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Significant increase in HIV PrEP awareness does not correspond with use

Researchers in Canada have tracked a significant increase in awareness of HIV pre-exposure prophylaxis, or PrEP, although low rates of actual use were reported in the Momentum Health Study.

Nathan Lachowsky, PhD, assistant professor at the University of Victoria School of Public Health and Social Policy in British Columbia, and colleagues evaluated responses to a computer-assisted survey of 732 HIV-negative and HIV-positive men who have sex with men (MSM) regarding PrEP between 2012 and 2016.

Awareness of PrEP among HIV-negative men increased from 18% to 80%, and awareness among HIV-positive men increased from 36% to 77%. Lachowsky and colleagues, however, determined that the higher levels of awareness were not impacting the levels of use, with only 2% of MSM surveyed using PrEP.

Researchers concluded that affordability and access were two factors that could explain the low use of PrEP, despite increased awareness. “Indigenous, Latino, bisexual and single men are less likely to be aware of the newly publicly funded HIV prevention medication,” the BC Centre for Excellence in HIV/AIDS stated in their press release. Funded by the Ministry of Health through the BC PharmaCare program, the BC Centre for Excellence in HIV/AIDS now allows free access to PrEP for people who need the medication.

“Our team and colleagues are engaged in trying to build capacity in health care providers and within health care systems to ensure services meet the demand from the community for PrEP,” Lachowsky told Infectious Disease News. “We also need to increase health promotion to ensure that men know PrEP is funded and to ensure those men who would benefit from PrEP pursue getting it. This includes needing to address and reduce stigma associated with taking PrEP and with HIV generally.” – by Marley Ghizzone


A Look At HIV Criminalization Bills Across The Country

As state legislative sessions get underway across the country, HRC and equality partners are tracking seven HIV criminalization measures that threaten the lives of those living with HIV & AIDS, LGBTQ Americans and their families. Despite advances in medicine that can prevent the transmission of HIV or treat those exposed to the virus, unconscionable HIV criminalization bills are currently being considered in Georgia, Kentucky, Arizona, New York, West Virginia and Oklahoma. According to HRC’s 2017 State Equality Index, 25 states currently have laws that criminalize behaviors that carry a low or negligible risk of HIV transmission.

HIV criminalization legislation does not work in the context of modern scientific developments. There is no evidence to suggest HIV criminalization helps to lower HIV transmission rates.

Georgia’s HB 737 would force individuals to submit to court ordered blood tests where a law enforcement officer alleges to have been exposed to blood or other bodily fluids that could result in HIV, Hepatitis B or Hepatitis C. The bill passed committee on February 5th. Kentucky’s HB 193 reached the House for consideration on February 16 and could be voted on any day now. As introduced, the Kentucky bill would criminalize the common cold as the definition of “communicable disease” would include diseases that are unlikely to cause lasting harm, much less harm warranting felony punishment. In the face of affirmative votes to push the bill to the House floor, a number of legislators took issue with the dangerously broad language that would punish the mere passing of the flu or common cold. This hearing revealed that HIV education is still needed in both the legislature and in the community.

The very nature of the HIV & AIDS epidemic means that the enforcement of these laws will target specific, vulnerable populations. These laws target transgender Americans as 1.4 percent of transgender individuals report living with HIV, compared with 0.3 percent of the general population who report living with HIV.  Furthermore, a 2015 Williams Institute reportfound that prior to California’s HIV modernization bill, every incident where there was an HIV-specific charge led to a conviction and 90 percent of those convictions led to immediate confinement. The report showed that white men were “significantly more likely to be released and not charged (16 percent)” and “black men (38 percent), black women (44 percent), and white women (39 percent) were significantly less likely to be released and not charged.”

Understanding the science behind HIV underscores just how ineffective these bills are in 2018. HIV can only be transmittedby blood, pre-seminal fluid, semen, vaginal fluid, breast milk or rectal fluids. Saliva, feces, urine and other secretions alone do not transmit HIV. Moreover, those who adhere to HIV treatment can expect to live long and healthy lives. Over the last 35 years, the medical community has made significant advancement in the treatment and prevention of HIV & AIDS. An individual may take Truvada, also called pre-exposure prophylaxis or PrEP, once a day to prevent contracting HIV before exposure. Lastly, for some people who know they are living with HIV, there is the possibility that the transfer of the virus to another person would be nearly zero because the undetectable viral load of HIV makes the virus untransmittable. HIV criminalization ignores these developments and perpetuates stigma.

