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

ISSN 1712-8536

SEPTEMBER • OCTOBER 2019 VOLUME 21 • NUMBER 5

Ha r

A WA Y OU T

m re d uc t io n Va nc o uv er s t yle

Opioid crisis and women

Perk that libido up

Dating app niceties

HEALTH CLINICS Good for your body, Good for your soul!

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BIO ENERGY HEALING

MASSAGE THERAPY

NATUROPATHIC MEDICINE

REFLEXOLOGY

REIKI

TAI CHI

THAI YOGA MASSAGE

YOGA THERAPY

I N S I D E

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A CUP OF TABOO

Breaking down the walls of a low libido

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COVER STORY

Harm reduction: what does it look like and can Vancouver deliver?

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LET’S GET CLINICAL

Non-occupational PEP needs greater awareness and implementation

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FIGH BACK!

Foodsafe practice to ward off food poisoning

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HIV PATHOGENS

Demystifying their cellular structure

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POZ CONTRIBUTIONS Recognizing Positive Living BC supporters

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PREP AROUND THE WORLD

Looking for answers as to why Australians would turn away from PrEP

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GIVING WELL

The inimitable Conni Smudge will drag you out of despair

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VOLUNTEER PROFILE Volunteering at Positive Living BC

 positivelivingbc.org

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TRAUMA IN THE CITY Looking at the opioid crisis from the eyes of those most vulnerable: women

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BACK TALK

When it comes to money and political will, nothing seems to change

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LAST BLAST

Dear Dating App Users: Be nice or go ---- yourself!

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 | SEP •• OCT 2019

It began decades ago...

A community came together.

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 6,000 HIV+ members. POSITIVE LIVING EDITORIAL BOARD Tom McAulay - chair, Joel Nim Cho Leung, Victor Elkins, Jason Motz, Adam Reibin MANAGING EDITOR Jason Motz DESIGN / PRODUCTION Britt Permien COPYEDITING Maylon Gardner, Heather G. Ross PROOFING Ashra Kolhatkar CONTRIBUTING WRITERS Jaylene Acheson, Gus Cairns, Victor Elkins, Karen Giesbrecht, Jason Hjalmarson, Gary Lising, Tom McAulay, Sean Sinden, Wendy Stevens PHOTOGRAPHY Britt Permien DIRECTOR OF COMMUNICATIONS AND EDUCATION Adam Reibin

YOU are that community.

DIRECTOR OF PROGRAMS AND SERVICES Glen Bradford TREATMENT OUTREACH COORDINATOR Wayne Campbell SUBSCRIPTIONS / DISTRIBUTION John Kozachenko, Matthew Matthew Funding for Positive Living magazine is provided by the BC Gaming Policy & Enforcement Branch & by subscription & 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

ENGAGE with

Positive Living BC

to build YOUR future. positivelivingbc.org P5SITIVE LIVING | 2 | SEP •• OCT 2019

UNAIDS 90-90-90 targets met early in parts of South Africa

pMédecins Sans Frontières (MSF) has

released findings from a follow-up survey of a community-based HIV/TB project in Eshowe, KwaZulu Natal, South Africa. The findings show that the project has met the UNAIDS targets of 90-90-90 one year ahead of the 2020 deadline. The survey ended with the result of 90-94-95, meaning 90 percent of people living with HIV (PLHIV) know their status, 94 percent of PLHIV were on antiretroviral treatment, and 95 percent of those had a suppressed viral load. The results support MSF’s view that interventions at the community level can successfully reach and directly support more PLHIV who do not access conventional health services, which is key to getting ahead of the HIV epidemic. These results offer strong evidence that achieving the 90-90-90 targets is possible in South Africa, along with the data suggesting that the number of new infections is decreasing in some areas. The 90-90-90 target is an important indicator of the success of a country’s HIV response, with South Africa’s national results estimated at 85-71-86. Source: www.msf.org

NIH experts prioritize research to achieve sustained ART-free HIV remission

pAchieving sustained remission of HIV

without life-long antiretroviral therapy (ART) is a top HIV research priority, accord-

ing to a new commentary in JAMA by the National Institute of Allergy and Infectious Diseases (NIAID). ART involves taking a combination of drugs daily, often combined into a sole pill. ART has transformed the lives of PLHIV, enabling those with access to the medications to live a near-normal lifespan. Despite this success, the side effects, pill fatigue, stigma and expense of taking daily ART for life have motivated researchers to find an alternative, writes NIAID Director Anthony S. Fauci and colleagues. Thus, scientists are seeking ways to put HIV into full and sustained remission so daily ART is unnecessary. The authors say feasible approaches must involve minimal risk and manageable side effects for PLHIV and must be inexpensive and scalable to millions of individuals. A major obstacle to sustained ART-free HIV remission is the persistence of viral reservoirs. These reservoirs consist of HIV-infected cells containing HIV genetic material that can generate new virus particles. The cells have entered a resting state that they maintain until they are activated to produce HIV. The authors explain that two paths are being pursued toward sustained ART-free HIV remission: total eradication of the HIV reservoir, classically referred to as a “cure,” and sustained virologic remission, which would control HIV replication but not eradicate the virus. The authors outline specific strategies under investigation to achieve these goals. Several approaches to eradicating the HIV reservoir have been attempted, but P5SITIVE LIVING | 3 | SEP •• OCT 2019

none except stem cell transplantation from a donor with a specific genetic mutation has succeeded—and only in two cases. The risks, expense, and complexity of stem cell transplants make them impractical for eradicating the HIV reservoir in people who do not require such a transplant for a separate underlying health condition. Many cutting-edge strategies to achieve sustained virologic remission are being studied. The authors describe how some of these strategies have the potential to replace daily ART with an intermittent or continual non-ART intervention, while others seek to induce permanent immunemediated control of HIV without further intervention. Clinical trials of numerous different approaches are underway. Source: JAMA

Study reveals global disparities in cervical cancer rates among women with HIV

pA new International Journal of Cancer

study indicates that rates of invasive cervical cancer (ICC) are especially high in women living with HIV (WLHIV) in South Africa or Latin America. For the study, researchers compared ICC rates in 45 countries across Europe, South Africa, Latin and North America among WLHIV who initiated ART between 1996 and 2014. Among 64,231 women in the analysis, 356 incident ICC cases were diagnosed. Compared with rates in European women, ICC rates at five years after initiating ART were more than double in Latin America and 11-times

higher in South Africa, but similar in North America. “Cervical cancer is a preventable disease, but many WLHIV, especially in Latin America and South Africa, are still being diagnosed with this potentially deadly cancer,” said corresponding author Dr. Eliane Rohner, of the University of Bern, in Switzerland, representing the International epidemiology Databases to Evaluate AIDS (IeDEA) Southern Africa collaboration. “We need to improve access to effective cervical cancer screening and treatment for WLHIV globally.” Source: onlnelibrary.wiley.com

