NEW S A ND T RE A TM E NT I N F O RM A T I O N FRO M TH E PO S ITIV E LIV IN G SO CIE T Y O F B R ITISH CO LUM BI A
ISSN 1712-8536
JULY • AUGUST 2018 VOLUME 20 • NUMBER 4
The message and the movement The Bollies
CAHR 2018
Life Insurance & You
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I N S I D E
Follow us at: pozlivingbc positivelivingbc
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THE OPIOID EPIDEMIC The shocking numbers inside North America’s opioid crisis
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COVER STORY
A first-person account of the birth of the U=U movement
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LET’S GET CLINICAL
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NUTRITION Why PLHIV need to take care of their bones
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REALIZE YOUR FULL POTENTIAL
Making life insurance a priority for PLHIV
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POZ CONTRIBUTIONS
Commemorating 25 years Recognizing Positive of CAC research success Living BC supporters
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positivelivingbc.org
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ViVA WOMEN
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PREP AROUND Let’s talk menopause, sisters THE GLOBE Stories and data from the global PrEP movement
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CAHR 2018
One man’s adventures at the conference in Vancouver
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VOLUNTEER PROFILE Volunteering at Positive Living BC
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GIVING WELL
A special feature on the legacy of David Maclean
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LAST BLAST Debunking HIV myths
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 | JULY •• AUGUST 2018
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 5900 HIV+ members. POSITIVE LIVING EDITORIAL BOARD Joel Nim Cho Leung, co-chair, Neil Self, co-chair, Ross Harvey, Elgin Lim, Tom McAulay, Jason Motz, Adam Reibin MANAGING EDITOR Jason Motz
DESIGN / PRODUCTION Britt Permien FACTCHECKING Sue Cooper COPYEDITING Maylon Gardner, Heather G. Ross PROOFING Ashra Kolhatkar CONTRIBUTING WRITERS Gus Cairns, Chad Clarke, Ana Gajic , Jason Hjalmarson, Kathy Ho, Bob Leahy, Jason Motz, Kevin Pendergraft, Wendy Porch, Stephanie Viguers 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, Matthew Matthew Funding for Positive Living is provided by the BC Gaming Policy & Enforcement Branch and by subscription and donations. Positive Living BC | 1101 Seymour St. Vancouver BC V6B 0R1
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
© 2018 Positive Living
from the chair I’m
writing this having attended Positive Living BC’s annual Volunteer Recognition Party last night, June 7, and it occurs to me that readers should know more about the essential role volunteers play in our Society. Of course, each issue of this magazine includes a volunteer profile [see page 25] featuring someone who has made special individual efforts to further our Society’s mission. But it is only by the collective effort of over 200 volunteers that Positive Living BC can truly function. Indeed, the pages that follow are written by a team of writers who are not paid, but who donate their time and talents to help inform and educate readers like you. (We are always looking for new writers to contribute to our publication. If you are interested, please contact our Managing Editor at jasonm@positivelivingbc.org.) To those volunteers who were unable to attend last night’s event, I will reiterate here my deep, heartfelt thanks for all that you do to help make living with HIV a hopeful, healthy experience for my peers and me. Positive Living BC’s membership has now surpassed 5,900 people living with HIV. Given that there are less than 30 paid staff members at the Society, our success relies on the active contribution of skilled and dedicated volunteers. These folks work in every corner of our organization—they give massages, haircuts, computer
P5SITIVE LIVING | 2 | JULY •• AUGUST 2018
NEIL SELF
expertise, admin support in Communications, professional guidance on our Red Ribbon Advisory Council and Community Dental Clinic Working Group… the list goes on. Any reader who is interested in volunteering with Positive Living BC should contact our Manager of Volunteer Services at marcs@positivelivingbc.org today. As a longstanding volunteer myself, I can tell you that the Society makes it worth your while. Great opportunities to get involved are coming in September at the 2018 Vancouver AIDS WALK. While we are scaling this event back this year (to save money and get back to our “roots”) there are plenty of volunteer slots that need to be filled. Are you a detail-oriented person who is good with forms and data? Then you might consider joining the registration crew. Are you a born motivator? Then you would be a perfect fit for our cheerleading crew along the WALK route. Contact kenc@positivelivingbc. org to learn more about these opportunities. And please notice the ad for this year’s WALK in this issue, an image created expressly for us by Joe Average. His artwork for past WALKs is nothing short of iconic. We are thrilled to welcome Joe back to the WALK after a long hiatus! 5
By 2030, prostate and lung cancers expected to be most common cancers among PLHIV
pDespite declines in cancer incidence
rates among HIV-positive people, cancer remains a significant concern as this patient population ages. By 2030, prostate and lung cancers project to be the most common cancers among people aging with HIV. Due to their weakened immune systems, PLHIV have a higher risk of some cancers than the general population. The development of modern ART has allowed PLHIV to live to older ages and reduced the risk of certain cancers, such as non-Hodgkin lymphoma and cervical cancer, which was previously prevalent in this population. This trend, along with the aging population, has resulted in a shift in the types of cancers diagnosed in patients with HIV. Thus, projecting cancer rates and the expected number of cancers in this high-risk population is necessary to inform public health efforts like cancer screening and prevention. Researchers from the National Cancer Institute used data from linked HIV and cancer registries to project cancer incidence rates in HIV-infected people from the Centers for Disease Control and Prevention (CDC) to estimate the future cancer burden. By 2030, the expected substantial aging of the US HIV population, with the proportion of HIV-infected people who are 65+ years old projected to be 21.4 percent (up from 8.5 percent in 2010). While the number of cancer cases diagnosed among adults with
HIV is projected to decline, incidence of non-AIDS-defining cancers will remain a concern. Prostate cancer cases are expected to increase over this timeframe, and prostate and lung cancers will each be more common by 2030. According to researchers, these findings underscore the continuing importance of cancer as a co-morbidity as PLHIV live longer and age. The findings should help to inform the priorities of targeted screening, treatment, and prevention programs. Source: http://annals.org/aim/article/ doi/10.732/m17-2499
Risk to babies of mothers with HIV from three ARVs regimens appears to be low
pThe risk for preterm birth and early
infant death is similar for three antiretroviral drug regimens taken by pregnant women with HIV according to a new Harvard study. Global use of three-drug ART by pregnant women with HIV has reduced the risk of mother-to-child transmission of the virus to less than 1 percent, but an earlier trial, PROMISE, had raised concerns about the safety of one regimen. In that trial, it was found that woman in sub-Saharan Africa and India who took TDFFTC-LPV/r (tenofovir disoproxil fumarate, emtricitabine, and ritonavir-boosted lopinavir) had infants at greater risk for every premature birth and death within 14 days after delivery than those taking ZDV-3TC-LPV/r (zidovudine, lamivudine, and ritonavir-boosted lopinavir.) Because the WHO recommends a once-daily TDF-FTC-based regimen as P5SITIVE LIVING | 3 | JULY •• AUGUST 2018
first-line therapy for all HIV-infected adults, including pregnant women, the Harvard researchers wanted to compare the risks posed by the two regimens studied in the PROMISE trial and an additional regimen using TDF-FTC and a different protease inhibitor (drug that prevents viral replication) called ATV/r (ritonavir-boosted atazanavir.) The researchers found that all three regimens pose similar risks for adverse birth outcomes. In addition, women using TDF-FTC-ACT/r had lower risks than those using ZDV-3TC-LPV/r. However, the authors noted that TDF-FTC-LPV/r is rarely used in the US, which may have limited the statistical accuracy of the study to identify risks associated with this combination. “It was reassuring to see that the use of TDF-FTC-ATV/r during pregnancy was not associated with an increased risk of poor birth outcomes in our study,” said lead author Kathryn Rough. “But based on the earlier results from the PROMISE trial, it may be wise to continue limiting the use of TDF-FTC-PLV/r in pregnant women with HIV.” Source: For more, see the April, 26 2018 issue of the New England Journal of Medicine.
