Positive Living 106 by Positive Living Magazine

N E W S A N D T R E AT M E NT I N F O R M AT I O N F R O M T H E P O S IT I V E L I V I N G S O C I E T Y O F B R IT I S H C O LU M B I A

ISSN 1712-8536

• FEBRUARY 2017 VOLUME 19 • NUMBER 1

HIV Home Test

JANUARY

Dump on Trump

Smoking & Weight

I N S I D E

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PAC’S FIGHTING WORDS

Provincial election battle plans

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COVER STORY Severe health cuts undermine HIV/AIDS health services in BC

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LET’S GET CLINICAL Viral suppression in HIV+ MSM

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NUTRITION Butting out and weighing in on weight

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RETHINKING SEX & HIV

Why are some people, Doctors even, not getting the message about PrEP?

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THE POSITIVE GARDENER GIVING WELL Holidays are over, time to reboot the garden

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POZ CONTRIBUTIONS Recognizing Positive Living BC supporters

Powering up with Body Energy Club

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VOLUNTEER PROFILE Volunteering at Positive Living BC

 positivelivingbc.org

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COME ALIVE Volunteers’ voices from History Alive

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SISTER TO SISTER Learning to live through art

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LAST BLAST The future starts now

HEALTH PROMOTION PROGRAM MANDATE & DISCLAIMER In accordance with our mandate to provide support activities and prejudice. The program does not recommend, advocate, or endorse facilities for members for the purpose of self-help and self-care, the the use of any particular treatment or therapy provided as information. Positive Living Society of BC operates a Health Promotion Program The Board, staff, and volunteers of the Positive Living Society of to make available to members up-to-date research and information BC do not accept the risk of, or the responsiblity for, damages, on treatments, therapies, tests, clinical trials, and medical models costs, or consequences of any kind which may arise or result from associated with AIDS and HIV-related conditions. The intent of the use of information disseminated through this program. Persons this project is to make available to members information they can using the information provided do so by their own decisions and access as they choose to become knowledgeable partners with hold the Society’s Board, staff, and volunteers harmless. Accepting their physicians and medical care team in making decisions to information from this program is deemed to be accepting the terms promote their health. The Health Promotion Program endeavours to of this disclaimer. provide all research and information to members without judgment or P5SITIVE LIVING | 1 | JAN •• FEB 2017

Message The Positive Living Society of British Columbia seeks to empower persons living with HIV disease and AIDS through mutual support and collective action. The Society has over 5700 HIV+ members. POSITIVE LIVING EDITORIAL BOARD Earl Sunshine - chair, Tyler Chudday, Ross Harvey, Joel Nim Cho Leung, Elgin Lim, Jason Motz, Adam Reibin, Neil Self MANAGING EDITOR Jason Motz DESIGN / PRODUCTION Britt Permien FACTCHECKING Sue Cooper COPYEDITING Maylon Gardner, Heather G. Ross PROOFING Ashra Kolhatkar CONTRIBUTING WRITERS Lorenzo Cryer, Brandon Laviolette, Kevin Moroso, MT O’Shaughnessy, Taylor Perry, Neil Self, Sean Sinden, Alena Spears, Zoran Stjepanovic, Darien Taylor, Denise Wozniak PHOTOGRAPHY Britt Permien DIRECTOR OF COMMUNICATIONS AND EDUCATION Adam Reibin DIRECTOR OF PROGRAMS AND SERVICES Elgin Lim TREATMENT, HEALTH AND WELLNESS COORDINATOR Brandon Laviolette SUBSCRIPTIONS / DISTRIBUTION John Kozachenko Funding for Positive Living is provided by the BC Gaming Policy & Enforcement Branch and by subscription and donations. Positive Living BC | 803 East Hastings Vancouver BC V6A 1R8

 Reception 604.893.2200  Editor 604.893.2206  living@positivelivingbc.org  positivelivingbc.org

Permission to reproduce: All Positive Living articles are copyrighted. Non-commercial reproduction is welcomed. For permission to reprint articles, either in part or in whole, please email living@positivelivingbc.org

from the chair

NEIL SELF

What a wonderful world this would be….

titled this Think+ with a bright Sam Cooke lyric to contrast the gloomy, Dickens quote I used in the last issue. That’s because optimism is key to healthful outcomes for PLHIV. Positive Living BC members prove this by always working toward a better future for each other. Since 1986 we’ve fought to keep our personal experience of the disease at the forefront of HIV care. Make no mistake: Canadian community-based HIV programs and services are in peril due to drastic funding shortfalls, especially from government sources. So we start 2017 in much the same way as we ended 2016—with major cause for fear, anger, and collective action. This current climate may seem familiar to those of us who were around in the eighties and nineties. Remember Bill 34 to legislate quarantine for anyone “likely to wilfully or carelessly or because of mental incompetence, expose others to the disease”? Our fight never ends. We can’t let our detractors weaken our resolve by devaluing the work we do and the special wisdom we’ve cultivated over 30 years on the HIV frontlines. We have to guard the promise of a wonderful world for PLHIV by ensuring our members and our HIV-positive peers across the country are given honest, fair consideration when public funds translate into direct support for our community. (See cover story on pgs. 13-15, Rude Awakening.) Many PLHIV enjoy the quality of life made by that promise. Some of them feel so

P5SITIVE LIVING | 2 | JAN •• FEB 2017

far removed from community-based HIV care that they don’t appreciate the true scope of responsibility carried on their behalf by Positive Living BC and other agencies. Consider that criminalization of HIV non-disclosure threatens basic human rights of all PLHIV in Canada, but only not-for-profit non-governmental groups lead the fight against this legislative travesty. As long as funding shortfalls force us to cut thin budgets and redistribute the leftover pittance to protect essential direct-to-user services, the health and safety of PLHIV will remain at the mercy of people who are ignorant to this complex, stigmatizing disease. But there is hope. And that’s where you come in, valued readers. You can shape a better future for all PLHIV. If you can offer financial support, please visit www.positivelivingbc.org or call 1.800.994.2437 to find out about your giving options. And please take our Positive Living Magazine readers’ survey at www.positivelivingbc.org, active until February 15, 2017. This publication is one of our strongest resources because it is built on by input from people just like you. While you always contact me with your thoughts and concerns, the survey allows you to share your voice in a quick and easy multiple-choice format. It also gives you a chance to win a prize, compliments of your Editorial Board. Thank for your ongoing support. 5

Smoking bigger threat to PLHIV

Smoking cigarettes reduces the lifespan of PLHIV, according to the Journal of Infectious Diseases. Researchers used a computer model of HIV disease and treatment to project the life expectancy of PLHIV based on their smoking status. For men and women who adhered well to HIV medicines, the study found that smoking reduces life expectancy by nearly twice as much as HIV. Smokers entering treatment for HIV at age 40 who continued to smoke, lose over six years of life expectancy. Those who quit smoking at 40 regain years: 5.7 for men, 4.6 for men and women respectively. (The study shows) that even people who have been smoking till age 60 but quit at 60 have a substantial increase in their life expectancy compared to those who continue to smoke,” says study author, Dr. Krishna P. Reddy. “So it’s never too late to quit.” Smoking reduces life expectancy through cardiovascular disease, such as stroke and heart attack, cancers, and emphysema. “Smoking is now the primary killer of people with HIV who are receiving treatment,” says Dr. Rochelle Walensky, a senior author on the study. Anyone in BC trying to quit smoking should contact Healthlink BC for information about smoking cessation programs across the province. Or contact our own Treatment, Health and Wellness coordinator, Brandon Laviolette at brandonl@positivelivingbc.org or 604.893.2239. Source: globalnews.ca/news/3047115/ smoking-is-now-more-likely-to-kill-hiv-patients-than-the-virus-itself/

HIV test performed on USB stick

Scientists have developed a type of HIV test on a USB stick. The device, created by scientists at Imperial College London and DNA Electronics, uses a drop of blood to detect HIV, and then creates an electrical signal that can be read by a computer, laptop, or handheld device. The disposable test could be used for HIV patients to monitor their own treatment. Furthermore, the technology could enable patients with HIV to be managed more effectively in remote locations. New research, published in the journal Scientific Reports, shows the device is not only very accurate, but can produce a result in under 30 minutes. The new technology monitors the amount of virus in the bloodstream. This is crucial to monitoring a patient’s treatment. Current tests to detect the amount of virus take at least three days, often longer, and involves sending a blood sample to a laboratory. In many parts of the world, particularly those with the highest number of HIV infections, such testing does not exist at all. Anti-retroviral treatment reduces virus levels to near zero. However, in some cases the medication may stop working—perhaps because the HIV virus has developed resistance to the drugs. The first indication of this would be a rise in virus levels in the bloodstream. Furthermore, regularly monitoring of viral levels enables healthcare teams to check a patient is taking their medication. Stopping medication fuels HIV drug-resistance, which is an emerging global problem. P5SITIVE LIVING | 3 | JAN •• FEB 2017