Diabetes screening amongst older patients living with HIV

pHIV patients can suffer from a range

of ailments. However, the prevalence of specific diseases may depend on geographic or demographic factors. A team of researchers from the University of Fort Hare in South Africa have studied the incidence of diabetes mellitus in HIV patients. Their research has shown the need to screen older individuals diagnosed with HIV as crucial in offering a timely point of care and interventions to enable prompt diagnosis of diabetes mellitus. The study examined the prevalence of diabetes mellitus in newly diagnosed HIV-positive patients in Buffalo City Municipality, East London, South Africa. The majority of the participants were female (75 percent) and the prevalence of diabetes mellitus was 6 percent amongst newly diagnosed HIV-positive patient using the definition based on the Society for Endocri-

nology, Metabolism and Diabetes of South Africa (SEMDSA) 2017 guideline of HbA1c of above 6.5 percent. The multivariate analysis indicates only age and race significantly shows a correlation to increase the risk of development of diabetes mellitus in newly diagnosed HIV positive patients. The binary logistic regression analysis shows that age (above 46 years) was directly related to the development of diabetes mellitus. Source: Benthamscience.com

Large positive returns on HIV treatment

pIn 2014 the Joint United Nations

Programme on HIV/AIDS (UNAIDS) established 90-90-90 treatment targets for HIV treatment. These goals include 90 percent of PLHIV will know their status; 90 percent will receive appropriate treatment; and 90 percent will suppress the virus. Steven Forsythe of Avenir Health and coauthors evaluated data used by UNAIDS to calculate that ART averted 9.5 million deaths worldwide between 1995-2015, with global economic benefits of $1.05 trillion. The authors also found that for every $1 spent on ART, $3.50 in benefits was realized globally. Including future projections, the authors estimated that in 1995-2030, approximately 40.2 million new HIV infections could be averted (more than twice as many deaths as occurred during World War I), with economic gains reaching $4.02 trillion in 2030. With different countries achieving different results for the different targets, the authors recommend analyses of national treatment program performance to enhance overall benefits and efficiency. Source: healthaffairs.org P5SITIVE LIVING | 4 | SEP •• OCT 2019

New research looks into the chronic illnesses that people living with HIV are at most risk of developing

pIn the United States, over 1 million

people are currently living with an HIV infection. Worldwide, 1.8 million people have HIV. Overall, the incidence of HIV infections has declined over the past few decades. The mortality rate from an acquired immunodeficiency syndrome (AIDS)-related illness fell by nearly 80% since the year 2002, according to some estimates. Despite these trends, HIV remains a global health priority. Worldwide, the leading cause of death among people with HIV is tuberculosis. However, in countries such as the U.S. where tuberculosis is uncommon, people with HIV die from other conditions that are not related to the immunodeficiency virus. Conditions include diabetes, kidney disease, liver disease, and cardiovascular conditions. New research set out to examine more closely the specific conditions that people with HIV are at risk of developing. 5 Source: Lee Smith, Anglia Ruskin University, United Kingdom

UP of taboo

Overcoming a low libido

By Jaylene Acheson ometimes we hit a wall in our lives. A wall that affects our mood, mental state, and libido. To protect ourselves, we sometimes put up a wall between ourselves and the bedroom. Little thoughts tell us, “Do not go in there! Sex? Right now? You have bigger things on your mind.” So, how do we tear down this barrier that our mental state has set for ourselves? How do we turn that wall into a door that leads back to good sex? Commitment, for starters, but also empathy, from both yourself and your partner(s), to work through the dry spells and the lulls. How can you feel connection with someone else when you’re disconnected from yourself? Barton Goldsmith writes about how with depression it is hard to feel the inspiration to “give” to others. Which, when you think about sex with others, consists a lot about sharing actions that give pleasure to your partner(s) and yourself. The more giving the each of you do, the more fulfilling sex shall be. This requires energy, which is hard to find when you feel down. To muster up the “giving” mind frame inside yourself, first, find the energy to “give” to yourself. What act do you feel is selfcare? One you know will help get you in a positive place? In bed, it could be the connection factor, or the factor of releasing certain emotional energy that your body has been supressing during your depressed state. So, how do you connect with yourself? How do you help “release” yourself? A bath where you take time washing yourself, or a run with strong tunes in your ears helps you get into this “self care” mode. Self-talk is also encouraged, as your emotional self is just as involved as your physical self when it comes to sex. With

these somatic activities, try affirmations that give you energy to share yourself with another. “I am fulfilling” or “I am pleasurable” are empowering words for your sexy self. Hype yourself up before you enter the bedroom. You will feel fulfilled about the care you took for yourself, enough perhaps to be inspired enough to continue “giving” with your sexy partner(s). Nobody likes the idea of disappointing their partner(s). With intimacy, it can be a sensitive subject to weave through. Anxiety may occur during your low mood when your other is in the mood and you’re not. You may be nervous about performing well or dreading having to say, “Sorry, but not tonight.” Remember, you do not need to have sex if only one of you is feeling it—obligations don’t exist in the world of fun, safe sex! Broach the issue at a time when your partner isn’t making a move; this will seem less like a rejection in the moment and more like a discussion to help them see that it has nothing to do with them. If your mental/emotional state is influenced by aspects of your relationship, address it in a manner of non-blaming. It is important that you and your partner(s) provide empathy towards each other in the moment, as both sides can be difficult to navigate, so feeling understood is key for keeping your intimacy in a connective state. 5 Jaylene Acheson is a sex coach who works with individuals and couples towards a fulfilling sex life through sexuality empowerment workshops. Find her on Instagram and Facebook: @femmeforth.

P5SITIVE LIVING | 5 | SEP •• OCT 2019

Fight back against food poisoning By Karen Giesbrecht

often speak with groups in the early stages of recovery to review the basics of nutrition and self care. These tips are important during any acute stress to our bodies: Staying hydrated; Eating every few hours, but not to the point of feeling stuffed; and Be aware of hygiene and food safe practices while your body regains its strength. I make this last point by asking if anyone in the room has experienced food poisoning, or a foodborne illness. A few hands usually go up, and I follow that by asking the group what their experience was like. “Worse than a bad trip… the sickest I’ve ever been… shit came out of every part of my body…” and increasingly graphic descriptions, not necessary to describe for anyone who has eaten something that had gone off. All food has some bacteria on it, some of which can be beneficial to our health, and some which may be pathogenic, or harmful. In small amounts, our bodies can handle harmful bacteria without issue. Our digestive system, from our mouth to our intestines, has many ways of disarming what it finds foreign. But all systems can get overwhelmed, especially when we are already run-down or tired, and fighting something else like HIV. Food poisoning does not tend to be serious; it just has to work its way though the body. That alone takes a few days, plus another few weeks before the baseline energy and metabolism return to normal. Food poisoning can be serious for vulnerable bodies, like the young, elderly, or those who are immunocompromised. With that in mind, I tell my groups that if they only remember two things from our discussion, it should be these: First, do not take risks with what you eat, especially while your body is recovering and getting strong again. If you do not know where food came from, or how long it sat in your