Early HIV treatment key to avoid brain atrophy
pWhile HIV has largely dropped from
news headlines since the 1990s, at the end of 2016 there were 36.7 million people PLHIV with the infection, and of those only 53 percent had access to treatment. A new study underscores the neurological consequences of exposure to HIV without antiretroviral therapy.
Scientists have known for some time that HIV-infection cases reduced volume and cortical thickness in some regions of the brain, but it was unclear when these changes begin and what role combination antiretroviral therapy (CART) plays in stopping or slowing its progression. To answer these questions, researchers from the Montreal Neurological Institute and Hospital (The Neuro) of McGill University, in collaboration with researchers from University of Washington St. Louis and Yale University, analysed magnetic resonance imaging (MRI) data from 65 patients at the University of California San Francisco who had been infected less than one year before. They compared the data to that of the 19 HIV-negative participants and 16 HIV-positive patients who had been infected for at least three years. The researchers found that the longer the duration of untreated infection, the greater the volume loss and cortical thinning in several brain regions. Once CART treatment began, the volume changes in these regions stopped, and cortical thickness increased slightly in the frontal and temporal lobes. These results reinforce the need for early-detection of HIV and delivery of cart as soon as possible to avoid neurological damage. HIV-infection can lead to memory loss, dementia later in life, balance and vision problems, among other symptoms. Early screening and antiretroviral therapy can stop these symptoms before they occur, or stop their progression in patients who haven’t received fast enough treatment.
“There have been few longitudinal structural neuroimaging studies in early HIV infection, and none that have used such sensitive analysis methods in a relatively large sample,” said Ryan Sanford, lead author of the study. “The findings make the neurological case for early treatment initiation, and sends a hopeful message to PLHIV that starting and adhering to cart may protect the brain from further injury.” “It also helps focus the search for possible mechanisms of brain injury in this condition, pointing towards injury that occurs principally during untreated infection. This opens the door to novel treatments focused on potentially reversing these observed structural changes.” Source: Eurekaalerts.org
Transgender people denied mental health care at higher risk of self-harm
pA study co-authored by Dr. Michael A.
Lindsey, Executive Director of the McSilver Institute for Poverty Policy & Research at the Silver of Social Work at New York University, has found that transgender people who are denied access to mental health treatment experience a higher risk of substance about and attempted suicide. The findings, published online in Administration and Policy in Mental Health and Mental Health Service Research, hold critical implications for service access and delivery policies that protect transgender help-seekers in the health care system. An estimated 1.8 million Americans indentify as transgender. P5SITIVE LIVING | 4 | JULY •• AUGUST 2018
Professor Lindsey’s study, is titled “Examining Mechanism and Moderators of the Relationship Between Discriminatory Health Care Encounters and Attempted Suicide Among U.S. Transgender Help-Seekers.” Lindsey and his co-authors draw correlations between lower levels of mental health are access and its deleterious effects on transgender peoples from their analysis of the responses of over 4,000 respondents in the National Transgender Discrimination Survey. The findings indicate that about 25 percent of the survey respondents had been denied access to one or more health care settings, and 28 percent had been turned away from at least one setting. It is everyday discrimination that can lead LGBTQ+ people to seek out care in the first place, the authors note. According to the study, the consequences of service denial are not directly associated with a heightened risk of attempted suicide. Rather, service denial, whether due to systemic barriers or low-quality care settings, contributes to increased rates of substance abuse as a coping method. The use of substances, in turn, contributes to the greater risk of attempted suicide evidenced by the survey data. Source: www.NYU.edu 5
The opioid epidemic
O
Opioid deaths could have generational effect in North America By Ana Gajic
ne out of every five deaths among young adults in the United States is related to opioids, suggests a study led by researchers in Canada. The study, published in June in JAMA Network Open and led by St. Michael’s Hospital in Toronto, found that the percentage of deaths attributable to opioids in the US increased by 292 percent from 2001 to 2016, with one in every 65 deaths related to opioid use by 2016. This number varied by age group and sex. Men represented nearly 70 percent of all opioid deaths by 2016, and the highest burden was among young adults aged 24 to 35 years. This study expands on research in Canadian populations. “Despite the amount of attention that has been placed on this public health issue, we are increasingly seeing the devastating impact that early loss of life from opioids is having across the US,” said Dr. Tara Gomes, a scientist in the Li Ka Shing Knowledge Institute of St. Michael’s. “In the absence of a multidisciplinary approach to this issue that combines access to treatment, harm reduction, and education, this crisis will impact the US for generations.” Researchers reviewed all deaths in the US between 2001 and 2016 using the Centers for Disease Control and Prevention (CDC) WONDER Multiple Cause of Death Online Database. This record captures mortality and population estimates across the US by age and sex. The most dramatic increase in illicit and prescribed opioid-related deaths was seen in those aged 24-35. By 2016, 20 percent of all deaths in the age group were related to opioid use— up from only four percent in 2001. Dr. Gomes, who is also a scientist at the Institute for Clinical Evaluation Sciences in Ontario, and her team found that a total
of 1,681,359 years of life were prematurely lost to opioid-related causes in 2016, which exceeds the years of life lost each year from hypertension, HIV/AIDS, and pneumonia in the US. “These numbers show us the dramatic impact of opioid-related harms across all demographics in the US,” Dr. Gomes said. “We know this is not an isolated public health issue—it is one that spans across North America.” The Government of Canada reported earlier this year that between January and September 2017 there were 2,923 opioid-related deaths. Ninety-two percent are thought to be accidental deaths. The data indicates that 28 percent of these unintentional deaths were people aged 30-39. 5
PERCENTAGE OF ACCIDENTAL PERCENTAGE OF OPIOIDOPIOID-RELATED DEATHS IN RELATED DEATHS IN BC BY CANADA BY AGE GROUP AGE GROUP
5 Under 19: 5 20-29: 5 30-39: 5 40-49: 5 50-59: 5 60-69: 5 Over 70:
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2% 19% 28% 22% 21% 7% 1%
5 Under 19: 5 20-29: 5 30-39: 5 40-49: 5 50-59: 5 60-69: 5 Over 70:
Source: Government of Canada
2% 18% 28% 24% 21% 6% 0%
Volunteer with
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Bon appétit for bone health
B
By Kathy Ho one health should be a priority for adults, in particular those who are HIV-positive. PLHIV face increased risk for both osteopenia and osteoporosis. There are several factors to consider: the virus, immunity, medications, and aging. Although some medications can increase your rate of bone loss, it’s crucial to control the viral load and maintain your immune system by taking ARVs as scheduled. Osteopenia means bone density has begun to decline but is not considered dangerous. When bone density levels do become critically low, causing bones to weaken or break, then Osteoporosis has set in. Osteoporosis increases as we age, but older women are at a higher risk. Two million Canadians are affected by osteoporosis. Since we cannot feel bone loss, often times, the first sign of osteoporosis is a broken bone! An adult body continuously replaces bone tissue. Up to age 30, bone tissue is replaced faster than lost. Past 30, more bone is broken down than replaced. Good thing it’s never too late to start taking care of your bones. Genes play a hand in your risk for bone disease, but lifestyle factors also make a difference: exercise, nutrition, smoking, and alcohol. Bones require an adequate and constant supply of nutrients such as calcium, protein, magnesium, phosphorus, vitamin D, and potassium. Magnesium, phosphorus, and potassium are easy to get by eating vegetables, whole grains, nuts, and pulses. Calcium and vitamin D are trickier, as few foods contain an absorbable amount. In order to take care of your bones, first, talk to your doctor. Are you at higher risk for bone disease? Can medication increase your risk? Do you need a bone density scan to see if you need treatment?
