Positive Living Magazine

A bi-annual awards gala honouring heroes in the BC HIV/AIDS movement

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

APRIL 22 • Vancouver Convention Centre ISSN 1712-8536

JAN • FEB 2018 VOLUME 20 • NUMBER 1

2018 accolaids.ca

Nominate YOUR hero for an AccolAIDS award!

Closing Date for Nominations: FRIDAY • MARCH 2 • 5 PM

Fill out the form included in this magazine.

PRESENTED BY

PHAC fallout

HIV & family planning

Expanding peer services

POSITIVE

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A CONFERENCE DEVELOPED FOR AND BY HIV+ PEOPLE IN BRITISH COLUMBIA

G AT H E R I N G

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

Acupuncture

Massage Therapy Naturopathic Medicine

Reflexology

MARCH 30

▾

APRIL 1 2018

Tai Chi

Thai Yoga Massage

Therapeutic Touch PRESENTED BY AIDS Vancouver AIDS Vancouver Island AFRO-Canadian Positive Network ANKORS DTES Consumers Board Living Positive Resource Center Positive Living BC Positive Living North REL8 Vancouver Native Health ViVa YouthCO

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Coast Coal Harbour Hotel 1180 W Hastings | Vancouver BC

positivegathering.com Space is limited. Register now!

604.893.2209 • 1.800.994.2437 info@positivegathering.com

FUNDING HAS GENEROUSLY BEEN PROVIDED BY THE COMMUNITY ACTION FUND, TRANSITION FUNDING, OF THE PUBLIC HEALTH AGENCY OF CANADA

Yoga Therapy

Check our website for Wellness Clinic schedules positivelivingbc.org To BOOK your appointment email clinic@positivelivingbc.org or call 604.893.2203

Health & Wellness services are FREE for Members of Positive Living BC

I N S I D E

Follow us at:  pozlivingbc  positivelivingbc

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PAC’S FIGHTING WORDS

Cold hard numbers show PHAC’s devastation

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COVER STORY

The BC-CfE issues new PEP guidelines for provincial physicians

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BACK TALK

Finding relevancy in yesterday’s news

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NUTRITION

Getting to know fermented foods

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THE NATUROPATH WILL SEE YOU NOW Naturopathy at Positive Living BC

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LET’S GET CLINICAL

The Engage Study recruits MSM from across Canada

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SISTER TO SISTER

Revealing insights on the HIV and pregnancy

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GIVING WELL

Positive Living Donor Profile

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VOLUNTEER PROFILE

Volunteering at Positive Living BC

 positivelivingbc.org

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NAVIGATING HIV PEER NETWORKS

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POZ CONTRIBUTIONS Recognizing Positive Living BC supporters

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LAST BLAST

The community speaks out against criminalizing HIV

HEALTH PROMOTION PROGRAM MANDATE & DISCLAIMER In accordance with our mandate to provide support activities and prejudice. The program does not recommend, advocate, or endorse facilities for members for the purpose of self-help and self-care, the the use of any particular treatment or therapy provided as information.

Positive Living Society of BC operates a Health Promotion Program The Board, staff, and volunteers of the Positive Living Society of to make available to members up-to-date research and information BC do not accept the risk of, or the responsiblity for, damages, on treatments, therapies, tests, clinical trials, and medical models costs, or consequences of any kind which may arise or result from associated with AIDS and HIV-related conditions. The intent of the use of information disseminated through this program. Persons this project is to make available to members information they can using the information provided do so by their own decisions and access as they choose to become knowledgeable partners with hold the Society’s Board, staff, and volunteers harmless. Accepting their physicians and medical care team in making decisions to information from this program is deemed to be accepting the terms promote their health. The Health Promotion Program endeavours to of this disclaimer. provide all research and information to members without judgment or P5SITIVE LIVING | 1 | JAN •• FEB 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 5700 HIV+ members.

POSITIVE LIVING EDITORIAL BOARD Neil Self, co-chair, Joel Nim Cho Leung, co-chair, Ross Harvey, Elgin Lim, Tom McCaulay, 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 Glen Bradford, Marianne Harris, Ross Harvey, Yoon Heo, Sean Hosein, Jason Motz, Neil Self, Sean Sinden, Heidi Standeven PHOTOGRAPHY Britt Permien DIRECTOR OF COMMUNICATIONS AND EDUCATION Adam Reibin DIRECTOR OF PROGRAMS AND SERVICES Elgin Lim TREATMENT, HEALTH AND WELLNESS COORDINATOR Brandon Laviolette SUBSCRIPTIONS / DISTRIBUTION John Kozachenko Funding for Positive Living is provided by the BC Gaming Policy & Enforcement Branch and by subscription and donations.