Viral levels cannot be detected by routine HIV tests, which use antibodies, as these can only tell whether a person has been infected. Dr Graham Cooke, senior author of the research from the Department of Medicine at Imperial explains: “HIV treatment has dramatically improved over the last 20 years—to the point that many diagnosed with the infection now have a normal life expectancy. “However, monitoring viral load is crucial to the success of HIV treatment. At the moment, testing often requires costly and complex equipment that can take a couple of days to produce a result. We have taken the job done by this equipment, which is the size of a large photocopier, and shrunk it down to a USB chip.” Dr Cooke added that this technology, although in the early stages, could allow patients to regularly monitor their virus levels in much the same way that people with diabetes check their blood sugar levels. The technology could be particularly powerful in remote regions in sub-Saharan Africa, which may not have easy access to testing facilities. Finding out quickly if a patient, particularly a baby, is infected with the virus is crucial to their long term health and survival. The device, which uses a mobile phone chip, just needs small sample of blood. This is placed onto a spot on the USB stick. If any HIV virus is present in the sample, this triggers a change in acidity that the chip transforms into an electrical signal. This is sent to the USB stick, which produces the result in a program on a

computer or electronic device. Professor Chris Toumazou, Regius Professor at the Department of Electrical and Electronic Engineering at Imperial adds: “This is a great example of how this new analysis technology has the potential to transform how patients with HIV are treated by providing a fast, accurate and portable solution.” Source: www.eurekalert.org/pub_releases/2016-11/icl-htp110916.php

Dolutegravir regimen highly effective in clinical trial for women

pA once-daily regimen containing the

potent HIV integrase inhibitor dolutegravir worked better than an older atazanavircontaining regimen—with higher rates of viral suppression both overall and across race subgroups—in the ARIA trial, one of the few antiretroviral therapy studies to enroll only women. Over the course of the HIV/AIDS epidemic, white men have been over-represented while women and people of colour have been under-represented in clinical trials of new therapies. But worldwide, women make up about half of all PLHIV and people of African heritage have the highest burden of disease, and it is important for new treatments to be tested in all the groups that will ultimately use them. The ARIA trial compared a fixed-dose combination of dolutegravir/abacavir/lamivudine (Triumeq) versus ritonavir-boosted atazanavir (Reyataz) plus tenofovir DF/em-

tricitabine (Truvada). Dolutegravir has been shown to have a high barrier to resistance and is potent enough to be used without a booster. Half the women were randomly assigned to receive dolutegravir/abacavir/ lamivudine and half to receive atazanavir/ritonavir plus tenofovir/emtricitabine. The study’s primary endpoint was the proportion in each arm with viral load below 50 copies/ml after 48 weeks on treatment. After 48 weeks on treatment, 82 percent of women taking the dolutegravir regimen and 71 percent taking the atazanavir regimen achieved viral suppression in an intention-to-treat analysis. The difference was large enough to show that the dolutegravir regimen was not only non-inferior, but also superior to the atazanavir regimen. Response rates were similar when comparing women with baseline viral loads above or below 100,000 copies/ml and CD4 counts above or below 350 cells/mm3. In a subgroup analysis by race, white women had higher virological response rates on both dolutegravir and atazanavir (86 vs. 80 percent) compared to black women (74 vs. 67 percent), but the difference between the two regimens was similar for both groups. Half as many women in the dolutegravir arm met the criteria for virological non-response compared to those in the atazanavir arm (6 vs. 14 percent respectively). None of the women who experienced virological failure while on dolutegravir/abacavir/ P5SITIVE LIVING | 4 | JAN •• FEB 2017

lamivudine developed resistance to these drugs. The higher response rate in the dolutegravir arm was largely driven by more discontinuations due to adverse events in the atazanavir arm. About 20 percent of participants in both arms stopped treatment before 48 weeks—including 13 women who became pregnant—but the reasons for doing so differed. About 80 percent of women in both treatment arms experienced some adverse events, but those taking dolutegravir were less likely to report moderate-to-severe events (46 vs. 55 percent) and drug-related events (33 vs. 49 percent). Women in the dolutegravir arm had fewer serious adverse events (0 vs. 3), drug-related serious adverse events (20 vs. 12) and discontinuations due to adverse events (17 vs. 10) than those in the atazanavir arm. As expected, women taking atazanavir were more likely to develop jaundice and yellowing of the eyes due to elevated bilirubin. Patterns and frequency of adverse events were similar when comparing black and white women. Source: www.aidsmap.com/ Dolutegravir-regimen-highly-effective-in-clinical-trial-for-women/ page/3096234 5

By Neil Self

Your Provincial Election Primer

clouds form in the sunny ways of the Federal Government and shock of the US election lingers, BC’s Provincial Election in May looms. The Positive Action Committee (PAC) has gauged our membership’s needs. We asked members at the Annual General Meeting what priorities they had for the next Provincial Government. The main concerns for our membership are: housing, mental health/ addictions, income, stigma/HIV criminalization, and funds for community-based AIDS groups. Little wonder that housing is the top concern. This reflects the view of the general BC public, regardless of socio-economic status. Low-income/fixed-income members need more access to affordable social housing. The waiting list to get into subsidized housing is daft. The amount of social housing units must increase. A lack of affordable rental units affects members with low- to moderate-income jobs. ASK THE CANDIDATES: What is your plan to increase social housing in BC? How will you work with Municipalities to increase affordable rental housing? One worry is Mental Health/Addictions. Understandable given the high rate of comorbidity between HIV and a mental health. Mental Health services are often neglected in lieu of other areas of health care, and because mental health can be considered more abstract than concrete, politicians are reticent to fund these services. These challenges combined with the current state of a public health emergency due to overdose death rates has elevated the areas of mental health and addictions to crisis proportions. ASK THE CANDIDATES: What is your plan to address the lack of mental health services? How will you address the opioid crisis? Another concern is income security. Due to the high costs of living/housing in BC, members’ income is spread thin. This is one reason why PAC is active on this issue by supporting anti-poverty

coalitions and movements to raise welfare, disability, pensions and minimum wage rates. ASK THE CANDIDATES: What is your position on the development and implementation of an anti-poverty strategy—something that only BC does not have? Will you commit to raising income assistance, disability, and the minimum wage? Would you consider developing a guaranteed annual income program similar to Ontario and PEI? And then there is stigma and criminalization of HIV. While we have come far with respect to treatment and extending the lives of PLHIV, we have not evolved with respect to stigma. Stigma continues to be a barrier to testing, treatment, and living with HIV. ASK THE CANDIDATES: How do plan to address stigma and discrimination against PLHIV? Will you work with these organizations to implement guidelines that only criminalize HIV non-disclosure in cases where deliberate transmission has occurred? The common thread here is a need for strong community-based support for PLHIV to keep them healthy and to empower them. Community support can help PLHIV at all stages of their disease, in finding housing, connecting them to mental health services, and mitigating stigma. But this requires a strong government. ASK THE CANDIDATES: Will you fund groups that help and support PLHIV? 5 Neil Self is the char of the Positive Action Committee and the Society’s chair.

P5SITIVE LIVING | 5 | JAN •• FEB 2017

UBCâ&#x20AC;&#x2122;s 4th Year Dental Hygienist Students are offering Positive Living BC Members oral assessments & dental hygiene care â&#x20AC;&#x201D; for FREE! Where: Positive Living BC (803 E Hastings St)

When: 1- 4 PM Wednesdays

(excluding school holidays & reading breaks)

For more information, or to schedule an appointment, leave a message at 604.893.2202 or dental@positivelivingbc.org to speak to the students in person while they are on site.