Talk to your dietitian, too. Are you getting enough calcium and vitamin D? Do you need to supplement? Dairy and fortified milk substitutes are great sources of calcium, but other healthy foods, like tofu, beans, canned fish with bones, green leafy vegetables, are too. Use an online calcium calculator to see how you measure up. Adults need 1000-1200 mg of calcium/day, depending on sex and age. Vitamin D supplementation of 1000-2000 IU/ day should be considered for PLHIV. Get moving! Strength, weight-bearing, and balance exercises strengthen bones and reduce the risk of falls. Strength training can be done using your body weight, a resistance band, free weights, or machines. Weight-bearing exercises include walking, hiking, jogging, dancing, etc. If you have thinning bones or are frail, talk to a physiotherapist to see if certain activity is right for you. Quit smoking—it’s worth it. There is a direct link between tobacco use, faster bone loss, and lower bone density. Even later in life, quitting smoking can limit smoking-related bone loss. Follow low risk alcohol drinking guidelines as alcohol affects hormones that regulate bone growth, and tissue replacement. Reduce your long-term health risks by drinking no more than 10 drinks a week for women, and 15 drinks a week for men. (And, if you don’t drink, don’t start!) More information is available at osteoporosis.ca. 5
Kathy Ho is a Clinical Dietician who specializes in Urban Health, HIV and IDC.
wom n Menopause and HIV an exhausting combo
R
By Stephanie Viguers esearchers at Columbia University found evidence that fatigue and muscle aches—two of the most common symptoms among patients with HIV—are exacerbated by menopause. This study underscores the need for health care providers to consider menopause when treating the often-overlooked aging HIV population, according to Rebecca Schnall, PhD, RN, Mary Dickey Lindsay Associate Professor of Disease Prevention and Health Promotion at Columbia University School of Nursing. “Given the shifting demographics in the HIV epidemic, our findings are very salient for PLHIV and for their health care providers,” Schnall. “If health care providers can better predict, identify and manage the symptoms that are most burdensome to women living with HIV (WLHIV), they can improve care for these women.” Schnall and colleagues previously conducted a national survey of 1,342 men and WL HIV in the US to better understand how they are affected by HIV-associated non-AIDS conditions and symptoms. The most common symptoms participants reported were fatigue, muscle aches, depression, anxiety, trouble staying asleep and difficulty falling asleep. A gender-based analysis showed that women experienced a higher burden of fatigue and muscle aches compared with men. In a follow-up survey, Schnall, Nancy Reame, Director of the Pilot Studies Core at Columbia University’s Irving Institute for Clinical and Translational Research, and colleagues further examined the burden of symptoms among 222 women. They compared self-reported symptoms among women who went through natural menopause or who had a hysterectomy with those of menstruating women.
“The study of differences in the way men and women experience HIV symptoms is an important emerging focus,” Reame, said. “A number of studies have described menopause symptoms in WLHIV, but few have examined whether menopause might help explain the enhanced severity of HIV symptoms observed in women when compared to men.” The survey results showed that postmenopausal women had higher burden scores for muscle aches/pains, fatigue and trouble falling asleep vs. menstruating women. These results were independent of age, HIV duration, and HIV-associated non-AIDS conditions, according to the researchers. “To what extent this finding is confounded by an overlap between symptoms of menopause and consequences of HIV is difficult to untangle as this interaction is likely multidimensional and bidirectional, that is, menopause exacerbates HIV and HIV exacerbates menopause,” the researchers wrote. “As the number of women transitioning through menopause expands within the aging HIV cohort, the needs of this population are likely to require a multidisciplinary team of health care experts and new directions for HIV care management.” 5 Iribarren S, et al. AIDS Behav. 2017;doi:10.1007/s10461-017-1786-6. Schnall R, et al. Menopause. 2018;doi:10.1097/ GME.0000000000001083.
This article originally appeared on Healio.com and appears here edited to fit the page. You can read the original here: https://www.healio.com/infectious-disease/ hiv-aids/news/online/%7b38238a43-4fee-4fef-a045-ef3c28a8d20e%7d/menopause-worsens-fatigue-muscle-aches-in-women-with-hiv
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Australia: PrEP leads to significant drop in new HIV infections By Gus Cairns
The
state of New South Wales in Australia has seen a fall of one-third in diagnoses of recent HIV infection since it started its pre-exposure prophylaxis (PrEP) implementation project, EPIC-NSW (Expanded PrEP Implementation in the Community), the 25th Conference on Retroviruses and Opportunistic Infections (CROI 2018) heard in March. Andrew Grulich of the Kirby Institute of the University of New South Wales told the conference that only two people who entered EPIC-NSW had been diagnosed with HIV (both entered the study by the end of October 2016): this represents at least a 97.6 percent decline in the HIV incidence that would have previously been expected in the study population. In New South Wales as a whole, HIV diagnoses in the last year fell by a third in the year after the trial was started compared to the previous year. They fell by half in people aged over 35 and in people born in Australia. Grulich said that participation in EPIC-NSW was concentrated among Australian-born, older, largely white gay men who live in central Sydney’s ‘gay village.’ There were considerably lower rates of participation among younger, non-white and suburban gay men, especially in Sydney’s western suburbs which are very ethnically diverse. The figures presented by Grulich supplement a report issued by the New South Wales health department in August last year, which also announced significant drops in HIV infection. This report attributes the drops not only to the PrEP study but also to a near-doubling in the number of tests taken by gay men after the start of the study. EPIC-NSW started in March 2016 and most other Australian states (apart from Tasmania and the Northern Territory) followed suit. The original intention, based upon calculations of the number
of people at high risk of HIV infection in the state, was to enroll 3700 people in the trial. This was in fact achieved in the first eight months of the trial. “We were very clearly seeing gay men at high risk of HIV continuing to want to join the trial,” Grulich commented at the Conference. “We asked the state Health Department for a formal protocol amendment and to remove the cap on recruitment. “It was really helpful to have a government that had an explicit target for reducing HIV transmission,” he added, referring to the New South Wales strategy for reducing HIV infections to near-zero by 2020. “The evidence for PrEP is now so strong that we could say ‘If you want this to happen, you have to include PrEP’.” EPIC-NSW had nearly 9000 people recruited by the end of last year and there is no sign of the linear increase in enrolments slackening off. Grulich said that it was estimated that the proportion of at-risk people on PrEP in New South Wales had increased from 3 percent in 2015 to 17 percent in 2016, and to 25 percent by the end of 2017.
