HIV frontline workers in Saskatchewan say more needs to be done

On a day where the world reflects on HIV and AIDS, frontline care workers say more can be done for people living with the disease in Saskatchewan, which has the highest rates of HIV infection in Canada.

Recent numbers for HIV/AIDS infection rates in Saskatchewan indicate that one health region has seen an 800 per cent increase in confirmed cases and access to treatment is more of a concern than ever.

Saskatchewan had 2,091 cases reported between 1985 and 2016. The number of new cases in Saskatchewan in 2016 — 170 — was almost triple the national average. Seventy-nine per cent of those new cases self-identified as Indigenous.

"Public health already provides access to free medication for chlamydia, gonorrhea and syphilis," said Susanne Nicolay, clinic and project co-ordinator for the Wellness Wheel, and the former HIV co-ordinator for Regina Qu'Appelle Health Region.

"But maybe we need to look at, from a public health context, the ability to prevent ongoing transmission by having universal access to medications and removing that barrier."

Saskatchewan Health doesn't provide universal access to antiretroviral drugs (ARV) which are highly effective in treatment of HIV.

"Currently in British Columbia and Alberta, anybody who has HIV gets medications offered 100 per cent regardless of what plan they're covered under," said Mike Stuber, a pharmacist with the Saskatchewan HIV collaborative.

"I wouldn't say we're the worst for access for medications, but given the epidemic we're in ... there's a lot of room to improve."

When asked Thursday at the provincial legislative building about the province's high HIV infection rates, Health Minister Jim Reiter said the province is "extremely concerned."

He said the province has dramatically increased HIV testing, which can be expected to increase the number of confirmed cases.

When asked about universal access to ARV treatment, he said "we're certainly looking at that" but added "the vast majority are covered already."

"The most vulnerable are already covered 100 per cent, and overall, when you account for everyone, 93 per cent of drugs are covered right now," he said.

Saskatchewan's Ministry of Health said in an email "It is not possible for the government to fully cover every medical treatment or prescription drug."  

It said delivery of First Nations health services is shared among provincial and federal governments and First Nations organizations.

Cultural awareness

Community organizations that are working on the front lines of Saskatchewan's HIV/AIDS initiatives also say successful treatment and health campaigns require cultural awareness.

"We have to look at what is happening in Saskatchewan in Indigenous communities," said Margaret Poitras, CEO of All Nations Hope Network in Regina.

According to Poitras, Indigenous people aren't making it to the doors of places that are there to help people living with HIV.

• Saskatchewan's HIV rate highest in Canada, up 800% in 1 region
• HIV treatment in First Nations communities in the global spotlight

"If we would look at solutions for Indigenous people ... one of those ways would be to have navigators that are Indigenous," she said.

Those navigators would help people who live with HIV find their way through the different health and social programs set up for Indigenous people.  

"It's Indigenous people that have to be in the lead," she said. 

"We are the true HIV experts in terms of delivering programs, services, care, treatment and support to Indigenous people from an Indigenous way."

Health care providers are wondering what Saskatchewan's transition to a single health region on Monday will mean for Indigenous patients.

"It will be interesting to see what will happen in terms of going from one jurisdiction to another," said Nicolay.

Health Canada said everybody in the system got one message about the amalgamation, "that there won't be any impact on the frontline services," said Dr. Ibrahim Khan, Regional Medical Officer, First Nations and Inuit Health Branch.

"I imagine it would not impact the service delivery to First Nations as well."