  • By Hope Jackson
  • Source:

What are the challenges for getting gay men at risk of HIV to take PrEP?



Professor Rusi Jaspal and Dr Jake Bayley of De Montfort University explain their findings from conducting research into PrEP and the attitudes of gay men.

In 2012 Truvada, an anti-HIV drug, was approved by the Food and Drug Administration in the US.

Since then, many gay men with private health insurance in the States have been able to access this important prevention drug.

The story in England is much more complicated. After a long legal battle with the UK Government, PrEP has been funded in England for 10,000 at-risk patients only, a fraction of the total of those who need it. This has left many gay men seeking PrEP through other channels, such as buying a generic (or cheaper non-branded) version online, often without clinical support.

Last week it was announced that 56 Dean Street, Europe’s busiest sexual health clinic, had launched a ‘PrEP Shop’ to provide access to generic PrEP. It will cost £55 per month allowing more gay men to access PrEP, but only those who can afford it.

PrEP is really important. We’ve already seen the incredible benefits of PrEP in reducing new HIV infections. Public Health England data revealed a 40 percent decrease in new HIV diagnoses in England in 2016 compared to the year before.

This eye-watering fall in new diagnoses marked a significant shift in the HIV epidemic in Britain, given the year-on-year increase in new diagnoses that had been observed previously.

Yet, the high cost of PrEP is not the only barrier to PrEP. There are other social and psychological factors that can make it inaccessible to gay men.

In 2016, we interviewed a group of gay men in London and Leicester to find out what they knew and thought about PrEP. All of the participants reported either ‘cursory’ or no knowledge of PrEP prior to the study but, when it was explained to them, most saw PrEP as a good thing.

However, when asked whether they would use PrEP themselves, most expressed concerns.


RELATED: What is PrEP and how can I get it?

There was uncertainty about whether PrEP would actually work and some men expressed fear that the drug might have long-term side-effects, despite being used for years in those living with HIV with few side effects.

Younger gay men thought PrEP would be effective in preventing HIV. However, older men thought that only condoms were an effective way of preventing HIV – unsurprisingly after years of public health messages advocating condom use.

Gay men may also worry that others will react badly to their use of PrEP, otherwise known as ‘slut shaming’. They may fear judgement from friends and family, and worry that their sexual partners might assume that they have HIV or that they like ‘bareback’ sex. PrEP stigma seems to put some men off.

Most interviewees just did not want to see themselves as ‘high risk’, a term that is often associated with PrEP use, even though many themselves reported engaging in behaviours that actually put them at high risk of acquiring HIV.

If you do not acknowledge that you are at risk of HIV, you are unlikely to take necessary steps to reduce your risk. It’s crucial that those gay men at risk of HIV actually acknowledge this and consider including PrEP in their risk reduction strategy.

We then conducted another survey of PrEP awareness in gay men in Leicester and found that 56 percent of those surveyed did not think that PrEP would be of personal benefit.

Those who correctly perceived themselves as high risk (i.e. those who barebacked regularly) and went for regular HIV tests (meaning a high level of sexual health knowledge and engagement) were much more likely to consider using PrEP.

Currently, most of the gay men who take PrEP are well informed about HIV risk, and they have knowledge of how to access it. Conversely, many of those who do not access PrEP have poor HIV knowledge and may be taking risks without being aware of this. Gay men from ethnic minority backgrounds are one such group.

So it is heartening to see that Public Health England’s HIV Innovation Fund has supported projects, such as our Sholay Love project, conducted in collaboration with NAZ Project London (a charity for supporting the sexual health of Asian, Black and Latino populations).

Sholay Love will raise awareness of HIV risk and prevention in South Asian gay and bisexual men, an underserved population in the world of sexual health to educate about the benefits of PrEP and engaging with sexual health services.

We aim to improve PrEP uptake in a group in which HIV infection rates have yet to see the dramatic fall seen in other groups. Only when all groups at risk of HIV have equitable access to PrEP will our goal of zero new HIV transmissions become a reality.



Here is why new HIV/AIDS statistics should worry all of us

Article Image

On December 1, 2017, the world marked World Aids Day, Kenya was not left behind.

The UNAids director Jantine Jacobi made startling remarks while speaking at the University of Nairobi grounds in a ceremony to mark the World Aids Day. According to a report published on the Daily Nation on December 1, 2017, the UNAids director said, “We need to focus our efforts on young people but those efforts will only be successful if prevention efforts are led by young people.”