Who joined the study
Of the 3700 people enrolled by October 2016, two-thirds were between 25 and 44 years old, 26 percent 45 or over, and only 8 percent aged 18 (the lower age limit) to 24. By that time, it had enrolled 23 transgender women (0.6 percent) and just one cisgender woman. Just 0.5 percent of the study were not men who have sex with men, and of the 99.5 percent, only 4.5 percent described themselves as bisexual or heterosexual rather than gay. Fifty-six percent of participants were Australian nationals, including 2 percent who were aboriginal/Torres Strait Islanders, which is roughly in line with national demographics. Eleven per cent were non-nationals from high-income countries, and 9 percent were classed as Asian, with 11 percent from other groups.
P5SITIVE LIVING | 10 | JULY •• AUGUST 2018
Only 11 percent of participants came from outside Sydney. Thirty-eight percent of participants came from seven postcodes that between them represent only about 3 percent of the population of Sydney, reflecting the concentration of the gay community there. In terms of adherence, half the participants in the period up to October 2016 obtained refills of their PrEP consistent with taking it every day, and 70 percent had 80 percent adherence, meaning at least 11 days in every 14. On the other hand, 112 people (3 percent) never returned to collect any more PrEP after their initial visit.
Reductions in HIV incidence
There were two HIV infections in 3927 person-years during this period, or 0.05 percent a year. This represents a 97.6 percent reduction in the HIV infections that might have been expected in a demographically similar group. One of the infections was in a person who never started PrEP (his doctor advised against combining it with hepatitis C treatment) and the other in a person who had not taken PrEP for at least six months prior to infection. To assess whether the EPIC-NSW project produced a populationlevel decline in PrEP, the researchers compared HIV infections in New South Wales in the year before the trial started (from 1 March 2015 to 28 February 2016), with infections in the year after the first phase of the trial, between 1 November 2016 and 31 October 2017. There were 295 infections in the state during the first 12-month period and 221 in the second – a 25 percent decline. There was a 32 percent decline in infections that were classed as
recent (acquired during the previous year), down from 149 to 102. The decline in infections was mainly in older people: infections fell almost by half (down 46 percent) in people over 35, but only fell by 22 percent in people aged 25-34 and 9.5 percent in people aged 18-24. Infections fell by 49 percent in people born in Australia but only by 21 percent in people born in Asia and actually increased, by 25 percent, in people from areas other than Australia, high-income countries, and Asia. Numerically this was only an increase from 17 to 21 infections, but it was statistically significant. Grulich commented that more needed to be done to reach out to young gay men and those who did not speak English as a first language. To make a larger population-level impact on HIV infections, the program had to reach out to these people so that more than the 25 percent of at-risk people in New South Wales who were currently on PrEP were taking it. 5 Grulich A et al. Rapid reduction in HIV diagnoses after targeted PrEP implementation in New South Wales, Australia. 25th Conference on Retroviruses and Oportunistic Infections (CROI 2018), Boston, abstract 88, 2018.
This article originally appeared online at Aidsmap.com. It has been edited for style.
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U=U The Origins of a Movement by Bob Leahy
The
story of U=U has two intertwined paths. I call them the message and the movement. The message is simple—that undetectable equals untransmittable, a truth that took its time to show its face. A person living with HIV, successfully on treatment, need no longer fear passing on the virus to their sexual partners. Could there be anything simpler yet more revolutionary, more uplifting, than that?
The answer is yes, for the story of the U=U movement is empowering, groundbreaking, and almost unknown. It’s that story I want to begin with: the story about the movement that introduced U=U to the world. Let’s start not at the beginning, but in Paris, July 2017. The International AIDS Conference that has attracted 6,277 HIV professionals and community members from around the world has just begun.
P5SITIVE LIVING | 13 | JULY •• AUGUST 2018
continued next page
The mood among those of us wearing U=U t-shirts, a group of maybe 40, is of excitement. True, U=U had not found its way to conference agendas, a disappointment for Bruce Richman, the charismatic founder of U=U’s Prevention Access Campaign. But early on, to much jubilation, the Mayor of Paris had officially declared support for U=U. Photographs from the crowded announcement show a glowing Richman surrounded by supporters. That jubilation was soon to turn to high anxiety. A U=U press conference loomed with high-level dignitaries set to speak. None was more anticipated than Michel Sidibé, Executive Director of UNAIDS, whose office—while not endorsing U=U—had been talking in supportive language. Richman was counting on hearing that UNAIDS was endorsing U=U. But at the last minute, Sidibé bowed out, sending a deputy to the press conference instead. Nobody was really sure what Deputy Executive Director Dr. Luiz Loures would say; the mood as tense. Richman, set to speak last at the podium, never looked more nervous. The panel all made supportive remarks before Loures’ turn. Serious and unsmiling, he says encouraging things like he sees a place for U=U in UNAIDS programming. It’s wishy-washy, not a firm “UNAIDS endorses U=U.” Supporters were deflated. Richman, looking tense, spoke next. “When I was diagnosed with HIV in 2003,” he says, “I felt like I was a walking infection. I was terrified about passing HIV on to someone that I love. I didn’t start treatment because taking a pill every day would remind me that I was infectious, every day. After I started treatment in 2012, when my health started to deteriorate, I learned from my doctor that because I was undetectable, I couldn’t transmit HIV. I couldn’t pass it on. I was elated.
The evidence was overwhelming, yet organizations everywhere kept mum.
“But very soon I became outraged. Because every HIV treatment site, every media outlet, every ASO, every federal health department, every state health department, everywhere, was saying that I was still a risk. And millions of people with HIV were still a risk. It was clear, for many reasons, that the breakthrough science wasn’t, and still isn’t, breaking through to the people it was intended to benefit.”
The question hangs in the air: was the UNAIDS statement strong enough? And then came validation. It’s question period. At the microphone, a reporter speaks. “I’d like to address this to the UN representative. You have said you see a place for U=U in programming, but could you clarify where the UN stands in terms of support? Where do you stand on the spectrum of accepting the message that U=U?” “We fully and unequivocally support the message,” Loures says. It was the quote, the kind of affirmation we were hoping for, one we had promised the community would hear. That reporter was me. At dinner that night with a group of my U=U comrades, I could not keep the emotion of the day hidden. It came bubbling up; I cried openly over my French onion soup.
I felt like I was a walking infection. I was terrified about passing HIV on to someone that I love.
