoms progress over five to 10 years to having end stage complications of HIV, or in other words, AIDS.

A lot of the people from my community, a lot of my relatives, could be having this strain.- Darryl Caldwell

"Here in Saskatchewan, we were seeing the rates of progression much quicker, sometimes within 12 months or just a couple of years," Wong told CBC Saskatchewan's Afternoon Edition.

An increase in mutated strains

A new study goes some way to explaining the change, showing that the strains of HIV in Saskatchewan have high levels of immune-resistant mutations compared to ones in other areas of Canada and the United States.

Research from the B.C. Centre for Excellence in HIV/AIDS and Simon Fraser University has hypothesized that the quickly developing illnesses were linked with resistant strains that had adapted to the specific immune profile of Indigenous people.

Wong said the research underscores the "need to do better as fast as possible" to address HIV in the province. Fortunately, existing treatment is effective in treating immune-resistant strains, according to researchers.

Treatment critical to curbing HIV

Treatment focuses on asking people to take one or possibly two pills a day, which work much better than former medications, and are also less toxic and better tolerated, according to Wong.

But he notes social challenges like mental wellness, homelessness, addictions or food security can pose challenges to people following the treatment properly.

Treatment is critical, since it's a key part of prevention, he said.

"Once you have a fully suppressed or undetectable viral load, your chances of transmitting the virus — even if you continue to practice very high risk activities — is essentially zero."  

Wong believes there needs to be more work engaging of people, and helping address some of the root causes of chaos in their lives, to allow them to follow their treatment regimen.

Caldwell notes it will take individuals like himself, who are facing HIV head on, to sit down with their communities and governments to develop solutions that address the root causes of HIV outbreaks.

To him, it's also key to stop the stigma surrounding HIV, including people who have the virus being ostracized. He believes that stigma is part of the reason people are loath to get tested.

"We have hearts too. We want to be loved and treated equally and we can't pass [HIV] onto you by kissing or hugging or by sharing utensils."