Raleigh Edmiston: COVID-19 pandemic threatens the resurgence of HIV

Raleigh Edmiston

This year should have been the year we controlled the HIV epidemic.

Four years ago, governments around the world, including Canada, promised to achieve three goals: 90% of people diagnosed with HIV. 90 percent of people diagnosed with treatment. 90% of people receiving treatment were able to keep the virus undetectable.

Scientists say that achieving these goals by 2020 poses a public hygiene threat by 2030, as available therapies eliminate the risk of HIV transmitting to sexual partners. Predicted that HIV / AIDS will be eliminated. Then COVID-19 occurred.

You may think that physical distance measurements to protect us from COVID-19 also limit the chances of transmitting HIV. However, the reality of the field is not so simple.

Consensual sex is healthy both physically and mentally and can provide the physical and emotional intimacy that many now crave. Similarly, many people use medications to help them cope during times of stress.

What makes this a bigger risk now is that our public health infrastructure is hampered by COVID-19.

HIV testing clinics needed to reallocate staff and resources to the COVID-19 response, save time, or shut down altogether to ensure adequate distance. Prevention and support services are also tense. The shortage of monitored consumption areas, HIV prevention clinics, counseling services, etc. is exacerbated by COVID-19.

These prevention, testing, and treatment programs form the basis of Canada’s efforts to eradicate HIV infection. Threats to any of these can overturn the entire foundation of HIV protection and cause an epidemic revival.

Researchers at the British Columbia Center for Excellence in HIV / AIDS recently predicted that a 50% disruption of HIV services with COVID-19 could result in a 9% increase in new HIV infections.

You don’t have to do this.

Even before the COVID-19 pandemic, community-based service providers were experimenting with innovative approaches to delivering HIV services remotely. This was primarily to provide greater convenience to patients and clients, but also to find the efficiency of the healthcare system.

The HIV self-test, recently approved by Health Canada, is one of the tools that can be effectively used to diagnose people when the clinic is unable to handle the same number of face-to-face appointments. Self-testing reduces the burden on the lab (currently processing the COVID-19 test backlog) by screening out negative test results and transferring only preliminary positive results to further lab tests. You can also.

Although self-testing is approved in Canada, there is still a long way to go before it becomes available to the average person, and pricing is a major obstacle.

Programs are emerging across the country to bring kits into the hands of those in need, but this requires financial support. Given the public health benefits of HIV diagnosis and the potential to ease the burden on testing laboratories, financial support for HIV self-testing is a cost-effective investment.

Researchers were also investigating ways to make it easier for HIV-negative people to take PrEP, a pill that they take regularly to prevent HIV infection.

Canadian guidelines recommend that people taking PrEP should see a doctor and be tested for sexually transmitted diseases every few months. This is especially difficult during a pandemic where the clinic is full, you need to maintain physical distance, and everyone wants to avoid unnecessary doctor visits.

Research projects have already demonstrated ways to reduce this burden, such as providing remote clinical counseling and allowing patients to take their own test samples at home and submit them directly to the lab.

Many healthcare providers are forced to offer these services for a pandemic, but now is the time to scale up and offer PrEP services at home for those who want it. It’s not just about convenience. It is to maintain our medical capabilities in a pandemic.

The same applies to the prevention of HIV infection from drug use with syringes.

Needle change, supervised consumption areas, and other harm reduction services have been proven to reduce HIV infection. However, the overdose crisis has already put a strain on services that provide sterile equipment and preventative information to drug users. The COVID-19 pandemic only added fuel to the fire.

Harm reduction workers have provided solutions through “satellite sites” that provide similar services to community-based health centers provided by peers of drug users at home. This gives drug users access to the necessary sterile equipment and preventative information, while reducing the risk of getting sick with COVID-19.

Researchers and community supporters have long sought a safe drug supply, as well as this type of peer-led harm reduction program, but pandemics make these programs even more necessary. It has become.

Instead of risking a recurrence of an HIV epidemic that puts more strain on the public health system, take this opportunity to provide HIV services in another way.

Laurie Edmiston is the Secretary-General of CATIE, a source of information on HIV and hepatitis C in Canada.

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