[CBC] Northern advocates say new HIV guidelines a win

Original article here: https://www.cbc.ca/news/canada/north/advocates-hiv-lgbt-north-1.4937107

New federal directive for Crown attorneys only affects how people with HIV are treated in the territories

Andre Corriveau, acting medical director for the Northwest Territories Health and Social Services Authority, says new legal directives won’t have an effect on medical care.

Northern advocates for people with HIV and people in the LGBT community are applauding changes to how HIV-positive people in the territories are treated by the law.

In Canada, it’s illegal to have sex with someone and not tell them if you have HIV, if the sex acts pose a realistic possibility of passing on the virus. But on Dec. 1, World AIDS Day, Canada’s attorney general announced more precise standards for what’s considered a realistic risk.

The directive, which guides prosecutors, states charges won’t be pursued in cases where the person has maintained a suppressed viral load. Scientific evidence shows people who take their medications regularly they may be able to keep the traces of the virus so low in their blood that it becomes undetectable, and people with these extremely low viral loads don’t have a realistic possibility of transmitting the virus to others.

The directive also notes non-disclosure before oral sex or sex with condoms shouldn’t lead to prosecution, unless there are other risk factors. And it encourages prosecutors to consider whether it’s in the public interest to prosecute.

In the southern Canada, Crown attorneys respond to their own provincial attorneys general. So this directive for federal Crown attorneys only affects the territories, where rates of HIV transmission are relatively low.

Patricia Bacon, executive director of the Whitehorse street outreach group Blood Ties, says the announcement is a win.

Carmen Logie is an associate professor in social work at the University of Toronto, and a Canada Research Chair in Global Health Equity and Social Justice.

“We sort of put [HIV] in this realm of … nefarious criminality,” she said.

Bacon believes the new directive will reduce the stigma around testing and getting treatment for HIV. It will combat “the idea people with HIV deserve what they get,” she said.

In the Northwest Territories, spokespeople for sex-ed groups FOXY, SMASH and the Rainbow Coalition also said the move would help open up difficult conversations about HIV.

Nunavut did not share the numbers of HIV cases for this story, citing privacy reasons.

In Yukon, seven cases of HIV were reported between 2010 and 2014. Between 2001 and 2014, rates of HIV in that territory remained stable with zero to three new cases announced a year.

The Northwest Territories shared the most details.

Fewer than 35 N.W.T. residents are living with HIV today, said health department spokesperson Damien Healy. That means HIV prevalence in the N.W.T. is 73 per 100,000 population. For people in Canada, that rate is higher — 173 per 100,000 people living in Canada, according to 2016 numbers from advocacy group Community AIDS Treatment Information Exchange.

Between 2001 and 2017, the number of cases reported in any given year ranged from zero to five in the N.W.T.

Outbreak possible in the N.W.T., says expert

Blood Ties executive director Patricia Bacon says Whitehorse still needs access to rapid testing for HIV. (By Mercedes Bacon-Taplin. Submitted by Patricia Bacon.)

Carmen Logie, an adjunct scientist at Women’s College Research Institute who has done research on the N.W.T. with sexual education groups FOXY and SMASH, told CBC the move makes northern public health providers better equipped to respond if a future outbreak occurs.

“We’re just waiting for a possible epidemic in the North,” she said.

Other sexually-transmitted infections, like chlamydia and gonorrhea, are prevalent in the North, and can increase susceptibility to the virus.

Food insecurity can make it difficult for people to take medications that can be hard on their bodies. Close-knit sexual networks can allow a virus to be passed on to several people. And for people in poverty or without stable housing, stress can limit the efficacy of medications meant to keep the virus undetectable.

It can also be difficult to ascertain exactly how many people in the North have HIV, because people who do get the virus may move south for testing and treatment for better care and to avoid shame.

Relevant case in the North

A criminal case around HIV non-disclosure went through a Northern court in the early 2010s.

In 2011, Bobby Kaotalok was accused of having sex with multiple women in Yellowknife with whom he did not disclose his HIV-positive status.

He pled guilty and was sentenced in 2013 for two counts of aggravated sexual assault. Crown prosecutors did not respond on Friday whether under the new guidelines he may have received fewer or less serious charges.

Kaolatok is once again facing a charge for aggravated sexual assault. His attorney, Jay Bran declined comment on the case.


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