News and Features
Treating HIV in British Columbia
By Michael Harris published Oct 9, 2012
Additional Images click to enlarge
More than 10,000 British Columbians are HIV positive. Only half of them take medication. How far will we go to change that?
Two years ago, Lisa lived on the street, addicted to heroin, and was slowly dying of an HIV infection that received no treatment. Today, she sits in a room three storeys above Hastings Street while Dr. Susan Burgess places a stethoscope to her chest. Lisa is small, pale, and a little dazed. Her meth-addled boyfriend just stormed off. The peanut butter and honey from breakfast still stick to her fingers.
“I was sick every day before,” she says. “But now Susan and the nurses can make me healthy, right? The smallest scratch, they care. Susan knows how everything is with me.” And why does the doctor come to her, instead of the other way around? “Lots of reasons. I mean, for one, sometimes the methadone makes it so I can’t get out of bed.”
Burgess does 40 to 50 house calls like this every week, attending to 200 patients who would otherwise be lost to care for a multitude of reasons (including outright fear of standard medical institutions). She writes a prescription for Lisa’s chest infection, checks about her HIV meds, meets the new kitten, and is back on the street in less than 10 minutes.
There are many people receiving treatment like Lisa’s because the B.C. government has invested $48 million in a pilot project conceived by the B.C. Centre for Excellence called STOP HIV/AIDS. The program has paid for new street nurses, new advertising campaigns, HIV testing fairs, and more, in an aggressive four-year push with two ultimate goals: universalize HIV testing (i.e., everyone gets tested, whether they’re “high risk” or not); and massively expand the delivery of HIV medication to hard-to-reach people, like Lisa, in the Downtown Eastside. (A concurrent program is running in Prince George.) The STOP stands for Seek and Treat for Optimal Prevention; it is a blitzkrieg in the war on HIV.
All this is predicated on the fact that Lisa, an HIV-positive person, cannot infect anyone else (via sex or through needle-sharing) if she’s taking her pills—the amount of virus in her bloodstream is so low it’s undetectable. But like hundreds of others, she will only take her pills if a health-care worker shows up weekly (or daily) to remind her. The promise of the kind of care STOP AIDS provides is enormous: if everyone were so treated, the spread of HIV would be essentially halted.