“Why young people?” someone may ask. Well, according to a report made public by the National Aids Control Council (NACC) on the same day, there are a whopping 238,987  young people between the ages of 15 and 24 years living with HIV. The report further says that only 48.5% of the total youth population between 15 and 19 years have been tested. This leaves 51.5% of the total youth population between ages 15 and 19 who do not know their HIV status.

These shocking statistics should worry all of us. In 2016, close to 1.6 million Kenyans were living with HIV/AIDS. While this number reduced slightly in 2017, the rate of new infections leaves a lot to be desired. Our youths are perishing and this will in turn affect our economy which is now being driven by the youths. We need to urgently do something, I propose two things;

First, we need to step up the condom campaign. Distribute them even in schools if possible. Our youths have become reluctant to use protection. We need to use these statistics to remind them that HIV/AIDS is real and still claims a lot of lives.

Secondly, and this applies to medics and care-givers. We need to monitor closely the intake of antiretroviral drugs by HIV/AIDS patients. The NACC report on World Aids Day marked on December 1st showed that many youths die despite the fact that they are on ARVs drugs. This only points to the fact that they do not take these drugs as frequently as required of them or they do not follow the doctor’s prescription.

Author: Daniel Many Owiti


Out in Vancouver: March 1–7, 2018

Choice events in the city this week

Thursday, March 1

Growing Room 2018: A Feminist Literary Festival

Growing Room is Room magazine‘s literary festival, a celebration of diverse Canadian writers and artists featuring more than 40 writers in 30 events. Check online for a full listing of writers, workshops, venues and times.

Festival runs until Sunday, March 4.

Red Ribbon Breakfast

Network with other busy professionals at this hour-long breakfast, and learn about the work Positive Living BC does in the community. This is a free event, but you will receive a fundraising pitch — donations are appreciated but not obligatory.

7am. Hyatt Regency, 655 Burrard St. RSVP by email or call 604-893-2282.

Bratpack Season 4

They’re back: part glamour, part brat and all sex. The hot girls of the infamous Bratpack are here to blow you away every Thursday with live episodes of the hottest show in the Village. With music by the hunky Nick Bertossi, you won’t even leave your seat for the bathroom.

10pm. The Junction, 1138 Davie St. Cover $6. For more info, visit Facebook.

Friday, March 2

Yoga With HIM

Winter is over and you have just five short months to get that body flexible enough for all your Pride dates. Every Friday, HIM provides the place and all you have to do is provide the body — as well as a mat, water and a lot of energy. Soon those legs will go over your head faster than a Carlotta cartwheel. Classes are open to all levels.

7–8:30pm. Scotiabank Dance Centre, 677 Davie St. Sessions are free but rely on your generous donations: most give $5–$10. Info from HIM.

Frisky Friday

Sienna Blaze can get frisky like the best of them; she just chooses to do it in public. Featuring some amazing talent from our city, this show is super hot. Check out the show and then dance the night away with one of the top lesbian DJs in North America, Miss M, the resident DJ for the Dinah Shore Weekend. Does the current generation even know who Dinah Shore was? Hmmm.

9:30pm. The Junction, 1138 Davie St. Cover $5. For more info, visit Facebook.

9 Lives: A Drag Show About Death

A Conni Smudge Lifetime Movie of the Week concept? No, you’re about to experience something completely different. This show will take you on a journey through the minds of nine drag performers as they explore death. Don’t wait for these artists to die before you appreciate their art; come see a more vulnerable side of drag performance.

10pm. XYYVR, 1216 Bute St. Cover $9. For more info, visit Facebook.

Saturday, March 3

Meet Mabel

Attention female ball players itching to get on the mound: the pre-season mixer for the Mabel League baseball season is here. The Mabel League welcomes teams of all skill levels, and they want to make it as easy as possible for you to start a team. Email for more info or to set up a table to recruit new players.

6–10pm. Cedar Cottage Neighbourhood Pub, 3728 Clark Dr. For more info, visit Facebook.


Wild Fruit

Time to get too sexy for your shirt. The ’90s best, catchiest and most obnoxious are back with DJ Miss M. It’s a night to dance your face off, give in to your guilty pleasures, and sing into your beer bottle as Flygirl brings you another party that will rock your world.

10pm–3am. The Odyssey, 686 W Hastings St. Tickets $7–$10. For more info, visit Facebook.