Positive Living BC | 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

© 2017 Positive Living

from the chair

NEIL SELF

Changes and challenges as the year comes to a close How good it is to be writing in the comfort of Positive Living BC’s headquarters now that many of the maintenance glitches we experienced since moving in have (more or less) been fixed. On behalf of the Board of Directors, I give my heartfelt thanks to our crack team of Operations staff and volunteers who continue to respond adeptly to building issues as they come up. And thanks to my fellow members who accessed our in-house services over the past few months. The iconic image of Bambi on ice comes to mind when I think of our new and sometimes wonky elevators, door locks, and phones—but the reality of our situation with these agency fundamentals has been far less cute.

Things can only get better from here!

We never forget that our Society is guided by a provincial mandate. And we understand that members in the Lower Mainland have an advantage of easier access to our services. We do our best to even out the score by working closely with other community-based HIV agencies throughout BC on projects like the Positive Gathering. Thanks to a provision by the Community Action Fund, Transition Funding, of the Public Health Agency of Canada, this year’s Gathering will take place from March 30-April 1 at the Coast Coal Harbour Hotel. I urge all PLHIV in BC to visit positivegathering.com to learn P5SITIVE LIVING | 2 | JAN •• FEB 2018

more about this vital event, and to submit a registration and/or scholarship application.

Please note that our government funding for the Gathering is not extended past 2018 so this will be the last of its kind until we find an alternate means of support.

Don’t miss it.

I encourage you to also follow our social media channels to keep updated about all other important Society events and goings-on. It’s here that we recently introduced our community to Positive Living BC’s new Director of Fund Development, Jason Hjalmarson. Jason comes to us with a strong professional background in fund development and is determined to help us balance the loss of government funds with returns from a creative and user-friendly approach to giving.

I can’t close this article without mentioning our new Dental Clinic. Thanks to our generous group of dental professionals and other community supporters (most notably Dr. Allan Hovan), dental services will be provided onsite at 1101 Seymour Street starting in January. If you are interested in booking an appointment, please call 604.893.2200 today. We are excited to be at the forefront of this important part of HIV health. 5

Epclusa approved for re-labelling HIV+HCV patients

pGilead announced in September that

Health Canada has granted a Notice of Compliance (NOC) for updated labelling of Epclusa, the first all-oral, pan-genotypic, once-daily single tablet regimen for treatment of adults with chronic hepatitis C virus infection (HCV), to include use in patients co-infected with HIV-1.

“HCV co-infection remains a major cause of morbidity in HIV-infected individuals. With this expanded indication, Epclusa provides co-infected patients with a much-needed one-pill-a-day regimen that works across all HCV genotypes and at all stages of disease.

Being compatible with most widely-used antiretroviral regimens adds to its convenience,” says Dr. Brian Conway, President and Medical Director, Vancouver Infectious Diseases Centre.

The supplemental new drug submission was supported by data from the open-label, Phase 3 ASTRAL-5 study, which evaluated 12 weeks of treatment with Epclusa in 106 subjects with genotype 1-4 HCV infection who were co-infected with HIV and on stable ARV. In the study, 95 percent of patients achieve the primary endpoint of SVR12, defined as an undetectable viral load 12 weeks after completing therapy.

Source: Gilead.com

Montreal scientist wins amfAR Award

p

On October 23, a Montreal researcher was one of three recipients of the Mathilde

Krim Fellowship in Basic Biomedical Research. Dr. Jonathan Richard will receive a prize of $150,000 over the next two years for his work.

Dr. Richard is the winner of the prestigious Frederick Banting and Charles Best Canada Graduate Scholarship Award, and in only four years of postdoctoral work has co-authored an impressive 21 publications. Dr. Richard has identified two host proteins that enhance the killing mechanisms that natural killer cells—part of the body’s first line of defense against infection— use to destroy virally infected cells. He will explore the effects of boosting these host proteins to determine whether they can be used as part of a strategy to kill viral reservoir cells.

As a testament to the success of the Krim Fellowship program, Dr. Richard is working under the mentorship of Dr. Andres Finzi, himself a former Krim Fellow. The Krim Fellowship has committed more than $7.8 million since 2008 to support the development of outstanding young researchers who have demonstrated a commitment to preventing, treating, and curing HIV/AIDS. Source: amfar.org

New insights into the heritability of HIV infection severity

pHIV’s pernicious persistence in

human populations—despite more than 25 years of heroic HIV research efforts— owes in part to its particular abilities to exploit its human hosts, constantly adapting and mutating to enhance its P5SITIVE LIVING | 3 | JAN •• FEB 2018

infectiousness and virulence.

