As doctors specializing in the clinical care of women living with HIV, we often get questions about breastfeeding and the transmission of HIV.
Here’s just one e-mail we received from an infectious disease specialist outside Ontario:
“I am seeing a young African woman as a patient who is HIV positive, had advanced disease, but now is suppressed. She is pregnant and had two deliveries in Africa, where she was encouraged to breastfeed. She is still quite adamant about breastfeeding despite my counselling otherwise. How do you manage these situations and what is your approach to this?”
Harm reduction and gay men’s HIV prevention could be considered two historic elements in our HIV response that have long stood separate from one another. Traditionally, HIV prevention with gay men focused on sexual risk, while harm reduction focused on risks associated with injection drug use. Both approaches have evolved over the decades and some might argue that safer sex is a form of harm reduction, but in the context of drug use, there has been little focus given to harm reduction in the context of gay men’s sexual health.
Ending the HIV epidemic in Canada in five years seems like an ambitious goal, but it is now in fact a target being advocated by a group of public health and HIV advocates in a new document published by the Canadian Foundation for AIDS Research (CANFAR). I am one of the authors of that document, which acknowledges the necessity of addressing racism and structural violence. But, except for support from a couple co-authors, I am dispirited by the co-authors’ failure to be clear about the difference those systemic and structural issues make, to inspire determination in addressing them, and to illustrate what is at stake and what it means to address racism and structural disadvantage.