Sunday, March 4

Kegger Sunday

Looking for something a little manlier than an Oscar party? Pumpjack is the place to be for men, beer, men, sex, men and dancing to some of the hottest DJs in the city. All this and not a red carpet or evening gown in sight. Specials run all day but, be warned: it fills up fast, so get there early.

2pm. Pumpjack Pub, 1167 Davie St. No cover. Info from Pumpjack.

Oscar Madness

Why sit at home and scream at the screen when you can do the same thing at the bar? Pick your winners and enjoy a fundraiser for Positive Living BC, while competing for a cash prize.

2:30–8:30pm. XYYVR, 1216 Bute St. $15 at the door. For more info, visit Facebook.

Oscar Viewing Party

Wait, is that Joan Rivers doing the Oscars from the grave? Oops, my mistake, the makeup is the same but this queen is Conni Smudge back for her annual Oscar Award Party and Red Carpet Dish. This year is the 90th — of the Oscars, people, not the Smudge.

3–10pm. The Junction, 1138 Davie St. No cover. For more info, visit Facebook.


Commercial Drag 3

Drag queens and comics and food, oh my! This is the first in a series of comedy shows at which drag queens, kings and things do stand up. Welcome Dust, Misty Meadows, Claire Pollock and more.

8–9:30pm. The Penny, 1601 Commercial Dr. For more info, visit Facebook.


Monday, March 5

QueerProv Workshop

Looking to learn some new tricks or hone your improv skills? You’ve practised long enough in the bathroom mirror; join in a workshop that will actually get you places. This drop-in workshop — every two weeks, open to the community — is facilitated by QueerProv performers and plenty of guest teachers to help heighten and expand your improv skills.

5:30pm. Qmunity, 1170 Bute St. $10 drop in. For more info, visit Facebook.


HIM Condom Packing Party

If you haven’t noticed, HIM condom parties are now the best stitch-n-bitch event around thanks to host Boy Spence and a rotating group of co-hosts. Tonight, you will have a chance to work with the Rhinestone Phoenix charity as you all happily stuff condoms and lube into tiny packages. It’s an effortless way to volunteer time to harm reduction while having low-key fun and good chats, and enjoying free yummy pizza.


Still All By Myself

The first show was such a rousing success that these actors have decided to subject themselves to another round of solo scenes. The actors will appear on stage alone and they can only use the help of the technical booth and the audience. It’s an improviser’s greatest fear. Hosted by Michael Sousa and featuring Sarah Dawn Pledge, Maya Ritchey, David Borja and many more.

10pm. XYYVR, 1216 Bute St. No cover. For more info, visit Facebook.

Tuesday, March 6

Magic Mic

The hottest open mic in the West End — sorry, no strippers, that was the movie. Calling all comedians, musicians and all performance acts. Steev Letts and Oli Maughan are thrilled to host Magic Mic open mic every Tuesday. Set length is five minutes, so get your material ready and take a chance.

7:30pm. The Junction, 1138 Davie St. No cover. For more info, visit Facebook.

Wednesday, March 7

Extra Wednesdays

The only extra I have ever done on a Wednesday is on my 649 lottery ticket, but I now know I’ve been missing out, because 1181’s Wednesday DJ is hot as hell and has an international flare with a sound that will rock you to your core. DJ Rafael Calvente knows how to get your inner self moving in ways you could never imagine.

11pm–3am. 1181, 1181 Davie St. No cover. For more info, visit Facebook.


Federal NDP, Liberals considering decriminalization of all drugs

For The Globe and Mail

An ambulance passes drug users as it arrives to help an overdose victim in a Downtown Eastside alley in Vancouver.



Two of Canada’s three major political parties are considering removing criminal penalties for the personal possession and use of all drugs – a step that health and drug policy experts say is critical in treating problematic substance use as a health issue.

At a national convention in Ottawa last weekend, the federal New Democratic party passed a resolution to end the criminalization of the personal possession of all drugs, a move in line with leader Jagmeet Singh’s position that problematic drug use should be treated as a social-justice and health-care issue rather than a criminal matter.

The NDP is the first major Canadian party to advocate for decriminalization, and it appears likely that it will also become the first to include it in a party platform.

Under decriminalization, which is different from legalization, it would remain illegal to manufacture, sell and distribute illicit drugs.

NDP MP and health critic Don Davies, who helped prepare the resolution, said it’s clear that punitive responses to illicit drug use have not worked and must be replaced with prevention, education and treatment.

“Let’s quit wasting billions of dollars on a failed, criminalized, stigmatized approach to drug use that is misconceived and ineffective,” Mr. Davies said in an interview. “I’m proud of our party for taking that bold step, for taking an evidence-based approach to this issue.”