No buts about your butts By Alena Spears

your biggest worry about quitting smoking is the potential for weight gain, you’re not alone. Almost half of female smokers and a quarter of male smokers opt not to quit for fear of weight gain. What’s more, the fear of gaining weight is a stronger predictor of relapse than weight gain itself. But by quitting, the benefits outweigh the risks, even if you do add weight. Smoking causes higher body fat breakdown that in turn increases how much energy we burn, lowers our appetite, and increases our sympathetic nervous system. But there are major health impacts from smoking, including increased risk of heart disease, diabetes, lung disease, and cancers, to name a few. Even if there is some weight gained when quitting, the above risks decrease. Research shows that if there is weight gain, it is usually gained within six to 12 months of quitting smoking — on average about 10 pounds — and is dependent on many factors: age, gender, and food availability. There are many theories as to why people gain weight soon after quitting. One is that cessation can cause a change in our gut microflora, making the bacteria in the gut more comparable to that of a person who is overweight. Another idea is that when the habit is removed, it can be replaced with a habit of snacking, a compensatory behaviour. Food targets the pleasure centre in the brain, especially foods higher in fat and sugar. Research shows that there is a higher chance that a person quitting smoking will eat these foods more often. By reading articles such as this, you are already doing something to quit smoking. Thinking about and discussing concerns about weight has been shown to help with weight goals, and leads to high quit rates in smokers. Talk about your concerns

with your dietitian, a smoking cessation group, or anyone you feel comfortable with. Increasing your fruit and vegetable intake before quitting smoking helps to reduce post-cessation weight gain. Mindful eating can be a useful tool to help manage food cravings. Mindful eating increases awareness of the senses when eating, physical hunger and fullness cues, and the positives of eating, all while limiting judgment. Eating is a social activity and we often eat responding to various emotions, (boredom, sadness, stress/anxiety, and joy). It can be hard to know why you’re eating, so try using a hunger scale. Before each meal, ask yourself how hungry you are on a scale from 1-10, 10 being totally full. People often find food is most enjoyable between 3 and 6 on the hunger scale. Mid-meal, rank your hunger again. If you’re between 6 and 7, stop eating. If you decide to keep eating, finish your meal and rank your hunger again. Be honest with yourself. If you feel like you’ve just eaten Thanksgiving dinner, but you still have a dessert in front of you, chances are you’re eating for reasons other than hunger. Remember, if you do gain weight on your path to smoking cessation, your overall health will still benefit in the end. Try the sugges tions above, be active, and eat a variety of foods – everything in moderation, without guilt. 5

Alena Spears is a Registered Dietitian at St. Paul’s Hospital and Providence Crosstown Clinic.

P5SITIVE LIVING | 7 | JAN •• FEB 2017

Let’s talk about PrEP, baby By Kevin Moroso

The views expressed in this article are those of the author and may not reflect those of the Positive Living Society of BC. was barebacking prolifically before I started on PrEP, which is what made me an ideal candidate for it. However, I took what precautions I could. If I wanted to fuck a guy, I’d ask some questions before we met up. I’d ask him his status. If he was HIV positive-undetectable, I’d ask if he adhered to his meds. If he was HIV-negative, I’d ask him when his last test was. This method wasn’t foolproof and did require me to trust someone with my health. But I did what I could to reduce my risk while still enjoying some of the sex I wanted. Then I started on PrEP and I could enjoy all of the sex that I wanted. Orgies at gay resorts, bathhouse hookups, gang bangs in the park or at the beach—all condomless and no questions asked about status or testing. During this time I switched doctors. My former doctor was superb—even though he was a straight physician out in the ‘burbs, he didn’t judge my behaviour and quite enthusiastically prescribed me PrEP. But his knowledge of gay men’s health was limited, so I decided to search out another. A gay doctor with many HIV-positive patients agreed to take me on as a patient—I’m sure many of you reading this have him as your physician. I felt better seeing him with his knowledge of gay sex and lifestyle, the bugs we pick up (gonorrhea, chlamydia, syphilis, cryptosporidium), and the medication I was taking (Truvada and Viagra).

So it all came as a bit of a shock to me when he gave me a stern warning about something I had done sexually. I’d been seeing him for a few months at this point and was in to have a checkup. He read through my test results and when he got to HIV—“negative…. Of course, you’re on PrEP.” Then I happened to mention something I was quite proud of: I had hooked up with a guy who isn’t on meds yet and isn’t undetectable. My doctor’s response jolted me: “you shouldn’t do that, it’s very risky.”

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None of these people are dumb, but it made me question the education that’is being done around PrEP.

I’d met the guy online, he came over to my place, and we fucked. Afterwards, we smoked on my balcony and chatted. He had been living in the US when he was diagnosed positive and it shook him. He moved back home to Montreal, but decided he wanted a fresh start and moved to Vancouver. He’d only been here five weeks and only been positive about four months. He told me his viral load and that he’d go on treatment once his employer’s insurance kicked in in a few months. I told him that treatment meds are provided free here in BC and that he didn’t need to wait.

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continued next page

I also wrote down some phone numbers for him to call—the Centre for Excellence, Spectrum, and Positive Living, of course (I wonder if he’ll see this article). Naturally I wasn’t worried about the sex we’d had—I’m on PrEP. Now, I was already going to sit down to write an article on this topic, and then, that same morning, a Facebook friend posted a Grindr conversation he’d had. This friend is undetectable and he was with another friend who’s on PrEP. They were chatting with a guy about a threesome, but then that guy told them that he wasn’t on meds and had a detectable viral load. They were aghast. The undetectable friend said he was worried about being re-infected with a different strain. The PrEP guy was worried about getting infected. The comments on this post echoed these sentiments. Another PrEP guy I know said he, too, wouldn’t sleep with the guy as he’d be worried he’d get infected. This from a guy who’ll take loads from complete strangers in the back of an adult video store? The undetectable friend will take loads from strangers at the bathhouse.

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Could it be this misunderstanding is that some people do not know that undetectable means non-infectious?

None of these friends are dumb and my doctor certainly understands HIV, but it made me question the education that’s being done around PrEP. To be frank, I was disappointed in their PrEP understanding. Their understanding of the stages of HIV infection was skewed, too. Around half of all transmissions occur when someone is in the early stage of infection, or acute infection. This is when their viral load skyrockets, often into the millions. Then the immune system fights back and reduces that viral load down to a more moderate level, though it is still considered high. Taking loads from random guys? You’re probably going to come across someone in the acute infection stage and PrEP is going to do its best to protect you. But if you come across a guy that has had it for several months or years? His viral load will have gone down and your risk is lower. So PrEP, what is it good for? Let’s break it down. If I’m HIV-negative and I have sex with a guy who is HIV-negative (actually negative, not just thinks he is), I can’t get HIV. I don’t need condoms. I don’t need PrEP. It would require an HIV-immaculate conception for me to acquire HIV from an HIV-negative guy. If I’m HIV-negative and I have sex with a guy who is HIV-positive undetectable, I can’t get HIV. Okay, maybe in that case there is a

remote possibility, but if it did happen, it would be so unheard of that I’d be poked and prodded by science to determine how it happened. If I’m having sex with an HIV-positive undetectable guy, I don’t need condoms. Ditto PrEP. Could it be this misunderstanding of PrEP is that some people still haven’t come to terms with the fact that undetectable means non-infectious? There is one use and one use only for PrEP: I’m HIV-negative and I have sex with a guy who is HIV-positive and has a high enough viral load to transmit the virus. That is the only reason for PrEP. I get fucked bareback by five random guys, one after another, down at Wreck Beach—that’s what PrEP is for. Not that I’ve ever done such a thing. I meet a guy on Grindr and he tells me that he’s positive and not on meds—fine, let’s swap loads—that’s what PrEP is for. Bottom line, if you’re willing to take loads from random guys with no discussion about status, but you’re not willing to take loads from a guy who has had HIV for a while and is not on meds, you’re not thinking rationally. So, yes, I’ll keep on fucking guys who aren’t on meds and/or haven’t achieved an undetectable viral load because, in simple terms, PrEP works. 5 Kevin Moroso has his B.A in Art History and Critical Studies in Sexuality, and his MBA from the University of British Columbia.

PrEP Talk

The research: PrEP trials have happened or are happening in Africa, Asia, South America, and North America. They include different people who may be exposed to HIV through unprotected anal and vaginal sex and sharing injection needles … we know that if you don’t take PrEP consistently, it can’t protect you from HIV; but if you do take it regularly, it can offer strong protection. Source: Prepfacts.org Who is PrEP for? PrEP should be offered as a choice to people who are at substantial risk of HIV infection. Previously, it was only recommended for … as sex workers, men who have sex with men, and people who inject drugs. Source: Avert.org Is Prep Safe? Some people in clinical studies of PrEP had early side effects such as an upset stomach or loss of appetite, but these were mild and usually went away within the first month. Some people also had a mild headache. No serious side effects were observed. Source: AIDS.gov.

P5SITIVE LIVING | 10 | NOV •• DEC 2016

Will the gay community get Trumped?

By MT O’Shaughnessy

ovember 9. My head is down and my mouth is shut today. I’m in Canada and the perverse sense of privilege people have, that quiet voice filled with relief as they whisper, “Not us,” is everywhere. As a gay man with HIV who came out in the 80s and 90s, I recall. I recall what this world looked like. Felt like. I recall the people beaten and bodies stepped over. The people who would be “in the wrong place at the wrong time” and then would try to find a way to survive two or four or six men with fists and bats and boots. As it was nothing more than chance, just an ‘oops’ moment. I recall the hospital halls filled with packed beds, frail men shitting themselves on gurneys as their families, their hometowns told them, sometimes to their faces, they deserved it. And nobody but their brothers and sisters of choice cared. I recall the reaction times to loud sounds in the bars or on the streets. Because firecrackers weren’t just pretty lights, they might be the beginning of something. Because they had been, in the past. I recall the conversation rules on pronouns and events. We watched how people reacted to things and knew that if we talked about Pride HR might show up talking about how sexually charged conversations were unprofessional.Or how you’d answer the door and make sure only one of you was seen when the landlords showed up you wouldn’t remind people it was two men or two women. I recall the clothing choices for safety, the hobbies and loves you didn’t admit for being the wrong gender. I remember “real men…” Real men didn’t like that, did it like that, and where was that fist to the shoulder as we talked about sports?

