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Physician Advocates for Kenora Safe Consumption Site in the Face of HIV/AIDS Surge

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More HIV/AIDS cases have been reported in Kenora, Ontario in the past 12 months than in the past eight years, and a practicing physician in the community says a safe consumption site is needed to help to fix the problem.

In 2022, the Northwestern Health Unit (NWHU) reported nine confirmed cases of HIV/AIDS in the northwestern Ontario city. In the previous eight years, there were only eight confirmed cases, according to NWHU data.

Dr Jonny Grek says that number could be much higher – he has seen 15 new cases reported in the past nine months and said data from the health unit lags behind what he is seeing at the level of the ground.

“Our numbers come from point-of-care testing on the street, which is then followed by a lab-confirmed test – and so far there have been no false positives on point-of-care testing,” Grek told CBC News in an interview.

NWHU Medical Officer of Health Dr. Young Hoon does not dispute Grek’s figures, but said the NWHU must follow provincial standards for reporting cases and cannot rely on preliminary tests or other clinical information. to confirm them.

Grek practices family medicine in Kenora Paterson Medical Centre, and provides outreach and street medicine services through the Sunset Country Family Health Team. He’s seen a lot of struggle on the streets of Kenora since he arrived in the area four and a half years ago.

The attitude and feel on the streets here is, I would say, desperation above desperation.– Dr. Jonny Greck

“The attitude and the feeling on the streets here is, I would say, desperation on top of desperation,” he said.

It works closely with people who may be more vulnerable to viruses, including those who use drugs, are homeless or poorly housed, or work in the sex trade.

Being a street doctor means that Grek literally meets people where they are. Sometimes they may feel more comfortable going to the homeless shelter or Kenora Fellowship Centre.

HIV (human immunodeficiency virus) attacks the immune system or its ability to fight disease. If left untreated, HIV can lead to AIDS (acquired immunodeficiency syndrome), which can be controlled with various treatments.

In Ontario, in 2020, more than 22,000 people are estimated to be living with HIV, according to the Ontario HIV Epidemiology and Surveillance Initiative.

The virus is mainly spread through bodily fluids, including blood and semen. Young Hoon said unprotected sex and sharing needles or drug preparation equipment are the most common ways to contract HIV/AIDS.

Kenora officials recently held an emergency council meeting where members of the public raised concerns about public safety in the downtown area.

Grek, who was at the meeting, said there was a collective agreement that conversations about these issues should take place – but there was also a lot of anger and resentment about the situation.

He said he would like to see more empathy towards people who use drugs, rather than judgment and fear of them.

Safe consumption sites

As part of the fight against the opioid crisis, calls have been made for safe consumption sites – where people are legally allowed to bring drugs to use in a clean and safe environment, and can also receive support in dependency on the part of health workers.

In Ontario, there are 26 safe consumption sites. But the closest to Kenora is Road 525, at 525 Simpson St. in Thunder Bay, Ontario.

During the second half of 2022, the NWHU worked with LBCG Consulting for Impact Inc. to conduct a feasibility study on supervised consumption services. The study examined whether supervised consumption services are needed in Kenora, Dryden, Fort Frances and Sioux Lookout, and what form they might take.

“The main objective is to prevent [opioid] overdoses, but it has the ability to increase access to clean needles and drug preparation equipment, which of course would reduce the spread of HIV,” Young Hoon said.

The NWHU is currently reviewing drafts of the report, hoping to finalize and publish the results in February.

Drug paraphernalia is displayed at the Vancouver Safe Consumption Site
On September 10, 2019, drug paraphernalia is displayed at the Molson Overdose Prevention Site in downtown Vancouver. (Ben Nelms/CBC)

According to Grek, a safe consumption site “would mean everything” to Kenora.

“We’re past the point here where we can stop people from using drugs. We’re way past the point where we’re able to control or even stabilize what’s dangerous…the toxic supply of drugs right now in the market,” he said. said. “But what we haven’t gone beyond is showing that people who use drugs are human beings.”

And when — not if — Kenora recognizes that’s the right approach, he said, it has to be more than “just a welcoming space where you go and do drugs and then you leave.”

He encourages people to challenge their views by having open conversations, like the one held at the Kenora council meeting last week.

“We’re all healthier when we learn more, especially if it means we’re just a little more open-minded about people,” he said.

Intensify testing and prevention programs

Anyone who thinks they are at risk of contracting HIV/AIDS can get a blood test by contacting their primary health care provider or by visiting a community health centre, primary care clinic or mobile clinic. Some NWHU offices also offer testing, Young Hoon said.

A photo of Dr. Kit Young Hoon, the Medical Officer of Health for Northwestern Health Unit.
NWHU Medical Officer of Health Dr Kit Young Hoon says, “Early detection and treatment of HIV means that people living with HIV can live with HIV for a long, long time and live with it in healthy ways. (Submitted by Lindsay Koch)

Young Hoon stressed that conversations with medical professionals are confidential.

“Many years ago when less was known and there [were] fewer treatment options for HIV, diagnosis seemed like a death sentence, but that is no longer the case,” she said. “Early detection and treatment of HIV means that people living with HIV can live with it for a very long time. , very long and live with it in a healthy way.”

But treatment should begin as soon as possible.

Testing helps prevent the spread of HIV, as does access to clean needles and protective barriers like condoms during sex. A list of syringe distribution sites can be found on the NWHU website. Many clinics also distribute condoms free of charge.

Making these services accessible to vulnerable populations – people who are poorly housed or affected by poverty – is essential, Young Hoon said.

The health unit is closely monitoring the number of HIV/AIDS cases to see what additional measures might be needed.

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