fridge, compost it and find something else to eat. Sometimes we can tell when food goes off, and something like a sip of sour milk will not harm us, but we cannot always see, taste, or smell offending pathogens. Second, wash your hands! We could have been served the most organic, local, gourmet food, cooked by the city’s top chef’s, but if we pick up our lunch with our hands, then whatever we had touched before is now in our mouths. Think about what potential germ carriers you touched before your last meal: car keys, money, doorknobs, bathrooms, cellphones, our hair, other people’s hands, etc. We have a safe food system. We can trust most of the food found in grocery stores and restaurants, as well as the water that comes out of taps. Health inspectors regularly monitor food service operations. But we have to do our part, especially when our bodies are not at their strongest. Ultimately, it is up to us to decide what we pop in our mouths, even when staying in a hospital or care facility, and food poisoning is something better avoided. Dietitians and other health professionals are available to help through the provincial organization HealthLink BC (healthlinkbc.ca; or call 811). 5

Karen Giesbrecht is a registered dietitian with Planted, a community food network in Metro Vancouver.

P5SITIVE LIVING | 7 | JULY •• AUGUST 2019

By Gus Cairns

Australian study shows that STI risk is just as great after people stop PrEP as while they were on it. The PrEPX study, undertaken by the state of Victoria, Australia, was set up with specific targets in mind: to reduce HIV incidence by 25 percent in the general population and 30 percent in gay and bisexual men. It enrolled 4,275 people between July 2016 and March 2018. They received 16,689 quarterly PrEP prescriptions—an average of 3.9 per person. The current study analyzed the 3,489 people who enrolled before October 2017. Some metrics, such as sexual risk behaviour, came only from the 2,900 people attending study clinics that were also in the Australian Collaboration for Co-ordinated Enhanced Sentinel Surveillance (ACCESS) programme. The average age of people starting PrEP in PrEPX was 34, with 25 percent aged below 29. A quarter of participants had taken PrEP before, many in the Vic-PrEP pilot study. Seventy-three percent had had condomless anal sex in the three months before enrolling, 13 percent had used methamphetamine, and 5 percent had injected drugs. During the study period, just 85 people officially withdrew from the study, but 877 people discontinued participation without notice. The definition of discontinuation was a gap between the last PrEP prescription and either any subsequent prescription or the end of the study of more than 210 days. Of the 877, 275 never returned after their first prescription. Certain groups of people were more likely to discontinue PrEP. Young people were especially likely to discontinue, with people under 29 being 75 percent more likely to discontinue than those aged 40-plus. People who had reported injecting drugs (64 percent) and people who had reported using methamphetamine

(34 percent) more likely to stop. People who were referred for PrEP by their clinician were 27 percent more likely to discontinue than people who came to the clinic asking for PrEP. There were ten HIV diagnoses among people who stopped PrEP, equal to an annual incidence of 2.3 percent. Of these, two people were diagnosed after their second visit and may have had an acute HIV infection when they entered the study. Four others never returned after receiving their first prescription. Of the other four, two had two PrEP prescriptions and two had three, but all were diagnosed well after their last prescription ran out. Diagnoses of STIs were just as common for people who stopped PrEP as people who kept taking it. There were diagnoses of gonorrhoea in 7.6 percent of those who remained on PrEP and 8.2 percent of those who stopped it. For chlamydia, the figures were 7.8 percent and 8.4 percent respectively, and 1.6 percent and 2.6 percent for syphilis. Although this appears to show that taking PrEP does not in itself lead to a rise in STI risk (or, that stopping it does not lead to a fall in that risk), it also implies that the behavioural HIV risk for people who discontinue PrEP is no lower than in people who stay on it, and that by discontinuing they are returning to the same degree of risk they had before starting PrEP. 5 Gus Cairns is a freelance journalist specialising in HIV, sexuality, and healthcare.

P5SITIVE LIVING | 8 | SEP •• OCT 2019

Trauma in the city

The need for women-only harm reduction services By Wendy Stevens Trigger Warning: The following article uses descriptive, “street” language reflecting the lived experiences of some women who inject drugs, are living with HIV, and lack secure housing.

or the last several years in Vancouver and other parts of BC, our communities have been gripped in an epidemic overdose crisis, due in large part to the presence of fentanyl, an extremely powerful opioid generally used in clinical care for pain and pain management, and carfentanyl, a synthetic opioid normally used as a sedative for large animals. Carfentanyl is so powerful, ingesting just one or two grains can be fatal.

Everyone practises some form of harm reduction every day. Harm reduction means to reduce negative health outcomes, so using a handrail when climbing steep stairs is practising harm reduction. But harm reduction also means trying to use STI transmission prevention tools as best we can when having sex or using new syringes as often as we can when injecting drugs. For women who inject drugs, harm reduction is far more complex. Women who inject drugs are at higher risk than their male counterparts to be infected with HIV and hepatitis C (HCV), including an increase in the associated opportunistic infections. The majority of women addicted to drugs have experienced early

P5SITIVE LIVING | 9 | SEP •• OCT 2019

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childhood traumas. This trauma continues when women experience physical and sexual violence by both their partners and pimps, are sought out for cheaper sexual transactions by their “Johns,” are robbed, or experience period of homelessness and/or food insecurity. All of these factors influence a women’s likelihood to suffer from post-traumatic stress disorder (PTSD), stay addicted, and, potentially, overdose. Often, women have more difficulty injecting than men. Anatomically, women’s bodies have a layer of fat beneath the skin that can make finding a usable vein difficult. This is made worse if the woman is attempting to inject outdoors, especially if the weather is cold and if she is in withdrawal. Being in withdrawal from heroin, or other opiates can make blood pressure dangerously low and injecting exceptionally difficult. Out of frustration and desperation to get their fix, they will allow someone to “jug” them. “Jugging” is the practice of injecting drugs into the jugular vein in the neck while holding their breath (holding your breath helps the jugular vein pop out and makes injecting much easier). There are many dangers involved with jugging, including the risk of the person switching the syringe in order to steal the drugs from the vulnerable person laying on their back. If this is a previously used “rig,” the person doing the jugging is likely to inject the blood and drugs of the prone person into themselves.

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Along with overdose rates, sexual assaults have skyrocketed since fentanyl first made its murderous appearance.