I recall the fear. And what bothers me most is that people think we lived in fear because… of fear. We lived in fear because things happened. We lost jobs. Homes. Lives. We lived in hell. And I watch people up here think “Not us” while this election rolls over the world. As if they’re separated out, as if it never happened. And I think you’ve no idea what’s coming. The problem has always been that we’re next to a country that barely recognizes we exist as anything other than a punchline or a younger brother to be punched and laughed at from time to time. But we have to live with what ever comes from this and what it will embolden. Already some of our Conservative Party members (Kellie Leitch, the Winnipeg MP and “Canadian values” advocate who supported Donald Trump’s victory, I’m looking at you) are starting to find microphones and rise up to encourage Canadians to follow this example. To start ‘sending messages to the elite.’ To close our borders. To, in other words, find our fears and start feeding them. Gleefully. As a gay man I look south and I see history in the making. Being repeated. I don’t say this because my community is the only community that I fear for, even if it’s across a line on a map. But because we know. And we recognize what could be. And today… that’s not a hopeful phrase. 5 Mike O’Shaughnessy is not allowed to sum himself up as “born in 1972, not dead yet.” Instead, he describes himself as a fairly average person, last seen in the presence of rather extraordinary people, living as best as he’s able.

P5SITIVE LIVING | 11 | JAN •• FEB 2017

By Taylor Perry

raser Doke is a long-term HIV survivor and Positive Living Society BC member. He has volunteered for the Society and the Gathering Place, and served as a board member for the Vancouver Pride Society. He sat down with the History Alive in March 2014. The following are excerpts from his interview. On his early years and Vancouver: I told my mom that I had feelings for men, so she went to a psychiatrist and said it was an illness. I went through shock treatments, and that went on for six months, and basically I couldn’t take any more of it. I ran away from home. I came to Vancouver. On his diagnosis: Working the streets wasn’t bad back then. I worked a wee bit, did some drugs, and had fun times … I started cleaning the bathrooms at Expo 86, which was one big party for our city, and that was great. I think that was when I got infected, because in ‘87, there was [sic] a lot of things happening in the newscast about people going to a quarantine area because they didn’t know what HIV and AIDS were doing. I went all the way back to Toronto to get my family physician to do my diagnosis on whether I was HIV or not. When he did it he sat with his hands on his table, away from me. He is the one who sat there and said, “Mr. Doke, you are HIV-positive, please find another doctor. You have probably a year to two years to live. Goodbye.” On cruising: I wouldn’t tell anyone I was HIV-positive for a while, except when we had sex. I would say, “We have to have safe sex.” One time, I ended up telling someone that I was HIV-positive when we were cruising each other in the bar and he smacked me on the face and totally humiliated me. He said, “How dare you fucking cruise me for being here? And telling

me you are HIV-positive? Fuck you!” I ran out of the bar crying, didn’t know what to do. On his health battles: I started taking the [antiretroviral] meds around ‘95 to ‘96. The doctor would say this or that could happen and I didn’t take any matter to it because I thought, “OK, I am going to get back to work and get my life going.” I had had a couple of hurdles … but nothing totally kicked me on the ground. On his new liver: [In] 2011, they [the doctors] were saying they saw some things on my liver and they put me to a specialist who said, “Your liver is … is not working as much as it should.” I had a liver transplant, and six months later, I got out of the hospital. They had me on life support for two weeks or ten days and I was down to 80 pounds. My brother was told I was on the way out. He said, “No, he is a fighter. He will keep fighting.” I was scared because I could see it in his face that he thought I was going to die. And I thought I was going to die because I had so many tubes hooked up to me and it was scary. I was bedridden for four months, and the last two months I had a walker and I would slowly start going around the ward. They say my transplant is doing extremely well. I feel like I am 30 years old again, not 52. On the future: I don’t think people nowadays think of HIV as a death penalty. It is a manageable disease. So they continue partying in a way and doing their thing. 5 Taylor Perry is a volunteer with Positive Living Society’s History Alive project.

P5SITIVE LIVING | 12 | JAN •• FEB 2017

Rude Awakening Cuts gut HIV groups in BC By Neil Self

Our

Society celebrated its 30th anniversary last year. Thirty years is a grand accomplishment for any consumer-based outfit. Considering how we are also a non-profit agency that continues to weather British Columbia’s ever tumultuous economic climate, our longevity seems even more impressive. I believe our success is made up of a ready mixture of commitment, tenacity, hard work, compassion and love. These qualities have fuelled our operations since day one. But now they must serve us even further, as we have awoken to a cruel and uncertain future.

The Vancouver Persons With AIDS Coalition (Positive Living BC’s originating body) was founded by a feisty bunch of poz guys dedicated to improving life with the disease for themselves, for their HIV-positive peers, and for the world around them. Their methods were necessarily bold and protective.

continued next page

P5SITIVE LIVING | 13 | JAN •• FEB 2017

When AIDS was a fast-growing public health crisis during the 1980’s, common knowledge about the disease was heavily influenced by fear, gossip, and untruths. PLHIV were widely shunned. The lethal silence of then-US President Reagan only intensified the matter. In BC, there was talk of quarantine. The wealth of practical experience we offered to help the cause was consequently devalued and the unique day-to-day needs of PLHIV were often ignored. We had no choice but to look out for ourselves. Our Society elders shed actual-not-metaphorical blood, sweat, and tears to secure rightful inclusion of PLHIV in the government-led response to the AIDS epidemic. Decision makers were slow to invite us to their table, but we insisted on being seated there.



Without direct services to support PLHIV, Canada will have no hope of reaching the UNAIDS 90-90-90 goal.

Much about HIV health has changed for the better thanks to everyone who has supported our Society since 1986—including many caring, generous, and forward-thinking policy makers working in government and other funding entities. Still, our Society operates in the spirit of our dogged founders because some essential elements of HIV culture remain unchanged: PLHIV are commonly marginalized by society at-large and criminalized by Canadian law; Government agencies retain ultimate responsibility for treatment, care, and quality of life among PLHIV; Yet no one can ever appreciate and address the complexities of HIV better than those of us who know this disease firsthand. Our mettle was tested not celebrated in 2016 when the Public Health Agency of Canada (PHAC) denied or cut back requests of several HIV organizations historically supported by the federal government, including Positive Living BC. The cuts come at the end of a laborious, poorly executed application process for funds from PHAC’s HIV and Hepatitis C Community Action Fund, which invests $26.4 million a year in community-based programs across the country to address HIV/AIDS, hepatitis C, and other sexually transmitted and blood borne infections. According to PHAC, the agency received 224 project requests following an open call for Letters of Intent (LOI) for organizations seeking support from the fund. The process has so far resulted in devastating cuts to approximately 33 percent of previously funded organizations providing

direct services to PLHIV and/or HCV, and further reductions in funding to several other organizations involved in HIV and HCV service delivery across Canada. Affected organizations in BC include, but are not limited to: AIDS Vancouver, AIDS Vancouver Island, ANKORS, Positive Living Fraser Valley, Positive Living North, and Positive Women’s Network. The list of financial losses reads like the ruddy remnants of the Battle of the Somme: AIDS Vancouver slashed of $148,500 per year; AIDS Vancouver Island gouged of $60,000 per year; ANKORS gutted of $338,400 per year; Positive Living Fraser Valley whittled by $350,347 per year; Positive Living North sliced by $75,000 per year; Positive Women’s Network hacked of $175,000 per year; and Positive Living BC … shredded by the sum of $276,300 per year. Each dollar lost, lands a direct blow to the heart of services for vulnerable and needy people. Some of these organizations will reel about on unsteady feet but with characteristic resolve, fight on despite the fatigue; others will simply crumple to the ground—a stunned, defenseless, and beaten heap. Furthermore, the Pacific Hepatitis C Network (which was previously funded by PHAC up to 2014) had applied for renewed funding, but was outright rejected. HepC-BC and the other Hepatitis C consumer organizations working in the province, which had not previously received PHAC funding, were also denied in their application for funding. Of course, these dollar amounts translate into essential and substantial supports for PLHIV. To put a “face” to the problem, here are just some of the direct-to-user programs and services in our community now slated for the chopping block: AIDS Vancouver will lose major volunteer support and coordination, resulting in the deficit of more than 11,000 volunteer hours annually and the consequent erasure of a host of volunteer-based prevention, education, and support programs. AIDS Vancouver Island will forgo selected prevention, skills building, and mental health support services for people living with or at risk of HIV, HCV, and STI in the Vancouver Island Health region. ANKORS will lose its HIV, Hepatitis C, and other STBBI prevention and education programs in 24 Kootenay communities, the Men’s Health Initiative in Kelowna, and peer development work with the Rural Empowered Drug User Network. (This during an opioid crisis no less.) Positive Living Fraser Valley will have to close its drop-in centre, support groups, counselling, food (food bank, hampers and weekly lunch), HIV/HCV education, and medical transport— total agency closure seems a near certainty.