Prime Minister Justin Trudeau, whose Liberal government will legalize the recreational use of marijuana this year, has repeatedly said his party is not considering the decriminalization of any other drugs. However, the national Liberal caucus has signaled an appetite for change with a resolution to be considered at that party’s national policy convention in Halifax in April.

“The government of Canada should treat drug abuse as a health issue, expand treatment and harm reduction services and re-classify low-level drug possession and consumption as administrative violations,” the resolution reads.

Nathaniel Erskine-Smith, Liberal MP for Beaches-East York in Toronto, has for the past year publicly advocated for the decriminalization of all drug use. In an interview this week, he commended his party for bold moves it has taken so far – such as reducing barriers to opening supervised consumption sites and overturning a Conservative ban on heroin-assisted treatment – but said more needs to be done.

“We’re light years ahead of where we were, but do I think we need to go further? Yes, without question,” he said.

Meanwhile, the Conservative Party of Canada says its priorities on drug use remain prevention and treatment. The party has floated the idea of reducing marijuana possession from a criminal to ticketable offence, but has never considered extending that policy further.

“The government should be focusing on treatment centres to get people that are on drugs now off, and on education,” said MP Marilyn Gladu, the party’s health critic. “We did see that when the Conservatives ran public education campaigns on marijuana, the marijuana usage rates were starting to drop. So really, that’s the key.”

The Global Commission on Drug Policy, the World Health Organization and both the Canadian and American public health associations support the decriminalization of possessing small quantities of currently illegal psychoactive substances. Such a move, they say, would free up police and court resources for more serious crimes, steer problematic drug users toward treatment rather than jail and underscore that addiction is a health issue.

Portugal decriminalized the purchase, possession and consumption of all psychoactive drugs for personal use in 2001. Those found using must appear before a local Commission for the Dissuasion of Drug Addiction, which then considers individual circumstances and can impose a non-criminal sanction such as a referral to treatment or a monetary fine.

Three population surveys since 2001 suggest drug use increased slightly, but then fell to rates lower than before the legislation was enacted. Drug deaths plummeted; a 2016 report by the European Monitoring Centre for Drugs and Drug Addiction found that fatal overdoses fell to levels among the lowest in the European Union, as did new cases of HIV and AIDS among drug users.

For such a decriminalization model to work in Canada, access to treatment would have to be much more accessible, Mr. Davies said, noting there is “an appalling lack of it in the country.”

On Tuesday, rallies were held across Canada as part of the National Day of Action on the Overdose Crisis. The top demand was for immediate decriminalization.

Initial estimates suggest that more than 4,000 Canadians died from opioid overdoses last year. In British Columbia, at least 1,422 people died of illicit drug overdose deaths, with fentanyl being a factor in 81 per cent of those deaths.



30 years after Canada’s first MP came out, LGBT politicians still face challenges

Former B.C. MP Svend Robinson says there’s been much progress against discrimination since then

In 1988, Svend Robinson became the first MP in Canada to publicly announce he was gay.

In 1988, Svend Robinson became the first MP in Canada to publicly announce he was gay. (CBC)

Former B.C. MP Svend Robinson was only 27 when he began his political career. Secretly, he’d always hoped to publicly announce he was gay.

“Nobody had ever done it before, and many people said this was political suicide,” Robinson said over a choppy phone line from a cruise ship in Norway, where he was recently on a five-day tour with friends.

Robinson is now retired. But 30 years ago when the then-NDP MP for Burnaby-Kingsway became the first MP to come out as gay, Canada was battling the HIV/AIDS crisis. Fear of the disease, coupled with longstanding social stereotypes, meant homophobia was rampant.

Today, there are LGBT elected officials across the country. They say it’s because of Robinson and others like him that they’re able to do their work.

But they also say they continue to face hatred and threats, and there is still work to be done to fight discrimination.

Here’s a short video of the broadcast news segment that aired at the time:

Robinson was re-elected six months after he came out. He said he won by a larger margin than he’d ever had before. He remained in office for another 16 years.

‘It was incredibly liberating’

It wasn’t without trepidation that Robinson sat with CBC reporter Barbara Frum on Feb. 29, 1988, and told her he was gay.

“It was a bit scary, but it was incredibly liberating, politically and personally,” he said.

The week before, rumours had swirled that he would make the announcement. The front window of his constituency office was smashed.