After a person injects, they will often fall into a nod. This is usually the desired effect after consuming opiates. Being “on the nod” is somewhere between being asleep and being unconscious. For women, this is an extremely vulnerable state. Along with overdose rates, sexual assaults have skyrocketed since fentanyl first made its murderous appearance in the drug supply. “Johns” drive around the “stroll” looking for women, specifically in withdrawal and desperate to get

out of it, so they can get a $10 blowjob. These women are trying to make money to get “un-sick” (out of withdrawal) to relieve the agony of being in withdrawal. Thus, the importance for women to have a safe place to sleep and access to drugs in order for them to avoid being assaulted or exploited on the street. Access to co-ed services can be challenging for some women. Usually, women to have to line up with men who have caused or want to cause them harm; or to have to wait in the same room. It has been a painfully slow process, but a few resources and services finally exist in Vancouver to keep women safer and to reduce the risks involved with being a woman who injects drugs.

P5SITIVE LIVING | 10 | SEP •• OCT 2019

A “safe supply” used to mean using clean needles from a needle exchange program. Now “safe supply” includes access to clean, predictable drugs such as injectable opioid replacement treatment and limited distribution of free Dilaudid pills to people as part of a research project. There are currently eight overdose prevention sites operating in Vancouver, one of which is a women-only site. The first overdose prevention site exclusively for women, SisterSpace, is located at 135 Dunlevy St. and can accommodate up to 15 women at a time. Along with supervised consumption, SisterSpace has a nurse practitioner to provide primary care for issues such as opportunistic infections, pregnancy testing, and STI screening.



The majority of women addicted to drugs have experienced early childhood traumas.

Between May 2017 and July 2018, there were over 16,000 visits to SisterSpace. On average, approximately 65-75 women visit SisterSpace each day. Since January 2018, the peer support workers have managed 18 overdoses and administered naloxone six times. They are now open from 6 PM-12 PM. There have been no overdose deaths on site. Operated by the Portland Hotel Society (PHS) out of its Molson Overdose Prevention Site (MOPS), a new pilot program launched in January aims to distribute free Dilaudid pills for 50 patients. Originally manufactured to be taken orally, hydromorphone pills are crushed up and rendered as an injectable drug, just like heroin. It is the first time in Canada a physician can prescribe opioids in this way and an idea that came directly from the street. Physicians prescribe the dosage and participants will inject up to five doses per day, under the supervision of PHS staff and volunteers. For women, this means they will not have to put themselves at risk for violence or sexual exploitation on the street when going through withdrawal. More women need more access to programs like this. 5 Wendy Stevens is formerly a Peer Navigator for Positive Living BC.

THE MEDS BEHIND HARM REDUCTION The following excerpt from Vancouver Coastal Health offers a primer on the medications used in the harm reduction context. For more information see www.vch.ca/ your-care/mental-health-substance-use/substance-use-services 9 Addiction to opioids, also known as opioid use disorder (OUD), like heroin, fentanyl and oxycodone, is one of the most challenging forms of substance use disorder to overcome. 9 M edications that treat opioid addiction are sometimes referred to as opioid against treatment (OAT), opioid substitution treatment (OST), or opioid replacement therapy (ORT). These include buprenorphine/naloxone (brand name Suboxone), methadone, sustained release oral morphine (brand name Kadian), and injectable OAT (iOAT) using hydromorphone (brand name Dilaudid) and diacetylmorphine (heroin). 9 i OAT is prescribed to people who have tried oral OAT but found that it didn’t work for them. iOAT requires daily supervised injections with hydromorphone or diacetylmorphine (heroin), like at a pharmacy or medical clinic. 9 All of these medications have been scientifically proven to decrease cravings and withdrawal symptoms, reduce the use of illicit opioids, prevent overdoses and death, and improve overall health and wellness. 9 Supervising patients taking medication ensures the safety of patients and people in the community and provides an opportunity for patients to receive other types of health care they may need.

P5SITIVE LIVING | 11 | SEP •• OCT 2019

Defeating the “Death Star” strain

mong HIV researchers, one seemingly indestructible HIV-like strain has earned the nickname “death star.” That’s due to the strain’s reputation for killing off hopes for potential vaccines and immunotherapies that could stop the disease. A team at the Scripps Research Florida campus reports successfully beating that challenge. In a paper published in Science Translational Medicine, lead authors Michael Farzan and Matthew Gardner describe their destruction of the “death star” strain and another equally tough strain, suggesting it may be possible to protect uninfected individuals from multiple forms of HIV. Their non-traditional vaccine achieved another critical goal: durability. This means it protected the research animals from infection long-term with a single inoculation. “We have solved two problems that have plagued HIV vaccine studies to date—namely, the absence of duration of response and the absence of breadth of response,” says Farzan. “No other vaccine, antibody, or biologic protects against the two viruses for which we have demonstrated robust protection.” Conventional vaccine approaches typically use a piece of virus or other immunogen to activate an immune system response. Because HIV replicates and changes so fast, that approach has been challenging. Farzan’s approach uses a safe virus to fight the dangerous one and relies on muscle cells rather than immune cells to create protective agents. Here’s how: a harmless, lab-made adeno-associated virus (AAV) carries within it a protective protein designed by Farzan and colleagues to stop HIV infectivity.

Called eCD4-Ig, the protective protein features two HIV co-receptors, CD4 and CCR5. Farzan’s viral vaccine is injected into muscle. It “infects” the muscle cells, which causes them to produce the protective eCD4-Ig. During exposure to HIV, the HIV virus is attracted to eCD4-Ig. It binds, and then “undergoes conformational change prematurely, and it’s no longer able to infect,” says Farzan. The tough-to-stop research strain is SIVmac239, dubbed the “death star” because it has proven nearly impossible to defend against. It’s a type of simian immunodeficiency virus, which is an HIV-like virus that infects primates. Primates are the only animals, other than humans, that support replication of these viruses. The study showed that the research animals could eventually become infected when exposed to atypically large loads of HIV. It also showed that HIV is capable of developing resistance to eCD4-Ig, albeit in a much-weakened state. The use of AAV as a gene therapy tool has generated considerable excitement of late, gaining FDA approval for genetic diseases including inherited retinal disease and spinal muscular atrophy. This study shows it also has the potential to save lives used as a protective vaccine. “The results of our paper are encouraging for the potential of AAV as a platform for prevention of disease generally, and in concert with eCD4 as an agent for stopping HIV infection,” says Farzan. “We hope ultimately to prove that our approach is safe for both infected and at-risk persons at a cost that makes it useable everywhere. 5 This article originally appeared online at ww.Scripps.edu.

