On World AIDS Day, N.S. sees spike in HIV cases — and a call to action

25 cases have been reported so far this year after 15 in all of 2017

Image | Matt Numer

Caption: Matt Numer is an assistant professor of health promotion at Dalhousie University and chairs the PrEP action committee in Nova Scotia. (Jeorge Sadi/CBC)

On the 30th anniversary of World AIDS Day, the battle against the virus that causes the disease is being marked in Nova Scotia with a significant rise in the number of infections.
At the end of November, there were 25 new cases of HIV infection in the province. There were 15 in all of 2017.
The concern among public health officials is that undiagnosed infections are being spread among some of the vulnerable people in Halifax(external link) — people who use injection drugs.
The other primary group affected is men who have sex with men.
According to the World Health Organization, one in four people with HIV don't know they have it. Once considered a deadly disease, AIDS can be a treatable, but chronic, condition.
But it's also largely preventable.

Test results on the spot

On World AIDS Day, a pop-up clinic to test people for HIV and Hepatitis C was held at Mainline, Halifax's needle exchange.
Dr. Lisa Barrett, an infectious disease specialist, administered the tests. Of the 20 clients who walked into Mainline, 15 agreed to be tested. A finger-prick test provides results within minutes.

Image | Dr. Lisa Barrett

Caption: Dr. Lisa Barrett administering a finger-prick HIV test at Mainline Needle Exchange on World AIDS Day. (Mainline/Twitter)

Even though the testing meant giving up her Saturday morning, Barrett said it was necessary.
"We just don't want to wait," she said. "We know this outbreak can't wait."
She said all the tests were negative, but it was time well spent because information was shared with clients about the HIV prevention drug, PrEP, a pre-exposure phophylaxis.

Ten people have Pharmacare approval

Since July, PrEP, which costs $260 a month, has been available to low-income Nova Scotians through Pharmacare coverage.
But Matt Numer, an assistant professor of health promotion at Dalhousie University and chair of the PrEP action committee, said the province should provide the prevention drug to all Nova Scotians who need it through universal coverage.
A Health Department spokesperson said that as of mid-October, 10 patients received Pharmacare approval for PrEP.
But Numer said many more people need the drug but can't afford it. He estimates it's between 200-500 people.

Universal coverage in western provinces

British Columbia, Alberta, and Saskatchewan provide universal coverage.

Image | Truvada

Caption: As many as 500 people in Nova Scotia might need pre-exposure prophylaxis treatment (PrEP) but can't afford it. (CBC)

Numer said the lifetime health-care costs of one patient is estimated to be $1.3 million. Providing the drug, he said, is fiscally and socially responsible at a time when cases are soaring and people are asking for the medication.
"This signals that something's going on and we really need to address that," he said.
On Thursday, Health Minister Randy Delorey confirmed the spike in cases of HIV infection, adding it's "still a condition that we're concerned with."
He said the department is talking to groups about how Pharmacare coverage of PrEP is going, and to look at other opportunities to support harm reduction and reduce the prospect of transmission​.
Numer said there's been plenty of consultation and is urging action now. "Why are we wasting our money consulting on answers we already know," said Numer.