Svend Robinson

The windows of former B.C. MP Svend Robinson’s constituency office were smashed after rumours swirled that he was about to come out as gay. (CBC)

But Robinson came out anyway. He said it was the possibility of giving “a message of hope and solidarity to the younger gay and lesbian people” that spurred him to do so.

“There were still lots of barriers,” he said. “People forget what it was like back then. I didn’t exactly start a trend.”

Robinson was the lone publicly gay MP for another six years, until Quebecois Réal Ménard came out in 1994. Then B.C. MP Libby Davies was the first lesbian to come out in 2001.

‘Sure, I’ve gotten death threats’

Spencer Chandra Herbert, B.C. NDP MLA for West End-Coal Harbour, said it was because of trailblazers like Robinson that he felt encouraged to go into office.

Chandra Herbert is openly bisexual and married to a man. He was only eight years old when Robinson came out, but years later he learned about it from a high school teacher.

“That was really inspiring to me. It may have planted the seed that had me ending up as an MLA here in B.C., because if he could do it, I could do it too,” Chandra Herbert said.

“[Coming out] wasn’t such an issue any more.”

Spencer, Romi Chandra Herbert and son Dev

Spencer Chandra Herbert and husband Romi were featured in a Georgia Straight newspaper article on Vancouver LGBT trailblazers. (Deborah Wilson/CBC)

That hasn’t meant a life entirely free of fear and discrimination. In 2014, an intoxicated man came into Chandra Herbert’s constituency office yelling homophobic slurs.

And last year, a family photo of him, his partner Romi and their son Dev prompted backlash and hate mail.

“That kind of violence and that kind of hatred is still alive in B.C.,” Chandra Herbert said. “Sure, I’ve gotten death threats. I’ve had really horrible things written to me. But it hasn’t stopped me.”

“Almost like a non-issue”

Despite those attacks, Chandra Herbert said pioneers like Robinson have made his job much easier overall.

Robinson echoed that sentiment. Looking back on the past 30 years, he said he’s seen a lot of progress since he came out.

He said he was especially moved by Prime Minister Justin Trudeau’s recent historic apology to LGBT Canadians, which Robinson worked on as part of a committee.

“That I would have never have imagined,” he said.

Trudeau tears up during LGBT apology

Prime Minister Justin Trudeau wipes his eye while he is applauded as he delivers a formal apology to LGBT people in Canada in the House of Commons in Ottawa, Nov. 28, 2017. (Adrian Wyld/The Canadian Press)

Whereas 30 years ago Robinson was part of “one of the most exclusive clubs in the world” as a gay MP, today he frequently meets and speaks with LGBT elected officials.

While Robinson acknowledges they still face discrimination, he said sexual orientation is “almost like a non-issue.”

“And that’s absolutely the way that it should be,” he said.



HIV pre-exposure drug approved for funding in B.C., but barriers remain


Oren Adamson received a prescription for pre-exposure prophylaxis treatment in July of last year. Also known as PrEP, the once daily pill is believed to reduce the risk of contracting HIV by more than 90 per cent.

Health Canada approved PrEP in the form of the drug Truvada last year, but it has remained too expensive for many patients at $1,000 month. It’s considerably cheaper – $70 – in the United States, prompting Mr. Adamson to drive from his home in Vancouver across the border every three months to a rented mailbox to pick up his prescription.

That changed in late December when the B.C. government announced it would become the first province, as of Jan. 1, to fully fund the generic form of the drug to patients at risk of contracting HIV – a policy that has seen 600 patients enroll in the program, but, patients and doctors say, hasn’t completely removed the barriers to getting the drug.

In Mr. Adamson’s case, even with a Vancouver-based physician who was supportive and open to prescribing PrEP, he had to educate his doctor about the funding decision.

“I was a little surprised. It seems like the word isn’t really out as much as I thought it was,” said Mr. Adamson. “I see it on my Facebook, in my social group it’s talked about and it’s a thing, but I guess it’s not everywhere.”

The funding program, which is overseen by the Vancouver-based BC Centre for Excellence in HIV/AIDS, or BC-CfE, provides the drug for free to people at high risk of infection. As of Feb.15, there were 601 people enrolled in the program, with 32 requests still being processed. Of those, 60 per cent are completely new to PrEP. So far, 120 physicians in B.C. have prescribed the treatment. Dr. Julio Montaner, director of the BC-CfE, said it was a positive trend that suggests the “dear doctor letters” and educational materials sent to prescribing physicians from the BC-CfE are having an impact.