We had planned a demonstration the next day to interrupt a plenary session in the huge conference hall. We were organized. We had the big U=U banner, we had our U=U t-shirts on, we had speakers lined up, and a boom box. “Celebration” was to be our theme music. At 10:15 AM local time we swooped—a conga line of black and white U=U shirts. And we shouted. We shouted “U=U, celebrate sex.” Then “U=U, science not stigma,” then “U=U, treatment for all.” It seemed like it took forever, but eventually we reached the stage; press photos show us euphoric. The group gathered behind the banner. Then Richman cranked up the music and “Celebrate” filled the auditorium. Arms raised, we danced. Christian Hui, my Canadian colleague was beaming; it was a magic moment. The three speeches which followed, all personal testimonies to the power of U=U, were powerful and electric. The audience applauded warmly. The social media reaction was instant. “#UequalsU supporters bring #celebration to #IAS2017 with the serious msg of undetectable= untransmittable,” one tweet said. “Just happened at the International AIDS Society Conference: dancing in the aisles, chanting ‘U=U, Celebrate Sex!’” said another tweeter. “‘U=U, Treatment for All!’ And demanding that physicians talk to their clients about the real science of HIV and also how undetectable viral loads can
P5SITIVE LIVING | 14 | JULY •• AUGUST 2018
allow people to enjoy sex and have families,” said science writer Heather Boerner. “We just did something so tremendous it is hard to fathom!!” Richman said. It was arguably the campaign’s finest hour—acceptance on the world stage. It had been a long time coming. The U=U campaign was born in July 2016, a product in part of Richman’s own journey with HIV, which he related to the assembled press in Paris. He had learned not long before what the science was saying to those who cared to listen. That science included The Swiss Statement of 2008, derided by almost every AIDS organization in Canada and beyond—but ultimately vindicated. It built upon the work of the BC Centre for Excellence in HIV/AIDS (BCCfE) around treatment as prevention (TASP), also disputed by some. It built upon HPTN052, a study that proved that those with an undetectable viral load don’t transmit the virus, although some still talked about a bogus “four percent risk.” Then came the PARTNER study results which saw no transmissions between mixed-status couples involving 58,000 acts of condomless sex, which nonetheless resulted in few changed opinions. The evidence was overwhelming, yet organizations everywhere kept mum, or maintained that people with an undetectable viral load still represented a risk to their sexual partners. Enter U=U. The grassroots campaign—with next to no money, no staff, and opponents aplenty—set out to change everything. Unusual in that it was a campaign led entirely by PLHIV, including Richman, with no prior experience in the sector, it was the ultimate expression of involving PLHIV in decision-making. Despite early successes in New York City and London, the 2016 campaign needed a more global uptake. My own involvement in the long and winding road had started with a request to Richman for an interview. Richman laid out some of his cornerstone beliefs. “I’ve come to realize that a lot of the information that is presented about us is often inaccurate and not up to date with current science,” he said. “It’s based on many, many years of entrenched stigma and all kinds of phobias and sex negativity against people with HIV. PLHIV and the field deserve accurate information.” Convinced—for I myself believed that people on successful treatment were not a danger to their partners, and never had been—I persuaded then-publisher John McCullagh that PositiveLite.com should sign on as a community partner. Canadian Positive People Network (CPPN) followed suit and by the end of that year BC’s YouthCO, AIDS Action Now, and The AIDS Committee of Ottawa all joined. But we were getting pushback galore.
We had to get CATIE on board, so McCullagh reached out to their Executive Director, Laurie Edmiston. To our joy, they came out with a ringing endorsement. “All of us here at CATIE, and indeed around the world,” said Edmiston, “are celebrating the most significant development in the HIV world since the advent of effective combination therapy 20 years ago: PLHIV with sustained undetectable viral loads can confidently declare to their sexual partners, ‘I’m not infectious!’” Richman credits this as a defining moment in the campaign’s history. He would go on to make several visits to Canada, speaking in Toronto, Montreal, Ottawa, and elsewhere. He values the Canadian connection. “Every time I’ve gone back to Canada, I’m moved and inspired by the trailblazing work of our Canadian partners,” he said.
It was arguably the campaign’s finest hour— acceptance on the world stage.
If U=U has received impressive recognition in Canada, the global uptake has been remarkable. The campaign now has over 550 community partners in over 75 countries and accolades aplenty. POZ magazine readers voted U=U the campaign of the year. The Lancet raved. The CDC backed the science behind the campaign. An Australian speaking tour by Richman was a huge success. The campaign received coverage in the Washington Post, The New York Times, CNN and CBS—the list goes on. Despite the positive media coverage, there remain those who reject the science—although that number diminishes by the hour. Those who claim they are unable to pass on the virus still face hostility and rejection. There are still questions and work to be done: how effective is undetectable viral load in preventing transmission from injection drug use, for example? Breastfeeding while undetectable remains controversial. Far too many people cannot benefit because being undetectable remains out of their reach. Nonetheless, this is a success story. In the history of the epidemic, it’s a significant marker—perhaps the most important since the introduction of antiretroviral therapy in 1996. Most importantly, people living with HIV did this. I’m proud to have been part of it. 5 Bob Leahy is the former publisher of PositiveLite.com as well as the lead Canadian organizer for the Prevention Access Campaign. He was diagnosed with HIV in 1993.
P5SITIVE LIVING | 15 | JULY •• AUGUST 2018
HEALING RETREATS FOR HIV+ PEOPLE
Meet New Friends
Nature Hikes Healthy Meals
Comfortable Cabins
Rock Climbing
Creative Projects Small Group Work
Swim | Canoe
Interviews Start May 15, 2018!
General inquiries to retreats @ positivelivingbc.org or 604.893.2200
Massage
to apply download application at positivelivingbc.org/healingretreats
Your Full Potential
HIV & Life Insurance in Canada
As
By Wendy Porch
a kid, I remember watching a stranger give my dad a medical exam in our living room. He took out a stethoscope and listened to my dad’s heart, right there on our rust-coloured couch. This wasn’t our doctor, so who was he? It turned out my Dad was applying for life insurance. He was approved, but the encounter stayed with me. Life insurance straddles the line between the financial and the personal—it’s a bet on your health. Money flows between the insured and the insurance company. This is more than just a financial transaction; life insurance is peace of mind—knowing that your passing won’t leave loved ones with financial worries piled on top of grief. PLHIV in Canada have long been excluded from access to life insurance. In the early days, some folks cashed in their policies after being diagnosed. Even long-term survivors were denied insurance. That changed when Manulife and Sun Life began accepting applications from PLHIV in 2016. Yet, this notable shift remains unknown within the community. In February, Realize partnered with the Canadian Positive People Network (CPPN) to explore why this was, and to facilitate access to life insurance for HIV-positive Canadians. In March, we held a think tank on the issue. Prior to the think tank, CPPN and Realize developed surveys to determine the current state of life insurance for PLHIV. CPPN asked its members if life insurance was on their minds and heard a resounding yes. Members asked: who offers coverage? How do I apply? Am I eligible? How much does it cost? What happens when it comes time to pay out? Do we face extra barriers? Realize canvassed insurance providers about insurance issues from the HIV-positive perspective. Despite assistance from the
Canadian Life and Health Insurance Association, an umbrella organization for the insurance industry, Realize was unable to garner a response. Insurance companies that were already accepting applications from PLHIV were forthcoming. But the majority of insurance companies, those who currently refuse applications from PLHIV, failed to respond. In March, participants representing the HIV and insurance sectors, gathered in Toronto for the HIV and Life Insurance Think Tank. Presentations from Realize, CPPN, Sun Life, and the Prisoners’ HIV/AIDS Support Network set the stage for participants to identify key issues. As the group talked through the ins and outs of insurance, it became clear how much remains unknown. There were few answers to questions asked by CPPN members. No one could say with any certainty what the pay-out process was like, as no one knew of any HIV-positive person who had been through it yet. One thing was apparent however—life insurance is a priority. Response to the survey and discussion suggest that life insurance is a hot topic, albeit one tempered with wariness. CPPN and Realize will collaborate to develop resources and tools, and to continue the conversation on life insurance for PLHIV. Life insurance offers financial stability and peace of mind for loved ones. Realize hopes that HIV-positive Canadians can reach these important and deeply personal goals. 5 Wendy Porch, M.Ed, is the Manager of Episodic Disabilities Initiatives at Realize.