P5SITIVE LIVING | 12 | SEP •• OCT 2019

A time to remember, a time to act

From drug panics to harm reduction nternational Overdose Awareness Day (IOAD) is a global event held August 31st each year to raise awareness of overdoses and reduce the stigma associated with drug-related deaths. It also acknowledges the grief felt by families and loved ones as they remember those they have lost from a lethal overdose or permanent injury as a result of an overdose. IOAD was initiated by Australia’s Pennington Institute in 2012. As part of our ongoing commitment to breaking down the stigma associated with opioid use, Positive

By Gary Lising

Living BC offers this peer-written article as a tool to help chip away at the barriers that opioidrelated stigma, institutional and otherwise, have caused. “The epidemic of opioid overdoses continues to be the most challenging public health crisis in recent decades, and the devastating impacts of the crisis continue to be felt in many parts of the country, from Canada’s largest cities to rural and remote communities,” Canada’s chief public health officer, Dr. Theresa Tam, said in a June 14, 2019 article for The Georgia Straight.

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Tam, who co-chairs the Special Advisory Committee on the Epidemic of Opioid Overdoses, continued by saying, “To respond to the crisis, we must continue to address the illegal drug supply and to work together to implement additional harm-reduction measures. We have seen that a combination of harm-reduction measures—such as access to supervised consumption sites, naloxone, and evidence-based treatments—are helping to save lives.” The latest Health Canada data on overdose deaths shows that the problem that began in BC continues to intensify in other areas of the country and suggests there’s no end to the crisis. “The latest numbers mean that last year someone in Canada died after taking opioids roughly once every two hours.” Or, a total of “4,450 fatal deaths occurred in Canada in 2018.” In BC, the percentage of illicit-drug overdose deaths involving fentanyl has increased from four percent in 2012 to 15 percent in 2013, 25 percent in 2014, 29 percent in 2015, 67 percent in 2016, 82 percent in 2017, and 87 percent in 2018, according to the BC Coroners Service. Though Vancouver is known to be ahead of the curve on progressive drug policy more so than any other city in Canada, might Vancouver also be the city hardest hit by the overdose epidemic? Dr. Thomas Kerr, Senior Scientific Advisor and Senior Scientist with the BC Centre on Substance Use, suggests this may be the case in an article, ‘Why Vancouver has always been an addiction Ground Zero’ (appearing online for Vice, and written by Sarah Berman): “Vancouver has always had a high diversity of drugs and a potent supply of drugs,” Dr. Kerr said in the 2017 piece. Berman goes on to write that, “Vancouver has long been an international drug distribution hub, and the reactionary criminalization efforts, as well as failing social polices, have created a concentrated underclass of marginalized drug users.” Academics such as Catherine Carstairs and Susan Boyd have researched Vancouver’s historically easy route for drugs of all stripe finding their way into the city via the port system. Drug hysteria, or “moral panics”, were routine across Vancouver from the late 1890s into the early 20th Century, becoming the stuff of B-film fodder, stoking anti-immigrant propaganda and violence, and leading to ever repressive laws throughout the twenties and thirties. By the fifties, Hastings Street first served transient workers which lead to an at-risk population facing substandard housing, homelessness, and criminalisation which became a recipe of disaster. Add to this the counterculture of the sixties, and Vancouver was ripe for something bad to come.

In the eighties and nineties, crack cocaine and methamphetamine hit the open streets, creating a new public panic in the Downtown Eastside (DTES). Alarming rates of HIV spread. The government reacted to the panic by launching the Crackdown on Drugs Campaign, and taking brutal cues from America’s War on Drugs, caused drug users to go underground and further away from health systems [which left Vancouver vulnerable when fentanyl hit the illicit markets.] In the meantime, the 1986 Vancouver Expo triggered a series of gentrification and rent evictions in the DTES in which lead to an uptick in homelessness. Heavy policing practices including raids, the revocation of business licences, and imposed curfews in the DTES only created tension and caused more social issues by concentrating drug users in the DTES. These condition sets up Vancouver for more drug panics to come.



The Province has embraced harm reduction and escalated the opioid crisis to a significant public health emergency.

In 2017, BC’s NDP government created the Ministry of Mental Health and Addictions to improve access to and quality of mental health and addictions services for all British Columbians, as well to develop an immediate response to the opioid public health emergency. That September, the Province announced a three-year, $322 million investment for comprehensive interventions focused on saving lives, connecting people to treatment and recovery, and addressing the root cause issues connected to problematic substance use, such as stigma. The responses focus on six key areas: saving lives; ending stigma; building a network of treatment and recovery services; creating a supportive environment; advancing prevention; and improving public safety. The Province has embraced harm reduction and escalated the opioid crisis to a significant public health emergency. Building on previous actions and guided by evidence, the following steps need to be taken: addressing the need for safer drug supply; expanding community-based harm reduction services; ensuring the availability of naloxone; proactively identifying and supporting people of risk of overdose; connecting people with a substance use disorder to appropriate treatment and recovery services.

P5SITIVE LIVING | 14 | SEP •• OCT 2019

The focus of the last few years has been improving access to treatment for opioid use disorders (OUD) with opioid against treatment (OAT). This means, expanding programs from the screening and referral phase; providing better point of access to engage care; supporting people at the induction of OAT and ensuring there is a wide range of OAT treatments. The Province has also invested in vital social supports such as modular housing, childcare, and other poverty reduction programs to ensure people with substance use disorders are better equipped to deal with recovery.

What is Harm Reduction?

Harm reduction refers to policies, programs, and practices with the aim of minimising negative health impacts, and both the social and legal impacts associated with drug use, drug policies, and drug laws. Harm reduction is grounded in justice and human rights—it focuses on positive change and working with people without judgement, coercion, discrimination, or requiring that they stop using drugs as a precondition of support. There are four principles guiding harm reduction: r Respecting the rights of those using drugs–Harm reduction is fundamentally grounded and aimed at protecting the rights of an individual and to improve public health. Treating people who use drugs with compassion and respect is integral to the principles of harm reduction. r A commitment to evidence–Harm reduction policies and procedures are evidence based. r A commitment to social justice and collaborating with networks of people who use drugs–The greater involvement of people who use drugs in strategy and delivery of services to address discrimination and ensure everyone is included. r The avoidance of stigma–Harm reduction care workers accept people who use drugs for who they are, and without judgment, bias, or condescension. The use of inclusive language is important to convey respect and dignity. Harm reduction is grounded in the idea that most individuals across the world are unable or unwilling to stop using illicit drugs. Hence, primary goals of harm reduction are to: keep people alive and encourage them to make positive lifestyle changes; reduce harm from drug policies and laws; and offer alternatives to approaches that seek to prevent or end drug use. Studies have shown harm reduction is not the cause of this the opioid epidemic. “It’s really frustrating listening to people offering non-evidence-based studies, which often happens in case of harm reduction. Intuitively it makes sense –if you provide a syringe, you’re enabling drug use,” said Kerr. However, data have