P5SITIVE LIVING | 14 | JAN •• FEB 2017

Positive Living North will bid adieu to the widely praised “Fire Pit” Program, a low barrier drop-in for those living with and at risk of HIV. Positive Women’s Network will be severed of direct service programs (food program, lunch-and-learns, hot meals, one-on-one counselling, peer mentorship), retreats, and education resource creation — and it’s possible that this agency will be entirely shuttered. Positive Living BC will be cleaved of the Prison Outreach Program (assistance, education, release preparation, societal re-integration), the annual Positive Gathering conference, and individual advocacy. Again, these loses, where they are not fatal to an agency, are no less critical. And those people who bank on these programs in their region? Whither they go from here? No one, not PHAC nor Positive Living BC, has the answers to that grim query.



It is unconscionable that, in many respects, we are still fighting the same fight as our founders did.

PHAC sent out responses from the LOI process starting on September 29, several months later than originally promised, and just two weeks after the federal government pledged $804 million to international efforts on AIDS, malaria, and tuberculosis at the Global Fund Replenishment Conference. Since the responses were received, community-based HIV service organizations across Canada have maintained that the process by which the PHAC arrived at its funding decisions was not transparent, inconsistent in its criteria, and unsupportive of community-based organizations which lacked the infrastructure and capacity to submit professional LOI’s. The results have been so catastrophic for our sector that we have banded together in a show of mutual support and collective action similar in spirit to our community’s tenacious efforts in the early years. So far, we have made some progress by our tried and true methodology. We have been anything but shy in letting PHAC and news media know that the outcomes of this process are perverse in that they will most certainly result in huge new gaps in service provision in communities where the consequences will only worsen the epidemic. Without direct services to support PLHIV, Canada will have no hope of reaching the UNAIDS 90-90-90

goal, despite its very public endorsement by the Minister of Health on World AIDS Day 2016. Even worse, there is no alternative national plan. Indeed, we held our own public demonstration in Vancouver on World AIDS Day to protest PHAC’s decision and demand change. We requested that, at minimum, PHAC work with PLHIV community to determine gaps in funding allocations and give affected organizations a full year to wind down while providing alternative funding, partnerships, or collaborators. We want more transparency in this process moving forward, including a review of the current applications and outcomes, and consultation on next steps to be taken. Our combined efforts—with very vocal support from Members of Parliament nation-wide—have brought the issue directly to the Honorable Jane Philpott, Canada’s Federal Minister of Health and have so far secured our chance to apply for transitional funding until the end of the 2017/18 fiscal year. As of this writing, Positive Living BC is looking forward to negotiating the terms of this stopgap measure with PHAC’s regional representatives. Frankly, I’m also looking forward to a time when PLHIV can wholeheartedly trust that the government agencies charged with our care give fair, meaningful consideration to our unparalleled expertise as HIV survivors. PLHIV should have spent 2016 celebrating the magnitude of our collective achievements since 1986. Instead, we spent long months defending ourselves to those outside of our community. It’s unconscionable that, in many respects, we are still fighting the same fight as our founders did. At least they left us a road map…and you can help. Tell PHAC to end the cuts to HIV and fund the groups that fight Hep C by voicing your concerns to Minister of Health, Jane Philpott. We have endured 30 years of struggle and strife; we can endure this battle too. Because, to be blunt, we must—for our lives and for the lives of our brothers and sisters in the HIV/AIDS community, going to sleep is not an option. We must stay awake, and fight on we shall. 5 Neil Self is Chair of the Positive Action Committee and the Society’s Vice Chair.

P5SITIVE LIVING | 15 | JAN •• FEB 2017

Post-holiday gardening suggestions

By Lorenzo Cryer

lants from tropical regions make up the bulk of what we grow indoors. It is important to do a few things to keep them healthy. Start by keeping the moisture level up. This can be as simple as having a bowl of water on the floor next to the plants. Make misting your indoor plants part of your care routine. Even better, put them in the shower and give them a good wash, allowing the whole plant to get wet. If you are growing plants with large leaves, you can wipe them down with a bit of vegetable oil on a paper towel and gently go over the leaves. If you have a poinsettia from Christmas, you can keep it growing all year, and even flower again. If you have not already done so, it will need repotting. (An all-purpose indoor potting mix is best.) Keep the soil moist, but not wet. Prune the old flower bracts off and place the poinsettia in a sunny position. Remember that the white ‘sap’ can be irritating to the skin, so wear gloves when handling this plant. Outdoors there is a lot going on. You may have late winter or early spring bulbs coming up. Snowdrops are flowering, bringing cheer to the garden. Camellias are starting to bloom. This evergreen shrub makes a perfect potted plant. Trim after flowering to encourage new growth in a shape that appeals. When tulips and daffodils start to break the soil surface, begin feeding them every two weeks using the same general-purpose plant food you use indoors. The benefit of feeding your bulbs is twofold: you get better flowers and foliage growth, and the bulb will store the food in preparation for next year’s flower. Clematis can be grown in a pot or in the ground, as long as it is in humus-rich, cool, potting soil. This plant likes to have its head in the sun and feet in the shade. Prune in spring.

My favourite spring flower is the hellebore, native to Europe and western Asia. The fifteen perennial, or evergreen, species are useful winter or spring flowering plants. They thrive in cooler environments and are perfect for the Vancouver climate. They bear stunning open flowers in a multitude of colours. As soon as hellebore flowers start to emerge on the deciduous species, remove the old leaves. They can take some time to break down and are an ideal hiding place for snails and slugs, which love to munch on the flowers. After flowering, the plant sends up fresh new leaves. Leave the flower stalks and watch the seedpods develop. Cut them before they burst open and add them to dry flower arrangements. Like the poinsettia, all parts of the hellebore are poisonous, making them extremely deer resistant. Grow in part shade in a moist, well-drained humus-rich soil. Do not let the plant dry out during summer. Apply a top dressing of manure/compost after flowering. Aphids are the main pest that can cause problems with this beauty. Washing them off is the best way to keep the pest under control. Walk around your neighbourhood to see what else is growing. A wander through Stanley Park at this time of year is so very rewarding since there is always so much happening as the earth awakens from its winter slumber. Happy gardening! 5 Lorenzo Cryer owns and operates Dig Dug Done, a garden design consultancy in Vancouver.

P5SITIVE LIVING | 16 | JAN •• FEB 2017

Giving Well

this year’s Scotiabank AIDS WALK to THRIVE, we were fortunate to have the Body Energy Club as the sponsor of our Health and Wellness Fair. They have been big supporters of Positive Living BC for a few years now, and we know loads of members access Body Energy Club goodies when picking their vitamins, supplements, and other health items. So, it only seemed natural to ask Dominick Tousignant, owner of Body Energy Club, to explain a bit of their health philosophy and why they sponsored us.

Q. Who are you? What do you do?

Body Energy Club was founded in 2002 with a mission to deliver an extraordinary customer experience and ensure customers have affordable healthy lifestyle options. Body Energy Club offers a wide-selection of

vitamins, supplements, pre-packaged meals, organic cold-pressed juices and smoothies. Body Energy Club’s smoothie bar is one of the most popular in the City and a favourite with our customers. We operate five locations in Vancouver: 2146 W Broadway, 746 Davie Street, 428 Robson Street, 555 W 12th Street and, our newest, 1131 W Georgia Street. Body Energy Club’s success and expansion is due to the loyalty and patronage of our customers. Last year, we opened a store on Hollywood & Vine in Los Angeles, California and will be opening a new store in West Hollywood in 2017. Body Energy Club strives to provide quality products and services, respect and support for our community, customer commitment and team work. We develop relationships that make a positive difference in our customer’s lives, work together to meet the needs of our customers, and support the communities in which we live and work.

Q. How did you first hear about Positive Living BC? Why do you support Positive Living BC? Through networking and through some of our customers, we learned about the Positive Living Society of BC. It seemed like a good fit for both groups. Body Energy P5SITIVE LIVING | 18 | JAN •• FEB 2017

A DONOR PROFILE By Zoran Stjepanovic

Club supports a number of organizations and charities throughout the year, because it’s important for us as a business to give back to the community. Much of our success is because of our patrons. Some of our customers are on a strict budget and it is important for us to provide affordable options for them, to help subsidize their costs.