P5SITIVE LIVING | 17 | JULY •• AUGUST 2018
P5SITIVE LIVING | 18 | JULY •• AUGUST 2018
Reflecting back on CAHR 2018
A
By Chad Clarke
rrival. My flight from Ontario was scheduled for 2:35EST and had me arriving in beautiful Vancouver for 4:30PST. A friend I haven’t seen in over 15 years picked me up and gave me a tour from the airport to my hotel in English Bay. First thing we did when we arrived at Sunset Beach was do what all travellers do: medicate! Around 9-ish I headed back to my hotel and showered, then out for a quick Zen at the beach before bed. Day one begins. The session I was presenting was in collaboration with two great allies, Positive Living BC and Canadian HIV/ AIDS Legal Network. We presented on the federal and provincial announcements that were made on World AIDS Day last year. Also touched on what the movement has done since, and where we see the movement going. (Hint. I’m ready to challenge the Supreme Court of Canada regarding the National Sex Registration.) I was asked if I had considered running as an MP and being a voice for the HIV Community. Hmm. I ended my day at four, and went hiking through Stanley Park with a friend. We started at the English Bay entrance and walked along the seawall for a good three kilometres, before heading into the park’s interior. I had to find the sacred medicine tree; I heard stories that this tree is a couple thousand years old. And boy was it huge. I felt all the anxiety leave me as those mountains welcomed me back. The sight of two bald eagles swooping through the air had me feeling like I could unfold my own wings and absorb the beauty of my surroundings. Back at the hotel for the Social Gathering and Poster Presentations, and did I ever feel under dressed! Here I was wearing a green golf shirt and black Hurley shorts. Well, every-
one got to see another side of Chad, just chilling and kicking back in his comfy kicks. Day four was the best day of CAHR. I spent time with someone I admire and love to pieces, Val Nicholson. We found a quiet little nook, and I shared with her some of the things that were causing me some self-doubt. The Cruise. This was something I was looking forward to! I got myself all cleaned up, put on my suit, and headed to the boat with Val. The tunes were playing and my soul was ready to move. (Music is life to me.) The dinner was great and this guy actually had salmon. Not really big on fish but I would have this dish again. I came back on the first drop-off and headed back to my hotel. I changed back into comfy clothes, and headed down to the bay to smudge and to leave an Inukshuk for the Creator. The last day. This night was the 25th Anniversary of the Canadian HIV/AIDS Legal Network and its work in human rights. Guest of honour was the Honourable David Eby. I was eager to hear the announcements from the meetings that had taken place earlier that day. Was impressed by what I heard. I’m not ready to leave. Before going back home, there was one more thing to do: being part of the video to be played at the International AIDS conference this July in Amsterdam. It’s important to me that people share their lived experience in what ever way they chose. I attend many little conferences in my area, but CAHR is what ignites me. 5 Chad Clarke is an activist, advocate, and writer based out of Ontario.
P5SITIVE LIVING | 19 | JULY •• AUGUST 2018
Giving Well
A DONOR PROFILE By Jason Hjalmarson
David MacLean Lorne Kutney
For
this special edition of “The Giving Well” we’re honoring the extraordinary achievements of David Wayne MacLean, who was involved in the Vancouver AIDS WALK every year for 20 years, and earned the title of “Top Walker” nine times. His participation raised a total of nearly $140,000.00. David passed away in late March of this year. In early May, Board Chair Neil Self and I sat down with Lorne Kutney, David’s partner of 38 years, to talk about what the AIDS WALK meant to David and to celebrate his legacy. Q: When did David first get involved with the AIDS WALK? What prompted his involvement? A: David was biologically programmed to do everything bigger, better, and showier than everybody else.
His first walk was in 1993. We had lost enough people already since the 80s and he was diagnosed in 1986 and I was in 1988, and by then we had already gotten exhausted with loss. At least then it was fast, you didn’t sit in palliative for a month mourning someone dying slowly. Before you could turn your head, the next person had died the night before. And I think because there was the beginning of this [the AIDS epidemic], David realized it was something that was unquestionably important and he couldn’t just sort of, you know, go on a walk. He needed to do more. We talked about it, and I told him I thought he had the passion and the vision, “you can do it and I’ll assist you. You can raise the money and I’ll do the paperwork, logging cheques, etc.” It would have been overwhelming for him to do it by himself. By the time he was doing well, he sent out individual letters to people using his own postage.
P5SITIVE LIVING | 20 | MAY •• JUNE 2018
Q: Would you say David was more of an introvert or an extrovert? Tell me some more about the methods David used to achieve his extraordinary results? A: He would send personalized letters, and follow up. He would go door to door in the community he lived in. If the money wasn’t coming in fast enough, then he became more of an extrovert. He would make long distance calls if that was required, he’d be on the phone saying, “Come on people! Last year you told me you wished you had done this and it got lost in a pile of stuff to-do and I only saw it after the fact.” He’d remember stuff like that, call them excuses or reasons or whatever, he logged all that stuff, and remembered it for the next year. He kept a lot of it in his head. And he wasn’t scared of asking high, when push came to shove, he would say to people, “I want you to go double!” and they would do it. And then once he started getting recognized for his efforts, the people he was asking began to realize they were doing something that was really effective, not because he was being recognized, it was because he really meant it. He was in it for the long haul. Q: When did David stop participating in the AIDS WALK? A: His last year walking was 2011, which makes it 19 years of walking. It was after the 2011 WALK that he was becoming frailer and he said to me, ‘Lorne, I can’t physically walk the walk” and I told him “You don’t have to, you never really had to walk to begin with.” So in 2012 we handed in the donations and went to the tents and had a hot dog. It didn’t matter that he wasn’t able to do the walk himself, he still raised contributions to support the cause. But after 2012 he told me he just couldn’t keep it up anymore, he couldn’t keep calling people and sending letters. I mean, it was a lot for him to do. I don’t remember how many pledges we handed in on his best year, probably 25 or 30 sheets of donors. His base was huge in numbers rather than having five or ten wealthy or corporate donations. He had to find the money in fives, tens, and twenties. He’d have a few doctors who would give him $1000, but his efforts were never, “I know the rich and famous, let’s get this wrapped up in a single night.” Q: How long would it take him to raise all the donations he brought in? A: As soon as he knew the date for the next walk, he’d get started. Letters would go out in February (with the WALK being in September) and he’d start engaging people. Then by June he’d start following up with people, around three months before the walk he’d start sending reminders saying, “I haven’t seen your donation yet, I’m used to so much mail and I haven’t seen enough so far. What do you need from me to make this happen?” and then the mail would start arriving. It was fantastic to watch all the contributions coming in
Q: HIV changed quite a lot during the course of David’s life, and the AIDS WALK changed a lot as well too. What were the biggest changes that David noticed during his years of participation? A: The urgency behind the walk changed, and so over time the walk had to change as well. It disappointed David to see numbers decline, to see the media coverage decline. He understood that people needed to get out there and let their community know that this was a need that wasn’t going away any time soon. Q: As a long-term survivor of the epidemic yourself, is there advice you have for younger people who’ve been recently diagnosed themselves with HIV? A: That’s a big question and it’s hard to answer it in a few sentences. But I owe my life to divine grace, forgiveness, and intervention for the miracles in our lives. I would say that it’s important for newly diagnosed people to acknowledge what’s happened to them, but not to blame themselves. To recognize that, yes, things like this can happen to you. We went decades with drugs that didn’t really work, and by the time there were drugs that actually worked, they didn’t work on us. We were already too far gone. For the few that survived, like David and me, what did work is what is being used now to start with right away. This has lead to a sort of glorified sense that it’s just a chronic issue now, we can manage it and you can still have a great quality of life, you can work and buy your home and stuff like this. I think that this is a blessing, but it shouldn’t take away from the fact that you still have something that isn’t curable, there’s still no vaccine, there’s still a lot of stigma. David had wasting syndrome, and so when he went out in the public he’d often have to deal with overhearing people say things like, “I think he’s got AIDS.”