Using a population of HIV-1 infected individuals (the 2014 Swiss HIV Cohort Study data), an international research team of 17 institutions, led

by ETH Zurich’s Roland Regoes of the Institute of Integrative Biology, has now examined all aspects of HIV virulence, with a particular focus on how it ravages the human immune system.

The study investigated the heritability, (statistical variability accounted for by genes), of three different aspects of HIV virulence: set point viral load (SPVL; which measures the virus’ ability to exploit the host by measuring the amount of HIV circulating in the blood), CD4+ T cell decline (which measures the damage caused by the virus), and CD4+ T cell decline relative to set point viral load (which measures the damage for a given level of exploitation, also called ‘per pathogen pathogenicity’ or PPP).

Per-pathogen pathogenicity captures how virulent a viral strain is irrespective of its load in the infected individual.

They investigated if HIV virulence, measured by the rate of decline in CD4+ T cells, and PPP are heritable from donor to recipient and therefore not solely dependent on the environment of the virus population (i.e. the human host). Using the Swiss Cohort donor-recipient pairs, and phylogenetic methods, they suggest that HIV virulence and its effect on the human immune system is heritable. They found that the heritability of the decline of CD4+ T cells and per-pathogen pathogenicity is 17 percent.

“Our analysis shows that the viral genotype affects virulence mainly by modulating the per-parasite pathogenicity, while the indirect effect via the set-point viral load is minor,” said lead author Roland Regoes.

With the results, Regoes, study first author Frederic Bertels et al. have brought important new insights into the role of HIV genotype in infection severity. With a new understanding of the different facets of HIV virulence, the study will stimulate further research on HIV and other pathogens.

Source: www.oxfordjournals.org

Judging the relevancy of TB chemoprophylaxis

pLong-term follow-up in the ANRS

TEMPRANO trial confirms that tuberculosis chemoprophylaxis in HIV-infected people is more than ever relevant in resource-limited countries. This prophylactic use of drugs reduces mortality, even among people taking antiretroviral treatment who have a high CD4+ T cell count. ANRS TEMPRANO was conducted by researchers of the Ivory Coast ANRS site, which comprises teams from Inserm (U1219, University of Bordeaux), the Infectious and Tropical Diseases Department of the Treichville University Hospital, and eight other infection treatment centers in Abidjan.

Tuberculosis is the leading cause of death among HIV-infected people in sub-Saharan Africa. In the 1990s, several studies showed that HIV-infected people who take the antibiotic isoniazid for six to twelve months are at lower risk of

developing tuberculosis. Based on these studies, since 1993 the WHO has recommended that people living with HIV in countries where tuberculosis is rife should take isoniazid for six months. However, this recommendation has been little applied because it was deemed obsolete following the advent of antiretrovirals that restore immunity and hence lower the risk of tuberculosis. ANRS TEMPRANO has reassessed the benefits of isoniazid prophylaxis in the era of early antiretroviral treatment.

Sponsored and mainly funded by the ANRS, ANRS TEMPRANO, which was conducted between 2008 and 2015, showed that 6-month isoniazid prophylaxis for tuberculosis and early antiretroviral treatment both reduced the risk of severe morbidity in the first two years of follow-up. Published in The New England Journal of Medicine in 2015, these results greatly contributed to the formulation of WHO treatment recommendations. ANRS TEMPRANO participants were then followed up for an average of 4.5 years, and the findings were published in the 9 October 2017 issue of The Lancet Global Health. This long-term follow-up shows that tuberculosis chemoprophylaxis reduces not only severe morbidity, but also mortality, and that this benefit, which is independent of and complementary to that of antiretroviral treatment, lasts at least six years after administration.

Professor François Dabis, the Director of the ANRS, notes that, “We now have irrefutable evidence of the value of P5SITIVE LIVING | 4 | JAN •• FEB 2018

tuberculosis chemoprophylaxis in HIV-infected people in resource-limited countries in the era of antiretrovirals, even when these are initiated very early.

The WHO recommendations should more than ever be applied.”