SELECT HARM REDUCTION SERVICES OFFERED IN VANCOUVER 9Rapid Access Addiction Clinic (RAAC) St Paul’s Hospital, Mental Health Wellness Clinic. Call 604.806.8867 9Overdose Outreach Team: 524 Powell Street 9Insite—The Supervised Consumption Site 139 East Hastings St. Call 604.687.7483

OVERDOSE PREVENTION SITES 9There are two sites open in the DTES: Molson OPS at 166 East Hastings Maple OPS at 177 East Hastings 9Crosstown Clinic: 84 West Hastings. Call 604.689.8803 9St. Paul’s Hospital Overdose Prevention Site: 1081 Burrard Street.

shown there has been an increase amount of people acquiring OAT treatments and detox admissions. Looking back over the last century, Vancouver has responded to “moral panics” like the current opioid crisis with a heavy hand, issuing reductive laws, over policing specific neighbourhoods, and broadly criminalizing vulnerable individuals which only leads substance users further underground and to disassociate themselves from health services. The death rates are taking a turn for the better. On July 11, 2019 the BC Coroners Service reported, “There were 84 suspected drug toxicity deaths in May 2019. This is a 28 percent decrease over the number of deaths occurring in May 2018 (116) and a 2 percent decrease over the number of deaths occurring in April 2019 (86).” These numbers are promising and hopeful, suggesting that maybe, just maybe, the attitudes towards addiction are shifting for the better, the more humane. 5 Gary Lising is a Peer Navigator with Positive Living BC.

P5SITIVE LIVING | 15 | SEP •• OCT 2019

3 Tuesday of the month 11AM -1PM rd

Living BC î&#x153;¤ Positive 1101 Seymour Street

Contact Roberta 604.908.7710

robertav@positivelivingbc.org

Demystifying the cellular structure of HIV pathogens

sing innovative cell culture systems, quantitative image analysis, and computer simulations, a team of scientists from Heidelberg University explored how HIV spreads in 3D tissue-like environments. The results show that the tissue structure forces the virus to spread through direct cell-to-cell contact. Despite over 30 years of research, many key aspects of how HIV, the causative agent of the AIDS, spreads are still not understood. One of these unresolved questions concerns the interactions between the virus with the environment in the human body. Traditionally it has been assumed that infected cells release viral particles which then diffuse and eventually infect other cells. But it is also possible that viral particles are directly transferred from one infected cell to the next through close contact. Until now it was unknown which of these modes of transmission prevailed in tissue. “Studies on HIV replication in the lab are mostly conducted in simple cell culture experiments in plastic dishes that do not reflect the complex architecture and heterogeneity of tissue,” explains study director Prof. Dr. Oliver Fackler of the Center for Integrative Infectious Disease Research (CIID) at Heidelberg University Hospital. In their approach, the researchers took into account that the so-called CD4 T helper cells, the preferred cell type infected by HIV, are highly mobile in their physiological environment. They used a novel cell culture system, in which a 3D scaffold was generated with the help of collagen. This allowed for maintaining the cells’ mobility and monitoring primary CD4 T-cells infected with HIV-1 in

a tissue-like environment over the course of several weeks. Using this innovative approach, the researchers measured a number of factors that characterise cell motility, virus replication, and the gradual loss of CD4 T helper cells. “This yielded a very complex set of data that was impossible to interpret without the help from scientists of other disciplines,” says Dr. Andrea Imle, of the Heidelberg group. The scientists collaborated with colleagues from the fields of image processing, theoretical biophysics, and mathematical modelling. Together they were able to characterize the complex behaviour of cells and viruses and simulate it on the computer. This made it possible to make important predictions on the key processes that determine HIV-1 spread in these 3D cultures, which were confirmed by subsequent experimentation. “Our interdisciplinary study is a good example of how iterative cycles of experimentation and simulation can help to quantitatively analyse a complex biological process,” says Prof. Dr. Ulrich Schwarz of the Institute for Theoretical Physics at Heidelberg University. The data analysis revealed that the 3D environment of the cell culture system suppresses infection with a cell-free virus while simultaneously promoting direct virus transmission from cell to cell. The researchers hope that these findings will eventually lead to new therapeutic approaches in the treatment of HIV. 5 The original version of this article is available at www.uni-heidelberg.de/en/newsroom/hiv-spreads-through-direct-cell-cell-contact.

P5SITIVE LIVING | 17 | JULY •• AUGUST 2019

Giving Well remember being the emcee at an event at the Royal Hotel, and after that first event I was hooked, you had my heart. Honestly, I would do anything for you.

For

this month’s Giving Well, I chat with the co-founder of the North Shore Pride Alliance and emcee for both the AIDS WALK and Drag Brunch, Conni Smudge. Positive Living: When did you first get involved with Positive Living BC? Conni Smudge: I got involved with Positive Living when I was an embryo! The Sisters of Perpetual Indulgence got me active in HIV/AIDS activism. We did a huge WALK before the AIDS Memorial had been built at Sunset Beach. I recall participating as a boy, so this was before the birth of Conni Smudge. I got pulled in after a few years as a drag queen in Vancouver. I

PL: What’s the story behind Conni Smudge? CS: In the mid-nineties, a friend of mine made a film called “Highway of Heartache” starring a bunch of downtown drag queens including Willie Taylor and Dusty Ryan, the Big Wigs duo of Vancouver’s scene at the time. When the film came out, they were too busy to promote it; me and a friend were looking at the costumes and one of them fit me and another fit her. So, we came up with this idea; my friend would be Vikki because she was victorious, and I would be Conni because I was convenient. We had Myria LeNoir do our makeup, and we just looked so spectacular, it felt like my childhood fantasies coming together. We did a bunch of promotions and went to the release party and had so much fun we kept at it. We did drag shows in stripper bars. For a while we even had a whole family act with an illegitimate daughter named Phylis DeLush. We went all over BC, often to logging towns, trying to spread some understanding. PL: Why is giving back so important to you? CS: I came out early, 1990 or 1991, and there was such a stigma. There were a lot of preconceived notions from my family and everyone who knew me as a straight guy. I was one of those gays who didn’t want P5SITIVE LIVING | 19 | SEP •• OCT 2019

A DONOR PROFILE

By Jason Hjalmarson

to be gay, so I had a few relationships with women. But once I found my tribe, it was astonishing to me after having been out for a few years and involved in Vancouver’s gay scene, the stigma that PLHIV face. Drugs like AZT, however, created a situation where they marked the people who were suffering with HIV. They had the gaunt faces and extended stomachs, and they were othered, stigmatized in their own community. Seeing this just broke my heart. The community that I’d become a part of when I came out, half of them were suffering with HIV/AIDS. Within about five years of coming out, I went to 39 funerals. So, I know, we’ve come so far, but every day I wake up and I am so grateful for, not only my life, but my health, my friends, and my community. PL: Any final words of advice? CS: My message this year is authenticity, about finding your tribe. If you’re trying to be something you’re not, you’re going to attract the people that are not your people, you are going to attract the experiences that aren’t who you are supposed to be. Just be your authentic self, that’s it. And for God sakes, try to leave a situation better than how you found it! 5

Jason Hjalmarson is Director of Fund Development at Positive Living BC.

