The world's largest AIDS conference took place in Washington, D.C. July 22 to 27 and it might surprise you to learn there was some local participation.
HIV/AIDS is, of course, a global issue, and something that is typically associated more with Africa rather than Assiniboia. But the human immunodeficiency virus knows no borders, and since 1985, doctors, health workers, researchers, government officials and other experts have gathered in a biennial conference to discuss the state of AIDS in the world today and the path forward. The 2012 conference, held in the United States for the first time in 22 years, appropriately had "Turning the Tide Together" for a theme.
This year, there was some local participation as Kent Lindgren, who works for BTC Indian Health, was among the 20,000 attendees.
Lindgren has worked for three years co-ordinating the organization's HIV prevention and awareness project targeting off-reserve First Nations and Métis. The project also targets pre- and post-natal women, men in correctional institutions, injection drug users and youth. Though a small project on the international scale, it is one of innumerable projects in the world working towards the common goal of the elimination of HIV/AIDS. The geographical closeness allowed Lindgren to take part in the week-long conference, a first for local workers.
Lindgren's background is in sociology, and his work revolves mostly around the issue of HIV stigmatization. Right now, for example, he and his organization are working to develop workshops to educate professionals on stigma and discrimination. The project is working with the health region and the public school district towards their goal.
The conference sessions helpful to Lindgren specifically dealt with stigma and discrimination, and Lindgren attended conferences based around this theme. But, as with any similarly large conference, there was plenty to take in. The science conferences, for example, were particularly valuable.
"Often you find yourself very engaged in your own area - this takes it out and presents what you know in new ways and presents new information, since I don't work in a scientific background," Lindgren explained. "It really gave me a strong basis in that area."
The science section was also important because, for the first time in history, there is talk of an AIDS-free generation. Even without a cure, advancements in treatment and prevention may actually eliminate the virus. The human immunodeficiency virus has tremendous variability, part of what makes the creation of a cure or vaccine extremely difficult. But antiretroviral drugs have so far had incredible success in reducing transmission rates. Vertical (mother-to-child) transmission has been reduced by 95 per cent, and promising new treatments also have the potential to dramatically reduce horizontal transmission (between sexual partners or intravenous drug users).
At the moment, treatment is a lifelong affair. Once someone is put on pills, they can't be taken off them or the virus will become active again. But here again, promising new trials in France and the United States seem to have developed immune systems to the point where they can take charge and control the virus. The studies are not conclusive. But if they are successful, they may further reduce the cost and complexity of treatment.
But the successes in the field of HIV/AIDS have not just been scientific. They have also been social. The reduction of stigma associated with being HIV positive, and the widespread increase in condom use have both been encouraging examples.
Thus for Lindgren, it was interesting to see the two voices - the scientific and the social - speaking "together, united, with one fight and one message."
The conference, however, was not all positive.
"There is also a negative side to it, as there are a lot of people who are still sick and dying from the virus."
And this darker side does have a more local component, as Saskatchewan currently has the highest rates of HIV in Canada. In 1998, Saskatchewan was near the bottom of Canada for HIV rates, with British Columbia, Ontario and Quebec at the top. While those provinces do still have high rates, Saskatchewan passed the rest of Canada in 2008 to become the province with the highest rates of HIV in Canada. Saskatchewan also currently has 16 times the national average for new cases of HIV, suggesting that it will remain in the first position for some time.
Saskatchewan is also unique in Canada for how HIV is transmitted. Unlike most of the world, the most common route of transmission in Saskatchewan for men is intravenous drug use, and for women is heterosexual sex. And Canada can learn from other parts of the world, as many of Canada's HIV issues have already been dealt with elsewhere. For example, rates of mother-to-child transmission remain high in Canada. Not dramatically high, but higher than they could be if proper treatment regimens were followed.
Faced with these facts, Lindgren still sees a silver lining. Saskatchewan's government responded to the high rates of HIV by establishing the Saskatchewan HIV Provincial Leadership Team in 2010. Based around the four pillars of community engagement, prevention and harm reduction, clinical management and surveillance and research, the program hopes to dramatically reduce the number of HIV infections, reduce risk factors for HIV infection and improve quality of life for HIV-infected individuals.
The fact that we could have the virus on the run is incredible, encouraging news. But in the years before we see dramatic reductions, we will see slow, incremental changes. Not all will be medical. One of the most important changes will be the reduction of stigma associated with HIV. Though there are behaviours that put one at a greater risk for HIV, anyone can become infected. And in Canada, a surprising number of HIV positive individuals were born with the virus.
It is of course too early to judge the successes or the failures of the provincial program, just as it is too early to declare the end of AIDS to be in sight. But if HIV/AIDS is to be eliminated, or even drastically reduced in the world, the reduction will come from a multi-pronged attack from scientists, researchers, educators, community workers and medical workers.