“I think this is very encouraging,” said Dr. Montaner. “The number of physicians prescribing PrEP is quite substantial within six weeks of the program.”

But advocates think there’s still work to be done breaking down remaining barriers to access – whether those barriers are geographical or stigmatic.

“Now that cost is not a factor, it’s actually getting people on the medication that’s going to be the next big thing,” says Jody Jollimore, executive director of the Community-Based Research Centre for Gay Men’s Health. “Sometimes people think, ‘Oh, there’s a program, so the work is done.’ What we’re saying is, it’s really not. For us the work is just beginning.”

In order to get on PrEP, a patient first needs a doctor to approve their request and submit a form to the BC-CfE on their behalf; the patient is also sent for blood tests.

“Outside of Vancouver, 50 per cent of guys, sometimes more, are not out to their doctor,” says Mr. Jollimore. “If you’re not out to your doctor, how can you have a conversation about PrEP?”

According to data from the BC-CfE, 88 per cent of PrEP recipients have picked up their drugs at St. Paul’s Hospital in Vancouver. Only 12 per cent have had their drugs delivered to their physician’s office outside of Vancouver.

Another barrier to access is physician misinformation. Mr. Jollimore said his organization has heard from men whose prescribing physicians declined to fill out the prescription, sometimes based on uncertainty about the complexity of the process. Some people have reported physicians suggested the person cut back on “risky behaviours.”

The BC-CfE says 50 applications for PrEP have been sent back for further clarification after being filled out incorrectly by the prescribing physician.

Mr. Jollimore and others are still working to help get PrEP to the people who would benefit from it.

Last week, the Community-Based Research Centre for Gay Men’s Health held a “PrEP Ed” session in Vancouver, where representatives for each local health authority attended a seminar covering the basics of PrEP, patient advocacy training, how to respond to PrEP pushback and strategizing ways to practise outreach in their home communities.

The Vancouver-based YouthCO HIV & Hep C Society is also holding sessions to help young people feel more comfortable with PrEP. Young people who are curious about whether PrEP is right for them can ask questions and walk away with the requisition they need to start the initial blood work.

YouthCO is also pairing people up to visit health clinics together and working with Vancouver-based physicians to connect with prescribing doctors in remote communities.

In Prince George, 21-year-old David Schroeter was reassured when he heard about the funding for PrEP. The drug had been outside his price range, and living in a more northern city, regularly travelling to the United .States to pick up a prescription wasn’t an option for him. “I was genuinely relieved and quite excited. It makes it so that I’m more sure that I’m safe,” said Mr. Schroeter.

He plans to continue working with local group Empowerment Prince George to help more people in his community feel comfortable getting on PrEP.

“I’m personally quite accepting of who I am and I think that had a substantial impact on my experience in acquiring PrEP,” says Mr. Schroeter. “I was able to just talk to my family physician, [an option] that I acknowledge a lot other people don’t have.”

Mr. Schroeter is still waiting for his medication to arrive. But he’s hopeful that the conversations the PrEP program have started will combat the stigmas that still survive around HIV and preventative treatments.


Victoria woman named ‘woman of worth’ for free vet care program

Honourees are celebrated and awarded $110,000 in charitable grants

Dr. Jane Vermeulen of Vets for Pets is among those recognized in L’Oréal Paris’ second annual Canadian Women of Worth program.

On International Woman’s Day (March 8), 10 Women of Worth honourees are celebrated and awarded $110,000 in charitable grants at an awards gala in Toronto hosted by award-winning actress Helen Mirren.

“We are astounded by our 2018 Canadian Women of Worth Honourees and the humanitarian work they champion to help so many people including refugees, homeless, food insecure, cancer patients and autistic adults. It is our honour and privilege to recognize this year’s exceptional Honourees and help shine a spotlight on their inspirational work on International Women’s Day,” said Milan Mladjenovic, general manager, L’Oréal Paris in Canada.

The Women of Worth program honours Canadian women who selflessly volunteer their time to serve and improve the lives of those in need. Selected from an impressive pool of public nominations, each honouree was chosen by an esteemed judging panel based on the impact of the cause she’s championed and innovation she has demonstrated to benefit those less fortunate.

Vermeulen, of Victoria, runs Vets for Pets that provides free veterinary care to more than 60 pets a month on a consistent basis to homeless and low-income pet owners.

Each honouree receives a $10,000 grant for her charity, as well as a trip for two to the gala in Toronto and marketing support to increase visibility for her charity.