Source: www.anrs.fr

New Model may provide insights on neurocognitive disorders caused by HIV HIV infects certain cells in the brain called microglia, and infected microglia release toxic and inflammatory molecules that can impair or kill surrounding neurons. Researchers have been limited in their ability to study HIV in microglia, but in a new FEBS Journal study, investigators developed a new model of infection in microglia using CRISPR/ Cas9 gene editing technology. The model will be useful for developing anti-HIV therapies and understanding how HIV infection damages the brain.

“This work is another step towards understanding how microglial cells, the primary reservoir for HIV in the brain, contribute to HIV-associated changes in neuronal function,” said senior author Dr. Brandon Harvey, of the National Institution Drug Abuse. “The model also provides a means of evaluating therapeutic strategies targeted at inactivating the virus in a challenging host cell.”

Source: newsroom.wiley.com 5

By Ross Harvey

Deep cuts to hinder BC’s HIV services

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ll the happy talk from the current federal Government notwithstanding, the cuts in funding by the Public Health Agency of Canada (PHAC) for long-established HIV programming (and the ongoing refusal to fund community-based Hep C work) have not yet been reversed. (See Positive Living Vol 19, No 1 (January/ February 2017), “Rude Awakening—Cuts gut HIV groups in BC”, p. 13.)

In BC alone, this means (starting at April 1) more than $1.5 million is being cut from programs and services that people living with or at risk of contracting HIV rely on. And no federal funding whatsoever for either the Pacific Hepatitis C Network or Hep C BC. Among the programs and services to be lost are the muchloved annual province-wide Positive Gathering of people living with HIV, the widely praised Fire Pit drop-in program in Prince George, the innovative Rural Empowered Drug User Network in the Kootenays, the all-but-unique Indigenous Bloodlines magazine ... and so many more.

And, of course, the cut to the Positive Women’s Network is widely understood to be the last straw that compelled PWN’s board to close its doors for good.

Across Canada, fully one-third of all existing HIV organizations have lost their previous PHAC funding. PHAC funding was crucial to the creation of the mix of HIV services that emerged over the past three decades — and it is grossly irresponsible now to withdraw funding for crucial elements in that mix. At very least, it places Canada’s achievement of its 90/90/90 targets in grave jeopardy.

So the Canadian AIDS Society has spurred and is coordinating a nation-wide effort to bring even more pressure to bear on the

Government to reverse the HIV cuts, and fund community-based hepatitis C work.

During December and January, organizations and individuals across the country are being urged to contact their Member(s) of Parliament to explain how damaging the planned cuts are, how (and how much) PLHIV rely on the programs and services being cut, and what the federal Government ought to be doing instead.

That is, basically, restoring the grant funding due to be cut by increasing funding for HIV and Hep C work in Canada overall.

That funding has been stuck at less than $73 million annually since 2008.

This is far from unreasonable. The one major encouraging development on this issue since previously levels of funding for the affected organizations was extended for one more “transition year” (to March 31, 2018) was the statement by then Health Minister Jane Philpott, under grilling by Vancouver Kingsway NDP MP Don Davies on April 6: “we did get new investments in the budget to expand the federal initiative on HIV in the order of $30 million … With this new funding that came in the budget, we will of course be looking at all of those groups [which have been de-funded] to make sure that we provide good, smart investments going forward to the groups that are delivering well on the group.”

(It is disconcerting that, despite the best efforts of Mr. Davies and others to track down this elusive additional $30 million, so far it has not been found. Still, the commitment is—or at very least was—there.)

Further, the PHAC itself has reported that, between 200809 and 2012-13, it underspent its budget for such purposes by $13.8 million, or $2.75 million each year. There is no reason to believe this record of ill-advised parsimony was suddenly reversed at some point since 2012-13.

P5SITIVE LIVING | 5 | JAN •• FEB 2018

continued next page

So, in a nutshell, PHAC is moving to obliterate some of the oldest, most effective and highest valued HIV services in Canada—and is continuing to ignore community-based Hep C programming—while easily enjoying the fiscal wriggle room to do the opposite: keep what its funding has built over the years and actually build further.

It’s time to act. Phone your MP. Tell her or him that you and your friends derive excellent value from these soon-to-be-axed programs and services, that, combined, they are aiding greatly in meeting Canada’s 90/90/90 goals, and that you are counting on them (your MP) to do whatever is necessary to get these cuts reversed and new additional funding put in place. 5 Ross Harvey is the Executive Director of the Positive Living Society of BC.

TAKE ACTION!

The most important thing you can do is phone your own Member of Parliament and let them know about the cuts and how they will affect you personally or people you know.