While it is difficult to say specifically, Positive Living BC’s Executive Director Ross Harvey estimates that David’s incredible work touched the lives of at least 3000 people living with HIV in BC. David’s legacy stands as a reminder to us all about what one person can achieve through determination, hard work, and tenacity. “To the best of my knowledge, no one else [who participated in the AIDS WALK] comes close to these astonishing totals. As far as we are concerned, if there is one thing about David Maclean that remains wholly indisputable, it’s that he made a difference. A huge difference. We are all profoundly grateful.”5
Jason Hjalmarson is Director of Fund Development at Positive Living BC.
P5SITIVE LIVING | 21 | JULY •• AUGUST 2018
25 years of CAC
W
hen the CTN Community Advisory Committee (CAC) first formed in 1993, an HIV diagnosis was considered a death sentence, and few drugs were available for HIV and its myriad related opportunistic infections. Twenty-five years later, while there is still no cure, HIV is a manageable chronic disease compounded by other health conditions and stigma that continues despite advances in treatment. “While HIV is no longer a death sentence for people with access to treatment, many people continue to lack appropriate diagnosis, care, treatment and support services in Canada. Along with other community groups, we have pushed the research agenda to include community members on study teams to ensure engagement at every stage of the research process,” says Shari Margolese, chair of CAC. CAC grew out of the work of HIV advocates who believed that it was essential for people living with HIV to be treated as partners to improve the quality and quantity of HIV research in Canada. In 1992, advocates called for the development of a community committee to review scientific protocols and informed consent forms as part of the CTN. In 1993 CAC was born, forever changing the dynamics between pharmaceutical companies, researchers, and people living with HIV in Canada. Since forming, the CAC has reviewed over 250 study protocols determining their strengths, weaknesses, risks, and importance. For today’s CAC, committee members build upon a new era of involvement as a result of CIHR’s policy for citizen engagement in all of its funding programs. Committee members do more than review studies, and many are also engaged in a variety of research projects ranging from tracking stigma to HIV and aging, and studies improving the health of different key populations including men who have sex with men, women, Indigenous people, people from endemic countries, and people who use drugs, to name a few. The meaningful involvement of people living with HIV is now integrated into priority setting and development of research priorities at the CTN. According to Ms. Margolese, who has been living
By Kevin Pendergraft
with HIV for over 25 years, “Community engagement has improved the impact and relevance of CTN studies and has increased the capacity of community members to participate in every stage of the research process.”5 Kevin Pendergraft is the Communications and Knowledge Translation Manager for the CTN.
Other Studies enrolling in BC CTNPT 014
Kaletra/Celsentri combination therapy for HIV in the setting of HCV BC sites: Vancouver Infectious Diseases Centre, Vancouver; Cool AID Community Clinic, Victoria
CTN 222
Canadian co-infection cohort BC site: St. Paul’s
CTN 262
Canadian HIV Women’s Sexual and Reproductive Health Cohort Study (CHIWOS) BC Coordinator: Rebecca Gormley, 604.558.6686 or rgormley@cfent.ubc.ca
CTN 281
EPIC 4 Study BC site: BC Women’s Hospital and Health Centre
CTN 283
The I-Score Study BC site: Vancouver ID clinic
CTN 292A
Development of a screening algorithm for predicting high-grade anal dysplasia in HIV+ MSM BC site: St. Paul’s
CTN 292B
Treatment of high-grade anal dysplasia in HIV+ MSM BC site: St. Paul’s
Visit the CIHR Canadian HIV Trials Network database at www.hivnet.ubc.ca for more info.
P5SITIVE LIVING | 23 | JULY •• AUGUST 2018
For a full list of donors visit positivelivingbc.org
$5000+ LEGACY CIRCLE
Merck Canada Inc. Peter Chung Wildlife Thrift Store The Benevity Community Impact Fund
$1000 - $2499 CHAMPIONS
Bramwell Tovey Fay Leung Tu Paul Goyan Allan Hovan Fraser Norrie Jackie Yiu Paul Gross Malcolm Hedgcock Blair Smith Don Evans Fraser Norrie Reka Gustafson Duncan Anderson Kari Hackett
$500 - $999 LEADERS
Leslie Rae Christian M. Denarie James Goodman Rebecca Johnston Emet G. Davis Dean Mirau Pierre Soucy Robert Capar Stan Moore Mike Holmwood Cliff Hall Ross Harvey Scott Elliott
Cheryl Basarab Emily A. Anderson David Hall Mark Hull Paul Gross
$150 - $499 HEROES
Erik Carlson Katherine M. Richmond Peter Nash Brian A. Yuen Len Christiansen James Ong Mark Mees Dena R. Ellery Ronald G. Stipp Bonnie Pearson Maxine Davis Darrin D. Pope John Bishop Gretchen Dulmage Jean Sebastian Hartell Sergio Pereira Tiko Kerr Mike McKimm Glynis Davisson Ross Thompson William Granger Ralph Silvea Patrick Carr Lawrence Cryer Brian Anderson Gbolahan Olarewaju Jamie Rokovetsky Jane Harris Pam Johnson Ralph E. Trumpour Keith A. Stead Joel N. Leung Lorne Berkovitz
Vince Connors Ken Coolen Jane Harris Elizabeth Briemberg Alex Smith Kindra Breau Sarah Chown Tim Stevenson Penny Parry Jane Talbot George Schwab Tom Mcaulay Ron J. Hogan Wayne Avery Susan C. Burgess Patricia Dyck Barry DeVito Laura Sauve Aaron Brown Stephanie Tofield Stephen French Glyn A. Townson Dennis Parkinson Patricia E. Young Rob Spooner Jeff Anderson Larry Hendren Edith Davidson Wayne Campbell Carmine Digiovanni
$20 - $149 FRIENDS
Emily A. Anderson Tracey L. Hearst Sandra Bruneau Zoran Stjepanovic John Yano Andrea Reimer Hans-Krishna Von Hagen Serena Eagland
P5SITIVE LIVING | 24 | JULY •• AUGUST 2018
Catherine Jenkins Sharon E. Lou-Hing Angela McGie Lisa Bradbury Scott Trombetta Laura Zerr Susan Giles Grant Minish Lynda Keyes Karen Kinvig Misty Bath Ainslie J Cooke Mike McKimm Aaron P. Johnston Barbe Pickering Evanna Brennan Laura Sauve Fiona Gold Cara Moody Daniel Retzlaff Aaron P. Johnston Adrian Smith Mike Hoche Jill Beamish Heather Inglis Robert Ablenas Miranda Leffler Chris Kean Lisa Raichle Lindsay Mearns Chris G. Clark Tobias Donaldson Adrienne Wong
To make a contribution to Positive Living BC, contact the director of development, Jason Hjalmarson. jhjalmarson@positivelivingbc.org 604.893.2282
The Bollies
Your BOLLIE winners
On June 7, 2018, Positive Living held it’s annual volunteer recognition event. This year’s theme was A TASTE OF INDIA. Henna tattoo artists Harmin & Nishi adorned people’s skin while the melodic sitar of Anju Bedi filled the room. The event’s highlight was a stellar routine by Adityas Dance School. And, oh my, the food was tasty.