The public can vote for one of the 10 to be national honouree. Others include: Carol Todd, The Amanda Todd Legacy in Port Coquitlam, that promotes mental wellness and healthy living by improving awareness of bullying, cyber abuse and internet safety; Chantal Bernatchez, Association Vergers d’Afrique in Montreal which has assisted nearly 5,000 women from Burkina Faso to create revenue producing activities to help fight poverty; Hazar Mahayni, Syrian Kids Foundation in Montreal offers education, humanitarian relief & social services to Syrian refugee children from different backgrounds, sects and religions; Lise-Marie Gravel, Autism Without Limits in Montreal spearheads the inclusion and personal fulfillment of autistic adults in social and learning environments; Lourdes Juan, The Leftovers Foundation in Calgary rescues 4,000 pounds of food per week from being thrown in landfill and delivers to service agencies in need; Maike van Niekerk, Katrin’s Karepackage in Halifax advocates for cancer patients in Nova Scotia and Newfoundland by offsetting travel costs for cancer-related appointments; Stachen Frederick, BrAIDS for AIDS in Toronto raises awareness of HIV/AIDS within the African, Caribbean and Black community through cultural practice of hair braiding; Subhra Mukherjee, Sai Dham Food Bank in Mississauga, ON is open 24/7 providing free deliveries of nutritious food to seniors and frail adults struggling with hunger across nine cities; and Victoria Plouffe, Beads of Courage in Calgary helps children & teens with serious illness to record, tell and own their stories of courage through programs of narrative medicine.

One of the 10 women will be selected as the national honouree earning another $10,000 grant for her non-profit cause. Visit and vote until March 4.


HR-HPV Infection Among HIV-Infected Women

With the introduction of highly effective antiretroviral therapy (ART) for the management of HIV infection, mortality rates for patients with HIV have decreased significantly, and patients are living longer. Unfortunately, patients with HIV also experience higher rates of conditions associated with long-term immune suppression such as cancer.
Persistent infection with high-risk strains of human papillomavirus (HPV) in the anogenital region is related to an estimated 40–90% of cancers of the cervix, anus, vulva, vagina, penis, and oropharynx.

Although secondary prevention strategies such cytology and HPV testing have reduced the incidence of cervical cancer, there is no current consensus on strategies to reduce anal cancers in women. Primary prevention strategies such as HPV vaccination have the potential to reduce the incidence of all cancers related to HPV infection, including both cervical and anal cancers. In the US, there are 3 approved vaccines for the prevention of HPV, but Gardasil 9, which covers 7 high-risk strains of the virus along with 2 other strains, is the only vaccine currently available.

Erna M. Kojic, MD, Chief of Infectious Diseases, Mount Sinai St. Luke’s and Mount Sinai West in New York City, and a researcher in the area of HIV and HPV coinfection, set out to investigate the incidence, prevalence and clearance of the 7 high-risk strains of HPV covered by Gardasil 9 as well as the 7 high-risk strains not covered by the vaccine in women with HIV.

Kojic and colleagues enrolled 126 women from 7 clinics in 4 US cities in this prospective observational cohort study. The women included in the study were HIV positive, ethnically diverse, generally healthy, and currently receiving outpatient care. Cervical and anal tissue samples were collected at baseline and annually for cytology and HPV testing for a follow-up period of 5 years.

At baseline, “HPV infection was more prevalent at the anus (90%) than the cervix (83%).” The prevalence of the high-risk strains both covered and not covered by the Gardasil 9 vaccine was also higher at the anus than the cervix. Overall, the clearance of any strain of HPV was lower at the anus than the cervix. In addition, the clearance of any high-risk strain of HPV was also lower at the anus than the cervix.

The researchers observed that HPV infection cleared more slowly at the anus versus the cervix regardless of the strain of the virus. The differences in infection between anatomical compartments, speculated by the authors, was related to local mucosal environment, different sexual behaviors and transmission, or efficacy of the immune response to clear infection, although they also noted anal sex history was not associated with HPV prevalence.

Dr. Kojic and colleagues also determined that most of the high-risk HPV types “detected in abnormal anogenital cytologies were types included in the 9v vaccine [Gardasil 9], and because its use might impact the clearance rates of HR-HPV (high-risk HPV) by decreasing the overall burden of anogenital HPV infection in HIV-infected women, these findings further support use of the nonavalent vaccine [Gardasil 9],” which is probably the most important and clinically relevant finding of the study.

Author: Erna M. Kojic