Q: What are some of the items you offer? Body Energy Club is now offering its own private label vitamins and supplements. One of our best seller’s is the Body Energy Club - Clean Whey Protein Powder. It is naturally sweetened and free from hormones, antibiotics, artificial colours and flavours. We also have a wide-range of grab-and-go items, fresh food, organic cold-pressed juices and smoothies. So next time you are in the neighborhood, stop in and try one of our delicious smoothies. You will not be disappointed. If you can’t make it into one of our brick and mortar stores, check out our website, www.bodyenergyclub.com which is one of the largest online vitamin and nutritional supplement stores in Canada. We would also like to take the time to simply say, thank you. 5 Zoran Stjepanovic is Positive Living BC’s Director of Fund Development.

Sister to Sister MARGARITE’S ART OF LIVING

By Darien Taylor rt gave and restored life to Margarite Sanchez. As a child, she was “always good with her hands.” She dabbled in drawing, painting, and ceramics. Her early attempt at batik, a wax-resist technique for dyeing fabric, was hung in front of the principal’s office at school—“the first recognition of her potential.” Mostly self-taught, Margarite has experimented in a variety of art forms and media. Now in her 50s, her art is all encompassing, present not only in her drawings, photos, and paintings, but in her daily life too. There is no division between art and life—they constitute a harmonious, spiritual whole. In the 1980s, Margarite rented a small house at the southern end of Salt Spring Island. “I thought I would live here till I died,” she says. “I didn’t realize how close to the truth that would be.” In the early ’90s, Margarite began dancing. While rehearsing for a performance, she felt fatigued. She lost weight and had recurrent Candida infections. Various tests gave no explanation for this turn in her health. She requested an HIV test, “to put my mind at ease.” No one expected her test to come back positive, least of all Margarite. But it did. She had 50 CD4 cells. Her journey with dance came to an abrupt end, and four years of illness and hospitalization followed. Initially reluctant to start antiretroviral therapy, she began taking ARV in 1997. Slowly, as her immune system rebounded, Margarite found she was even more driven to express herself through her art. She tackled life drawing in pencil and charcoal. The focus and meditative quality of drawing created a healing refuge for her, “a time for myself.”

Later, she moved into landscape painting, returning to the site of her first home and reconnecting with the life force of nature that nourishes her spirit. When speaking of this wild part of the island, Margarite refers to it as her “muse,” her “little piece of heaven.” While much of her drawing and painting is done as “playtime” and “for self-care,” Margarite also creates political art and activist statements related to her experiences of living with HIV. She characterizes these works as “catalysts for change” and “an education for the viewer.” Her artistic life knows no bounds—it extends to her kitchen and beyond. Living in a micro-climate where it is possible to grow food all year round, she sees the cyclical work of gardening, preserving, canning, freezing, drying and fermenting as part of her artistic life. “As the harvest builds up over the summer, parts of our house become like a still life, full of colours and textures … I think about food security, and the fact that so many PLHIV lack food security.” When asked what sustains her, she answers without pause: “I enjoy eating homegrown food and drinking Argentinian wine. I love the planet. I have an optimistic view of life. That doesn’t mean that bad things don’t happen. I’ve experienced difficult things in my life, but I honestly feel I am living an enchanted life with AIDS.” 5 Darien Taylor is CATIE’s former Director of Program Delivery. A version of this story was previously published in The Positive Side, and is reprinted in an edited form here by permission of the publisher.

P5SITIVE LIVING | 20 | JAN •• FEB 2017

OraQuick against the pricks

By Brandon Laviolette

raQuick is an oral swab HIV test kit made for home use. Using oral fluids to check for the presence of the antibodies to HIV-1 and HIV-2, OraQuick claims to give accurate results in twenty minutes. Although it is not yet approved in Canada, it can be bought in the US and brought over the border. I was given a kit at work and asked to write about it. Since I’m an HIV-positive gay man, I thought, so how am I going to check this thing out? I invited a friend to do the test. My buddy is a cool; he’s straight and ‘knows stuff’ about HIV. The interesting part is that he recently had a high-risk needle prick incident that included Post Exposure Prophylaxis (PEP) treatment, and he was overdue for his follow up test. This made me nervous — what if we find out he’s positive? I’m not sure I know how to give someone that kind of support. We talked about it a little, and he decided he wanted to help me out. I protested, but he reassured me that he could “handle it.” Speaking from experience, it’s not just something you handle… this is a life-changer.

I began by asking about his needle prick incident, which had occurred at work, disposing of trash he found in the parking lot of his Downtown East side office. Part of his job is to tour the grounds for stuff left lying around, often by IV drug users who leave used needles and rigs in the area. He always checks bags for dangerous items, but that day he only saw common personal use trash, gum wrappers, tissues, and the like. Gross, but harmless, so he tossed it into the bin. The lid was low so he pushed on the bottom of the bag to force it in. That’s when two IV needles jabbed his hand, and possibly also pushed in the syringe plungers. His first thought was, “how stupid am I?” He reported the incident right away and went to the hospital for treatment including PEP. A doctor drew blood for testing and gave him some counselling for the treatment. The PEP treatment includes a month of anti-retroviral drugs but they only give you the first five days at the hospital. He was told to see his doctor after to get a prescription for the rest of

P5SITIVE LIVING | 21 | SEP •• OCT 2013

the month. A powerful load of new medications for the treatment naïve means some rude side effects: body aches, nausea, diarrhea and irritability. He lost 15 pounds. Even worse was finding out how such a thing would affect his close relationships. His girlfriend was supportive and they discussed the possible outcomes. He shared the incident with his roommate, a mom to a young child, who was not so receptive. She asked him to take care not to share any dishes with her or her child, and their occasional sharing of a ritual cigarette ended. Her attitude turned cold. This was hurtful, and ever since, he’s felt their relationship distancing. From the kit, I asked him questions for a rundown of risk behaviours, questions about sex with multiple partners, partners whose HIV status is unknown, sex between men, sharing needles for drugs and steroids, exchanging sex for money, and any previous diagnosis for hepatitis, tuberculosis, or STIs. He answered no to all. (Ironically, the kit does not ask about accidental exposures such as a needle prick.) The kit tests for the presence of HIV antibodies, or immunoglobulins, which are the proteins that identify and help remove foreign cells in your blood, such as HIV. The package includes an oral swab, a vial of fluid, and brochures about HIV and what to do with the test results, all contained in a plastic table-top holder with concise instructions. I asked him to follow the directions and I would observe and ask questions along the way. He unpacked the kit and began. He swabbed his top and bottom gums, and put the test stick into the developing solution vial. The strip turned bright pink right away, which is part of the process. The kit has a small flap that covers the swab indicator so you don’t obsessively watch the indicator change to reveal the result. One must wait 20 minutes for the full chemical reaction to develop and show the result. Like a pregnancy test, there are two lines on the test swab indicator labeled C for ‘control’ and T for ‘test.’ Whether your result is positive or negative, a line should develop next to the C on the indicator. If there is a line next to the T on the indicator, even a very faint line, it means a positive result. If there is no visible line next to the T, this is a negative result. OraQuick says their test is 91.7 percent accurate when providing a positive result. That means that out of every 1,000 people in their study, 917 people who got a positive result with OraQuick had their results medically confirmed. The other 83 who tested positive, or thought they did, received a negative test result on a medical test. A negative result using OraQuick is a little more accurate at 99.9 percent. Of those in the study sample, one out of a thousand of those tested nega-

tive with OraQuick got a positive result on a medical HIV test. Most people exposed to HIV will have antibodies show up in their blood in about three months, but that one in a thousand may have had a defective OraQuick product or their antibodies were not detectable at the time of the testing. The kit advises: “If you get a negative test result and it has been more than three months since you may have been exposed you can be pretty sure that you don’t have HIV. If it has been less than three months since exposure, you should take another HIV test at the end of the three-month period, just to be sure … If you get a positive result, the lab should retest your sample to make sure it is accurate. A positive result on the follow-up test means that you have HIV. See your doctor as soon as possible to discuss your treatment and therapy options … Make sure you practice safe sex, using condoms and/or dental dams with any and all sexual partners.” Good advice, but the reality is that the test was a nail biter. We watched an online video of a guy taking the test; it was reassuring that he was calm and relaxed viewing his results. While my buddy did the test, we chatted, a welcome distraction. When our talk stopped, his first thought was to peek, but I said no. We set a timer and wrote down our start and end times, as advised in the directions. He left the room just before the 20-minute timer rang and I then was tempted to peek at his results. Soon, it was time to see the results. We both had butterflies. He said he felt anxious while we read up on how to read the test stick. “One line = negative, two lines = positive.” He removed the flap covering the results, the look in his eyes belied his apparent calm when he looked at me and said, “Negative.” I don’t recommend using this kit at home for discrete HIV testing. If you believe you are HIV-negative, or don’t know your status, you might not be ready to give yourself an HIV-positive result. I said at the top of this article that an HIV-positive diagnosis isn’t easy to deal with. You need support to work through the anxiety and to provide both context and information on what to do next. Get an HIV test by a professional; it is the best way to know your status. If you live in a place where discrete testing is not available, a home test is a good option until you can see a doctor who can verify your result and protect your privacy. 5 Brandon Laviolette is the Treatment, Health and Wellness coordinator at Positive Living BC.

