Every year on July 28, we mark World Hepatitis Day with an event to educate, gather together, and also remember those we have lost from the hepatitis C community. This year, we should have much to celebrate: in early 2017, medications that had previously been unavailable were finally added to some formularies, including Ontario’s. This means that people with certain types of hepatitis C who have been waiting years to access safe, effective medication will finally be able to start treatment and be cured. For many, being cured means avoiding potentially fatal outcomes like liver failure and liver cancer. It also means shedding the burden of carrying a highly stigmatized illness that is often met with ignorance, ostracism and discrimination.
The hepatitis C virus (HCV) is a major public health problem. Worldwide, about 70 million people are living with hepatitis C virus infection, with a higher prevalence in developing countries. In Canada, 210,753 to 461,517 people are infected with HCV, and an estimated 20 to 40 per cent of infections remain undiagnosed. Those born during the period of 1945 until 1965 have the highest rates of infection and, having acquired the virus decades ago, are now increasingly being diagnosed with serious liver-related illnesses, including liver failure and liver cancer and non-liver related illnesses such as cardiovascular disease, diabetes and kidney disease.
People living with HIV in Canada have been charged with some of the most serious offences in the Criminal Code, even in cases of consensual sex where there was negligible or no risk of HIV transmission, no actual transmission and no intent to transmit.
The Undetectable=Untransmittable (“U=U”) campaign is based on scientific research, including the ground-breaking PARTNER study, establishing that when a person living with HIV on treatment maintains an undetectable viral load for at least six months, the risk of transmitting the virus through sex is effectively non-existent. As advocates for persons living with HIV await action from federal, provincial and territorial governments to address the overly-broad criminalization of HIV non-disclosure, how might the U=U campaign and the results of the PARTNER study impact ongoing prosecutions under the current state of the law?
At the opening of the recent 25th Harm Reduction International Conference in Montreal, the Minister of Health Jane Philpott announced that more people have died in the overdose epidemic in the past few years than died during the height of the AIDS crisis in the late 80s and early 90s. In 2016, it is estimated that 2,300 people died of overdose—preventable deaths caused by the prohibition of drugs.
In response to that sobering and sad announcement, we wrote an article asking for people engaged in the response to HIV to show support and solidarity with people who use drugs. We believe that making connections between the two epidemics can help build solidarity, increase public support and mobilize people into action to address the national overdose crisis. We wrote:
“People who have lived through the AIDS crisis, who work in HIV organizations, who call themselves allies of the HIV community, who have attended an HIV fundraiser, who have learned about the history of AIDS activism, we make an appeal to you: The time for you to step up and end the massive injustice taking place against people who use drugs is now. We need more resources. We need the government to take our solutions seriously. We need the overdose epidemic to be declared a national emergency. Help us do this.”
So what can you do if you want to show support and solidarity? Here are six things you and your organization can do:
The possible unintended consequences of the introduction of PrEP to the sex industry is something that has been discussed in international sex work advocacy since at least 2012. So, when I saw that new PrEP prescription guidelines for Canada were being drafted, stating that “sex-trade workers” were a “significant risk of having transmissible HIV,” I was troubled that there had been no community consultation whatsoever. National guidelines required a national convening.
The CATIE Blog hosts the views and opinions of people and organizations working and volunteering in Canada’s response to HIV and hepatitis C.