When released, drop into our offices in either Vancouver or Surrey to be connected to a peer navigator, get linked into a variety of programs and services, as well as referrals to community case management services and health care.

POSITIVE LIVING BC

POSITIVE HEALTH 4th Fl. – 1101 Seymour Street, SERVICES CLINIC

JRC — ST. PAUL’S HOSPITAL

Vancouver BC V6B 0R1

5th Fl. – Burrard Building 1081 Burrard Street, Vancouver BC V6Z 1Y6

Jim Pattison Outpatient Care & Surgery Centre 3rd Fl. – 9750-140th Street, Surrey BC V3T 0G9

Contact the POPLine to request information about: • Anti-retroviral treatment information, side effects management, disease progression, disclosure strategies and criminalization • Peer counseling for people newly diagnosed with HIV • CHF updates POPLine: Federal 1.877.900.2437 Provincial 604.525.8646

By Tom McAulay

‘Funding Crisis!’ A headline as old as time

is a headline as old as time (well, 1994) for a long-term survivor such as me: AIDS funding crisis! If only I had a nickel for every time I have heard/read/said those very words myself. Of course, financial strains are nothing new to our community, and political foot dragging isn’t new to BC either. But when digging through the archives and seeing that worn-out chestnut of a headline leap out at me, I was struck at how similar the issues are for community-based organizations twenty-five years on. From BCPWA News issue #78 June/July 1994. Kathryn Eggert, the E.O. of BCPWA at the time, wrote: “The Provincial NDP Government has drastically reduced services and supports to people living with HIV diseases in British Columbia by cutting back funding to existing communitybased AIDS organizations by 22%. As a result, over 70 services will be reduced or eliminated. The British Columbia Persons With AIDS Society (BCPWA) has joined a coalition of over 35 AIDS groups to lobby the provincial government for adequate levels of funding and development of a Provincial AIDS strategy. At BCPWA, we too are affected by the inadequate levels of funding. With over 2000 active members, our resources are stretched beyond their limits. We did not receive enough funding to pay rent, utilities, telephone and other occupancy costs past mid-year. Each day. Two new members who are living with [HIV] join our organization. We are committed to being here to support the self-help and self-care needs of our members. We believe that it is critical that the provincial government demonstrate a commitment to improving the quality of life for people living with HIV [PLHIV]. To date with this epidemic, the government has not shown leadership. To encourage government action, the coalition has undertaken boycotts of 1994 BC AIDS Conference and the 1996 International AIDS

conference. We believe it is imperative that the government invest in the community, and that profits from such ventures as the International Conference be invested in PLHIV. On April 22, 1994, Premier Mike Harcourt wrote to me. “More work is needed to complete a Provincial AIDS Strategy that will enhance community-based education, prevention and care.” On May 2, 1994, the Coalition of community-based groups met with Health Minister Paul Ramsey. He asked for more time and refused to give a solid commitment on the funding crisis we are experiencing. I hold out hope that the Premier was sincere, when he wrote me and stated: “Be assured that my government will continue to work with all members of the community to respond to this critical crisis.” Circling back to 2019, how can one assess the future in the present environment of shrinking funding for most and a plateau at best for a select few? How does the struggling David community organization compete against the Goliath large institution such as a university for less funding? And why doesn’t anyone ask for new and/or revised National and Provincial AIDS Strategies? Pardon me for ending this column with questions instead of answers. If you have any yourself, email them to me at tomm@positivelivingbc.org. Thanks! 5

Tom McAulay is Chair of Positive Living BC.

P5SITIVE LIVING | 21 | SEP •• OCT 2019

PEP is a Step to HIV Prevention By Sean Sinden

ost-exposure prophylaxis (PEP) can be an effective tool in reducing the chance of acquiring HIV after a high-risk exposure, but its success suffers from lack of awareness and access. PEP is a 28-day course of antiretroviral therapy started within 72 hours of HIV exposure. If taken as prescribed, PEP can reduce the chances of acquiring HIV. However, the short window of time between exposure and initiation of PEP shows the importance of access of these drugs to ensure efficacy. In 2005, PEP was recommended for use in non-occupational high-risk exposures, such as condomless sex or needle sharing with someone who has a high likelihood of being HIV-positive. This type of PEP is termed non-occupational PEP, or nPEP. However, awareness and usage of nPEP is low, even in the populations most affected by HIV, such as men who have sex with men (MSM). A 2016 study co-led by CTN Investigator Dr. Nathan Lachowsky showed that only half of HIV-negative MSM in Vancouver were aware of nPEP. There are similar gaps in nPEP implementation across Canada. In Ontario, access to PEP and related quality of care is inconsistent across the province and many point-of-care health care workers are unfamiliar with PEP. Also, many people who access nPEP do not return for follow-up visits, making it hard for researchers and public health officials to estimate this strategy’s effectiveness. A new CTN study (Optimizing the Delivery of HIV nPEP—Opt-In), led by Dr. Darrell Tan, is testing whether text messaging can support nPEP patients to fully adhere to 28 days of ART and return for final testing. This study also considers how effective patient follow-up from nurses at sexual health clinics is in supporting patients in PEP adherence and testing. The efficacy of PEP in protecting against HIV is not 100 percent, but it is a central part of current prevention strategies, also one of the few post-exposure strategies. There is increasing awareness and coverage of nPEP in Canada, but the need remains

for targeted public health messaging and provider education to realize the preventative potential of this strategy. The Health Initiative for Men has an ongoing awareness campaign about PEP; go to checkhimout.ca/pep for more information. 5 Sean Sinden is the communications and knowledge translation officer for the CTN.