P5SITIVE LIVING | 22 | JAN •• FEB 2017

Predictors of cART outcomes in HIV+ MSM

By Sean Sinden

new publication from the Canadian Observation Cohort (CANOC) Collaboration has identified socio-demographic and clinical predictors of viral suppression and rebound in HIV-positive men who have sex with men (MSM). The study was the first analysis of the clinical and social factors associated with virologic outcomes for MSM living with HIV. Eighty-six percent of the men analyzed achieved viral suppression after beginning combination antiretroviral therapy (cART), half within 5 months. Younger men, men who started cART in the early 2000s, and men with a history of injecting drugs took longer to achieve viral suppression. Being on an initial regimen that included a non-nucleoside reverse-transcriptase inhibitor and having a low baseline viral load were associated with faster time to viral suppression. “These findings show that Canadian gay, bisexual, and other MSM are close to achieving the United Nation’s target that 90 percent of individuals on cART reach viral suppression,” said Dr. Nathan Lachowsky, co-author of the study. Of those that achieved viral suppression, 12 percent had a viral rebound. Similar to viral suppression, starting cART earlier, injection drug use, and younger age were associated with quicker experience of a viral rebound. Having a higher baseline CD4 count and living in BC were linked too an increased risk for viral rebound. Lachowsky says that the factors associated with viral suppression are a result of the improvement of treatments and the increase in use of NNRTIs in recent years. The finding that living in BC was associated with viral rebound may be because physician-directed treatment interruption was more common in BC than other provinces in the early cART era. A higher CD4 count before initiating cART being linked with viral rebound was unexpected because prior research hadn’t suggested this as a risk factor for poor adherence. Researchers suggest that people with a higher CD4 count may have been more likely to take a break from their medication as a result of feeling healthier than those with a lower CD4 count. Aside from collecting vital observational data about PLHIV, there are other important takeaways from this study. Younger MSM and those with a history of injecting drugs are at an increased risk for

treatment failure and viral rebound. The complex set of challenges faced by these sub-groups need to be understood as we strive to optimize the health of all Canadians living with HIV. 5 Sean Sinden is the Communications and Knowledge Translation Officer for the CTN.

Studies enrolling in BC , a partial list CTNPT 003

Bone and renal outcomes in tenofovir exposed BC site: BC Women’s Oak Tree Clinic

CTNPT 011

Monitoring penicillin levels for syphilis BC sites: St. Paul’s | Oak Tree Clinic

CTNPT 014

Kaletra/Celsentri combination therapy for HIV in the setting of HCV BC sites: Vancouver Infectious Diseases Centre (VIDC), Vancouver | Cool Aid Community Clinic, Victoria

CTN 222

Canadian co-infection cohort BC site: St. Paul’s

CTN 248

Incentives Stop AIDS and HIV in drug users BC sites: VIDUS/ACCESS Project, Vancouver | Cool Aid Community Clinic, Victoria

CTN 286

TriiAdd Study BC sites: Cool AID Community Clinic, Victoria | Oak Tree Clinic; Vancouver IDC

CTN 288

LHIVE healthy Online, nation-wide

CTN 291

Pre-term birth in HIV-positive pregnancies

Visit the CIHR Canadian HIV Trials Network database at www.hivnet.ubc.ca for more info.

P5SITIVE LIVING | 23 | JAN •• FEB 2017

In grateful recognition of the generosity of Positive Living BC supporters Gifts received September – October 2016

$5000+ LEGACY CIRCLE Peter Chung

$2,500-$4,999 VISIONARIES

Workers Compensation Board of BC

$1000 - $2499 CHAMPIONS

Gina Best J. Bhandary Victor Elkins Don Evans Paul Goyan Dean Nelson Fraser Norrie Alin Senecal-Harkin Harvey Strydhorst Bramwell Tovey Metropolitan Pharmacy

$500 - $999 LEADERS

Cheryl Basarab Deborah Bourque Melody Burton Emet G. Davis Christian M. Denarie Scott Elliott Silvia Guillemi David Hall Cliff Hall

Ross Harvey Mike Holmwood Rebecca Johnston Brian Lambert Dean Mirau Blair Smith Dean Thullner David C. Veljacic Mahmoud Virani

$150 - $499 HEROES

Wayne Avery Lorne Berkovitz Erik Carlson Patrick Carr Aimee Cho Len Christiansen Vince Connors Ken Coolen Maxine Davis Edith Davidson Glynis Davisson Carmine Digiovanni Gretchen Dulmage Patricia Dyck Dena R. Ellery Don Evans Stephen French Ricardo Hamdan Jean Sebastian Hartell Ron J. Hogan Pam Johnson Tiko Kerr

Colin Macdonald Tony Marchigiano Kenton R. McBurney Mike McKimm Kate McMeiken Mark Mees Laura H. Morris James Ong Dennis Parkinson Penny Parry Bonnie Pearson Sergio Pereira Mary Petty Angelika Podgorska Louise Pohl Darrin D. Pope Adam Reibin Katherine M. Richmond Lillian Soga Keith A. Stead Ronald G. Stipp Jane Talbot Ross Thompson Stephanie Tofield Glyn A. Townson Ralph E. Trumpour Brian A. Yuen

Canadian Working Group on HIV & Rehabilitation Chris Clark Barry DeVito Jamie Dolinko Tobias Donaldson Tracey Hearst Heather Inglis Chris Kean Miranda Leffler Sharon Lou-Hing Salvatore Martorana Angela McGie Lindsay Mearns Lisa Raichle Andrea Reimer Adrian Smith Zoran Stjepanovic Vancouver and District Labour Council Adrienne Wong John Yano

$20 - $149

To make a contribution to Positive Living BC, contact the director of development, Zoran Stjepanovic.  zorans@positivelivingbc.org  604.893.2282

FRIENDS

Bernard Anderson Jeff Anderson Lisa Bradbury Sandra Bruneau

P5SITIVE LIVING | 24 | JAN •• FEB 2017

PROFILE OF A VOLUNTEER

Thomas has been invaluable in supporting the members of the organization through his volunteering in the Housing Kiosk. Thomas is always ready to assist members, volunteers, and staff. Marc Seguin,Volunteer Coordinator

*Thomas McClean*

What is your volunteer history with Positive Living BC? I started in the cafe serving coffee in the lounge. From Polly’s to the housing kiosk, I’ve done it all. Red Ribbon Breakfast and Accolades, too. Why did you pick Positive Living BC? I moved here from Toronto and began volunteering six years ago. I was new to the city wanted to meet people; came in for a coffee and saw this great community and wanted to help. How would you rate Positive Living BC? High! Saved members’ lives and enriches the quality of our dayto-day lives too.

What are Positive Living BC ‘s strongest points? The volunteers! Their passion inspires me daily. Members are a family for those without one. What is your favourite memory of your time as a volunteer at Positive Living BC? When we started up the housing kiosk four years ago, I helped a member find an apartment and the next week she told to me, ‘I feel safe.’ I knew then that I belonged here. What do you see in the future at and /or for Positive Living BC? Moving into our new offices this year.