STRENGTH For the volunteer who demonstrates initiative, support, and dedication. WINNER: Ricky Sykes WISDOM For the volunteer who thinks on their feet, is revered as a leader, and inspires all. WINNER: Chris Clark LOYALTY For the volunteer who can make friends with anyone.
This person is known for being loyal, outgoing, welcoming, and having a positive attitude. WINNER: Joel Leung
DEPENDABILITY For the volunteer who goes the distance.
This person demonstrates initiative and is recognized for their dedication and dependability.
Long-Term Volunteer Milestone Awards: Gregg McKibbin Shane Foster Kangsoon Park Joel Leung
P5SITIVE LIVING | 25 | JULY •• AUGUST 2018
WINNER: Stephen Goodacre
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
1449 Powell St, Vancouver, BC V5L 1G8 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
1101 Seymour St Vancouver, BC V6B 0R1 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
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 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
bOKANAGAN ABORIGINAL 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
bPOSITIVE LIVING NORTH WEST
3862F Broadway Avenue Smithers, BC V0J 2N0 250.877.0042 or 1.866.877.0042 plnw.org P5SITIVE LIVING | 26 | JULY •• AUGUST 2018
bPURPOSE SOCIETY FOR YOUTH & FAMILIES 40 Begbie Street New Westminster, BC V3M 3L9 604.526.2522 info@purposesociety.org purposesociety.org
bREL8 OKANAGAN
P.O. Box 20224, Kelowna BC V1Y 9H2 250-575-4001 rel8.okanagan@gmail.com www.rel8okanagan.com
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 2018
JOIN A SOCIETY COMMITTEE!
EVERY 2ND WEDNESDAY | 2 pm | 2nd Floor Meeting 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”.
July 11
Reports to be presented >> Complete Board Evaluation Chart (2) | Director of Programs & Services | Executive Committee | External Committee Reports | Events Attended
July 25
Reports to be presented>> Written Executive Director Report | Quarterly Department Reports - 4th Quarter/Year End | Events Attended
Board & Volunteer Development_ Marc Seguin
August 8
Education & Communications_ Adam Reibin
Reports to be presented>> Standing Committees | Director of HR | Events Attended
August 22
604.893.2298 604.893.2209
marcs@positivelivingbc.org adamr@positivelivingbc.org
History Alive!_ Adam Reibin
Reports to be presented >> Written Executive Director Report | Executive Committee | External Committee Reports | Membership Statistics | Director of Operations & Administration | Financial Statements April | Audited Financials | Events Attended
Positive Action Committee_ Ross Harvey
September 5
604.893.2206
Reports to be presented >> Financial Statements - May | Executive Committee | Director of Communications | Events Attended
604.893.2298 604.893.2252
adamr@positivelivingbc.org
rossh@positivelivingbc.org
Positive Living Magazine_Jason Motz
jasonm@positivelivingbc.org
ViVA (women living with HIV)_Charlene Anderson 604.893.2217
charlenea@positivelivingbc.org
Positive Living BC is located at 1101 Seymour St, Vancouver, V6B 0R1. 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)
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 | JULY •• AUGUST 2018
Last Blast The Myths of HIV 10. Coughing or sneezing
Many people still find danger just being near someone who is HIV-positive. But there’s no need to be afraid. HIV is not an airborne disease and cannot be transmitted even if someone with HIV coughs or sneezes on you or onto your food.
9. Underwear
Sometimes, things happen. Someone else’s underwear ends up in your dresser, and before you know it, you’re wearing another person’s gonch. Then you find stains on the item: They might excite you or they might disgust you, but they set off all kinds of anxieties about your health. But, whatever fluid might be dried on a piece of clothing, HIV doesn’t survive long enough outside the body for it to pose a risk. There’s no way you could pick up HIV this way.
8. Food
Whether it’s sharing the same dish or biting into a burger that an HIV-positive friend was eating, sharing food represents no HIV risk. HIV is not transmitted through saliva; this is why you can also use the same utensils, drink from the same glass, or chew the same piece of gum as PLHIV.
5. Bathrooms
Did you forget to put down toilet paper on the toilet seat? No need for an HIV test. Even if a fluid left on a seat were somehow to get into your bloodstream (almost impossible), any HIV within that fluid wouldn’t live long enough outside the body to harm you.
4. Restaurants
Restaurants make the imagination run wild. People may fear a chef’s accidental slip of the knife, a server with a scratch on her hand, or a piece of food that falls off a plate and onto the table. But in all of those infectious fantasies, there simply is no risk. In most of them, there’s zero chance that HIV would be present at all.
3. Lap Dance
Lap dances—and most other strip club encounters— bear no risk for one huge reason: At least one of you is wearing clothing on top of your happy parts, and no bodily fluids are being exchanged. Even if you felt a little bit of wetness on your skin, that doesn’t count as “exchanging fluids.” With no chance for an exchange of fluids, there is nothing to fear.
2. Handshakes
7. Mosquito Bites
What if a mosquito bites an HIV-positive person and then bites you? If a mosquito can transmit malaria, it can transmit HIV too, right? Wrong! Malaria is a different kind of disease than HIV. Even if HIV survived long enough in the extracted blood, there would be so little HIV in there that you’d have no risk of being infected by it if you were the mosquito’s next victim—even if you squashed that sucker on your arm.
Shaking hands is considered “casual contact” and does not put you at risk. It doesn’t matter whether those hands were peeling, sweaty, or had cuts on them. The same goes for other common concerns, like hugging, scratches, or bites (unless the bite is deep, meaning it went all the way through your skin—and even then, the risk would be minute).
6. Masturbation
Kissing carries no HIV risk whether it’s a peck on the cheek or tongue-on-tongue action. (Ditto cold sores.) The only kissing scenario that would involve even a remote risk would be if fresh blood were exchanged—and unless you’re dating a vampire, that kind of thing won’t happen. 5
Some people worry that they’ve been pleasuring themselves so much that somehow they could be at risk of HIV or another STI. Except you cannot give yourself an infection you don’t already have. Remember the “transmitted” in “sexually transmitted infection.” You can’t transmit something you don’t have, especially not to yourself.
1. Kissing
This article originally appeared online at TheBody.com and appears here in edited form.
P5SITIVE LIVING | 28 | JULY •• AUGUST 2018
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