Other Studies enrolling in BC CTNPT 030

Feasibility of crystal meth interventions among GBMSM BC Sites: St. Paul’s, University of Victoria

CTN 283

The I-Score Study BC site: Vancouver ID clinic

CTN 292A

Development of a screening algorithm for predicting highgrade 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

CTN 293

REPRIEVE Trial BC site: Vancouver ID clinic

CTN 299

Bone health in HIV+ aging women BC site: Vancouver ID clinic

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

P5SITIVE LIVING | 23 | SEP •• OCT 2019

For a full list of donors visit positivelivingbc.org

$5000+ LEGACY CIRCLE Peter Chung

$1000 - $2499 CHAMPIONS Paul Goyan Malcolm Hedgcock Joss De Wet Fraser Norrie Paul Gross Blair Smith Don Evans

$500 - $999 LEADERS

Brian Descoteaux Pierre Soucy Robert Capar Dean Mirau Cliff Hall Stanley Moore Michael Holmwood Emet Davis Rebecca Johnston Christian Denarie James Goodman Cheryl Basarab Mike McKimm Brian Lambert

$150 - $499 HEROES

Byron Cooke Katherine Richmond Len Christiansen 360 Brian Yuen James Ong Sharon Eistetter Darrin Pope Sergio Pereira Ralph Silvea Vince Connors Jamie Rokovetsky Ross Thompson Jeff Anderson Maxine Davis Mark Mees William B Granger Glynis Davisson Lorne Berkovitz John Bishop Lawrence Cryer Jean Sebastian Hartell Todd Hauptman Gretchen Dulmage Ronald Stipp Dena Ellery Bonnie Pearson Keith Stead Ken Coolen Michael Pangan Elizabeth Briemberg George Schwab

Penny Parry Ross Harvey Jane Talbot Susan Burgess Barry DeVito Ron Hogan Patricia Dyck Tom McAulay Wayne Avery Stephanie Tofield Glyn Townson Stephen French Rob Spooner Dennis Parkinson Edith Davidson Colin McKenna Jason Hjalmarson Patricia E. Young Carmine Digiovanni

Lisa Bradbury Andrea Reimer Catherine Jenkins John Yano Angela McGie Agung Fauzan Christine Leclerc Adrian Smith Heather Inglis Lisa Raichle Lindsay Mearns Tobias Donaldson Chris Kean Miranda Leffler Adrienne Wong Christopher Clark

$20 - $149 FRIENDS

Sheryl Burns Allen Hovan Jeremy Poster Zoran Stjepanovic Ha Thu Nguyen Kirsten Bowles Sarah Chown Colin McKay Sharon Lou-Hing HansKrishna Von Hagen Tracey Hearst

P5SITIVE LIVING | 24 | SEP •• OCT 2019

To make a contribution to Positive Living BC, contact the director of development, Jason Hjalmarson.  jhjalmarson@positivelivingbc.org  604.893.2282

20 year Volunteer Milestone Award KEITH LOHMEYER (in absentia) 15 year Volunteer Milestone Award ROBERT WARWICK 10 year Volunteer Milestone Award MIKE HOLMWOOD 10 year Volunteer Milestone Award MICHAEL HACKETT 10 year Volunteer Milestone Award MICHELLE AUBIE 10 year Volunteer Milestone Award JEFF ANDERSON Community Spirit Award 40 YEARS TO THE SISTERS OF PERPETUAL INDULGENCE

P5SITIVE LIVING | 25 | SEP •• OCT 2019

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 | SEP •• OCT 2019

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 2019

JOIN A SOCIETY COMMITTEE!

All meetings in the 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”.

THURSDAY — SEP 12, 2019 —2 pm Reports to be presented >> AGM Minutes | Executive Committee Update | Standing Committees | Events Attended

THURSDAY — OCT 10, 2019 —2 pm Reports to be presented >>

Written Executive Director Report | Executive Committee Update | Events Attended

Board & Volunteer Development_ Adam Reibin

THURSDAY — NOV 14, 2019 —2 pm Reports to be presented >>

Education & Communications_ Adam Reibin

Executive Committee Update | Events Attended

 604.893.2209  604.893.2209

THURSDAY — DEC 12, 2019 —2 pm Reports to be presented >> Standing Committees | Executive Committee Update | Written Executive Director Report | Events Attended

 adamr@positivelivingbc.org

History Alive!_ Adam Reibin  604.893.2209

 adamr@positivelivingbc.org

Positive Action Committee_ Wayne Campbell  604.893.2252

 waynec@positivelivingbc.org

Positive Living Magazine_Jason Motz  604.893.2206 Positive Living BC is located at 1101 Seymour St, Vancouver, V6B 0R1. For more information, contact: Mike Hedges, Director of Operations  604.893.2268 |  mikeh@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)

 jasonm@positivelivingbc.org

ViVA (women living with HIV)_Charlene Anderson  604.893.2217

 charlenea@positivelivingbc.org

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 | SEP •• OCT 2019

Last Blast Dating Apps need to be kinder, more inclusive spaces

by AIDS United

hat do you say to a guy on a dating app when you’re not into him? How would you want to be told that he’s not into you? We know that chatting with guys on a dating app can be hit or miss. And the pressure can be higher for those of us living with HIV. One of the most hurtful phrases to read in a dating profile is, “I’m clean - U B 2,” as if living with HIV is somehow dirty. And if you’ve ever been rudely rejected by someone or felt lesser-than by reading “no fats, no femmes, white guys only—just a preference,” then you also understand just how hurtful the power of “preference” can be. We’re determined to #StopHIVStigma and other stigmas that are prevalent in online dating culture. Re-

“When I’ve been online, sometimes guys will say ‘U=U isn’t true,’ ‘You’re a sexual predator,’ or ‘You’re a danger to men’s holistic health,’” said Bruce Richman, founding executive director of Prevention Access Campaign, which launched the U=U movement in July 2016. “At times I really wanted to respond with, ‘You’re a moron’ and then block them. But it feels better, and is more productive, to send them the uequalsu.org website with a couple of hearts [emojis]. It’s kinder, I feel better, it puts out positive energy to the world and hopefully it educates them.” NiceAF is a first-ever team effort of five dating apps and sites (Adam4Adam, Daddyhunt, Grindr, GROWLr, and POZ Personals) working with Building Healthy Online Communities (BHOC), a consortium

gardless of your age, race, body type, HIV status or gender identity, or what you like to do in or out of bed—dating apps should be fun, welcoming places for everyone. NiceAF.org is an online campaign where dating app users can post real-life stories to share with others about the best ways to be, well, nice as fuck. We’re looking for your best online dating stories. Submit a video telling us how you’ve dealt with an insult and risen above it to keep your own online experience a better one. You can also submit a screenshot of an interaction. Don’t worry: we won’t publish the screenshot itself. We will protect your identity, as well as the identity of the person you chatted with, and not reveal which app the dialogue took place on. (We’re also asking you not to say which site you were on, to not have the sites identified.)

of HIV and STD organizations. Together, we’re all committed to making our online communities more welcoming with the NiceAF.org campaign. Jen Hecht, BHOC’s director, added, “There’s more and more evidence that when we treat each other badly within the community, it can be even more harmful than when people outside the community insult us.” “There’s no reason you can’t find what you want without making everyone else feel terrible,” said Dan Wohlfeiler, BHOC’s co-founder. Chime in! Let us know how you turned around a hurtful interaction. Send us a video or screenshot detailing a dating app experience that turned out nice AF. 5 Source: This article originally appeared online at Poz. com. It appears here, edited for page limitations.

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