P5SITIVE LIVING | 25 | JAN •• FEB 2017

Where to find

HELP

If you’re looking for help of information on HIV/AIDS, the following list is a starting point. For more comprehensive listings of HIV/AIDS organizations and services, please visit www.positivelivingbc.org/links

bA LOVING SPOONFUL

Suite 100 – 1300 Richards St, Vancouver, BC V6B 3G6  604.682.6325  clients@alovingspoonful.org  lovingspoonful.org

cAIDS SOCIETY OF KAMLOOPS

(ASK WELLNESS CENTRE) 433 Tranquille Road Kamloops, BC V2B 3G9  250.376.7585 or 1.800.661.7541  info@askwellness.ca  askwellness.ca

bAIDS VANCOUVER

803 East Hastings Vancouver, BC V6A 1RB  604.893.2201  contact@aidsvancouver.org  aidsvancouver.org

bAIDS VANCOUVER ISLAND (Victoria)

713 Johnson Street, 3rd Floor Victoria, BC V8W 1M8  250.384.2366 or 1.800.665.2437  info@avi.org  avi.org

 gary@ankors.bc.ca

 ankors.bc.ca

bANKORS (WEST)

101 Baker Street Nelson, BC V1L 4H1  250.505.5506 or 1.800.421.AIDS  information@ankors.bc.ca  ankors.bc.ca

bDR. PETER CENTRE

1110 Comox Street Vancouver, BC V6E 1K5  604.608.1874  info@drpetercentre.ca  drpetercentre.ca

bLIVING POSITIVE

RESOURCE CENTRE OKANAGAN 168 Asher Road Kelowna, BC V1X 3H6  778.753.5830 or 1.800.616.2437  info@lprc.ca  livingpositive.ca

bMCLAREN HOUSING

200-649 Helmcken Street Vancouver, BC V6B 5R1  604.669.4090  info@mclarenhousing.com  mclarenhousing.com

bAIDS VANCOUVER ISLAND (Campbell River) bOKANAGAN ABORIGINAL AIDS  250.830.0787 or 1.877.650.8787  info@avi.org  avi.org/campbellriver

bAIDS VANCOUVER ISLAND (Courtenay)  250.338.7400 or 1.877.311.7400  info@avi.org  avi.org/courtenay

bAIDS VANCOUVER ISLAND (Nanaimo)  250.753.2437 or 1.888.530.2437  info@avi.org  avi.org/nanaimo

bAIDS VANCOUVER ISLAND (Port Hardy)  250.902.2238  info@avi.org  avi.org/porthardy

bANKORS (EAST)

46 - 17th Avenue South Cranbrook, BC V1C 5A8  250.426.3383 or 1.800.421.AIDS

SOCIETY 200-3717 Old Okanagan Way Westbank, BC V4T 2H9  778.754.5595  info@oaas.ca  oaas.ca

bPOSITIVE LIVING

FRASER VALLEY SOCIETY Unit 1 – 2712 Clearbrook Road Abbotsford, BC V2T 2Z1  604.854.1101  info@plfv.org  plfv.org

bPOSITIVE LIVING NORTH

#1 - 1563 Second Avenue Prince George, BC V2L 3B8  250.562.1172 or 1.888.438.2437  positivelivingnorth.org P5SITIVE LIVING | 26 | JAN •• FEB 2017

bPOSITIVE LIVING NORTH WEST

3862F Broadway Avenue Smithers, BC V0J 2N0  250.877.0042 or 1.866.877.0042  plnw.org

bPURPOSE SOCIETY FOR YOUTH & FAMILIES 40 Begbie Street New Westminster, BC V3M 3L9  604.526.2522  info@purposesociety.org  purposesociety.org

bRED ROAD HIV/AIDS NETWORK

61-1959 Marine Drive North Vancouver, BC V7P 3G1  778.340.3388  info@red-road.org  red-road.org

bVANCOUVER NATIVE HEALTH SOCIETY 449 East Hastings Street Vancouver, BC V6A 1P5  604.254.9949  vnhs@shawbiz.ca  vnhs.net

bVANCOUVER ISLAND PERSONS

LIVING WITH HIV/AIDS SOCIETY 1139 Yates Street Victoria, BC V8V 3N2  250.382.7927 or 1.877.382.7927  support@vpwas.com  vpwas.com

bWINGS HOUSING SOCIETY 12–1041 Comox Street Vancouver, BC V6E 1K1  604.899.5405  wingshousing@shaw.ca  wingshousing.org

bYOUTHCO

205–568 Seymour Street Vancouver, BC V6B 3J5  604.688 1441 or 1.855.968.8426  info@youthco.org  youthco.org

POSITIVE LIVING BC SOCIETY BUSINESS UPCOMING BOARD MEETINGS

JOIN A SOCIETY COMMITTEE!

WEDNESDAYS 3 pm | BOARD ROOM

If you are a member of the Positive Living Society of BC, you can join a committee and help make important decisions for the Society and its programs and services. To become a voting member on a committee, you will need attend three consecutive committee meetings. Here is a list of some committees. For more committees visit positivelivingbc.org, and click on “Get Involved” and “Volunteer”.

February 15, 2017

Reports to be presented >> Written Executive Director Report | Executive Committee | Director of Programs & Services | Financial Statements – December | Events Attended

March 1, 2017

Reports to be presented >> Complete Board Skills Chart (2) | Executive Committee | Director of CBR | External Committee Reports | Events Attended

March 15, 2017

March 29, 2017

Reports to be presented >> Executive Committee | External Committee Reports | Events Attend Positive Living BC is located at 803 East Hastings, Vancouver, V6A 1R8. For more information, contact: Alexandra Regier, director of operations  604.893.2292 |  alexr@positivelivingbc.org

Name________________________________________ Address __________________ City_____________________ Prov/State _____ Postal/Zip Code________ Country______________ Phone ________________ E-mail_______________________ I have enclosed my cheque of $______ for Positive Living m $25 in Canada m $50 (CND $) International Please send ______ subscription(s)

Board & Volunteer Development_ Marc Seguin  marcs@positivelivingbc.org  604.893.2298 Community-based Research_Terry Howard  terryh@positivelivingbc.org  604.893.2281 Education & Communications_ Adam Reibin  adamr@positivelivingbc.org  604.893.2209 History Alive!_ Adam Reibin  adamr@positivelivingbc.org  604.893.2298 Positive Action Committee_ Ross Harvey  rossh@positivelivingbc.org  604.893.2252 Positive Living Magazine_Jason Motz  jasonm@positivelivingbc.org  604.893.2206 ViVA (women living with HIV)_Charlene Anderson  charlenea@positivelivingbc.org  604.893.2217

m BC ASOs & Healthcare providers by donation: Minimum $6 per annual subscription. Please send ____ subscription(s) m Please send Positive Living BC Membership form (membership includes free subscription) m Enclosed is my donation of $______ for Positive Living * Annual subscription includes 6 issues. Cheque payable to Positive Living BC.

P5SITIVE LIVING | 27 | JAN •• FEB 2017

Last Blast

By Denise Wozniak

wenty years ago if a genie had granted my wish to learn my future, I would never have believed the results. If it was possible to change the future, would you? It’s a difficult question that means asking if the passing years have changed us for the better or worse. Have we gained a helpful perspective over the years, or do we feel more lost? As we come to the end of 2016, what are you looking back on? After 1994, my year of HIV diagnosis, I stopped caring about the future because I felt there wasn’t one for me. I was going to die; I had lost my respect for people I once believed in. I was angry at myself for my naivety in the past. I didn’t feel sorry for myself at all—I simply accepted the lack of control as fact. Several years into my life of “existing,” I was scared. I was divorced, on the verge of living out of my car, and I was hungry for days on end. I could have phoned any number of relatives who would have helped me out, but I was embarrassed. Guilt comes easily when you live in Canada. Other PLHIV in the world were dying daily, with no access to water or a bathroom, let alone medication. And many had malaria too. There were men in the Caribbean who were being murdered for being gay. What right did I have to feel that my life was going nowhere? A good friend asked me if I had a plan. A plan? The concept of a plan even hurt my head. But one day, I picked up the phone and called the Positive Living Society of BC and told them just how bad my life had become. They connected me with a debt solution company that showed me how to get a break from the bank’s demanding calls for repayment. The company put together a strategy for me to get back on my feet. I was getting a chance to swim or to carry on sinking. For the first time in months, I slept well, still

stressed but grateful that I had a Society that cared and people who were there to help. Now at the end of every year, I ask myself: What is my plan for my future? Am I just staying afloat, pretending this is not happening, “filling in time,” am I giving up on myself, am I too proud to reach for help? This process can be like quicksand: it seems impossible to believe that there’s any chance for you to crawl out. I desperately wanted to laugh and sing again. It took me four years of change and growth but finally I accomplished it. I entered a humorous speech contest in 2016, and spoke about getting older. It was a welcome respite, and something I wouldn’t have believed I would do if I had looked forward to the future me. It felt good, and it was tough, but in the past year I started to define myself by my humour and by my laughter again, not by the events of the day or the events of the past. And now we look ahead to 2017. What will your character say about you? Strength shows itself in many ways, both good and bad. How will 2017 change you? Will you accept help, show kindness, laugh at problems, thank someone, make new friends? Each year begins with a new chance to move forward. Don’t lose sight of your great gifts. This world can become wiser when it learns from you. You only live once, please believe in yourself and believe in others.5 Denise Wozniak is a certified public speaker.

P5SITIVE LIVING | 28 | NOV •• DEC 2016

Tickets available from Feb 1 at

SATURDAY | MAY 13 Event Harbour Centre 750 Pacific Blvd #REDYVR

REDVANCOUVER.CA Doors open 7 PM PRESENTS

A POSITIVE DAY IN VEGAS

Join us for a night of cabaret, fashion and fun, supporting people living with HIV in BC.