To find out who your MP go to Ö www.ourcommons.ca/ Parliamentarians/en/members

Ü Enter your home postal code in the “Find MP” rectangle search box on the left-hand side of the page

Ü Click on “Find MP” Ü Double click on your MP’s name when it comes up—

that will give you their contact information, including local office phone number

ACTION 1 > Phone them at their local (constituency) office ACTION 2 > Send a letter—postage-free—to their Parliament Hill office in Ottawa ACTION 3 > Send an email—but that’s probably the least effective of the three options.

THE CUTS IN BC

These are the programs and services that will be lost in BC in consequence of the Public Health Agency of Canada (PHAC) cuts:

AIDS Vancouver (Metro Vancouver) Major volunteer support and coordination, resulting in the loss of more than 11,000 volunteer hours annually and consequent loss of a host of volunteer-based prevention, education and support programs. $148,500 in 2016-17 ANKORS (Nelson, Cranbrook and east Kootenays) HIV, Hepatitis C and other STBBI prevention and education programs in 24 Kootenay communities, the Men’s Health Initiative in Kelowna, and peer development work with the Rural Empowered Drug User Network (aimed at “hidden” populations of People Who Inject Drugs). $338,400 in 2016-17 Positive Living BC Annual Positive Gathering (Lower Mainland and province-wide) of, by and, for people living with HIV (dependable attendance by 200+ British Columbians living with HIV—the largest annual gathering of people living with HIV in the country), Prison Outreach (assistance, education, release preparation, societal re-integration), and individual advocacy services. $276,300 in 2016-17

Positive Living Fraser Valley (Abbotsford and area) Drop-in centre, support groups, counselling, food (food bank, hampers and weekly lunch), HIV/HCV education, medical transport—and possible total closure of Positive Living Fraser Valley. $350,347 in 2016-17 Positive Living North (Prince George, Smithers, and all of Northern Health Authority area) Fire Pit Cultural Drop-in centre, street-level HIV/HCV prevention program, Prevention/Support Worker. $217,000 in 2016-17 Positive Women’s Network (Lower Mainland and province-wide) Direct service programs (food program, lunch-and-learns, hot meals, one on one counselling, peer mentorship), retreats, and education resource creation; final total agency closure in April 2017. $175,000 in 2016-17 Red Road HIV/AIDS Network (Province-wide) Bloodlines magazine, a full-color magazine featuring Aboriginal Persons Living with HIV/AIDS where they can share their personal experiences, discuss issues affecting them, and offer advice and suggestions to their peers. $110,391 in 2016-17

So that’s a total of $1.6 million in cuts to direct services and programs that people living with HIV in BC, or those at risk of contracting HIV, depend on.

P5SITIVE LIVING | 6 | JAN •• FEB 2018

F

Fawning over fermented foods

By Yoon Heo

ermented foods have popularity due to their various health benefits. It is easy to find fermented foodstuffs, such as kombucha or kefir in health stores, but also in grocery stores or cafés. I have more immuno-compromised patients asking me questions about the health benefits of fermented foods, and their effectiveness on our immune and digestive systems.

Fermented foods are foods made by a microbial or enzymatic process, and a method called “lacto-fermentation.” During lactofermentation, bacteria, such as Lactobacillus, converts sugars into lactic acid and this lactic acid acts as a natural preservative. This method has been used around the world for millennia to preserve foods and to improve their flavours. Kimchee, a spicy fermented cabbage from Korea, is one example of food made by lacto-fermentation.

Recent research indicates that some fermented foods that contain probiotics can improve digestive function and inflammatory bowel conditions. Some scientists believe that modern pasteurization and sanitization processes and the use of antibiotics could be affecting our gastrointestinal systems by killing the “good” bacteria in our body and contributing to an increased prevalence of inflammatory bowel diseases, such as Crohn’s disease, ulcerative colitis, or irritable bowel syndrome (IBS). Therefore, it is held that consuming certain fermented foods could add helpful bacteria to our digestive systems.

Some scientists think that fermented foods could improve our immune systems by adding “good” bacteria in our bodies. It is suggested that the fermentation process can increase the vitamin and mineral contents of foods. New research has shown that fermented foods can also decrease the risk of metabolic syndromes, such as

diabetes or heart disease, although more evidence-based research must be done in this area.

To achieve the positive health effects of fermented foods, some people choose to consume fermented foods rather than taking probiotic supplements. Be advised to choose fermented foods carefully when seeking positive probiotic effects because not all fermented foods contain probiotics. Kefir, miso, and kimchee, still contain microorganisms at the end of the fermentation process, thus they contain an abundance of probiotics. However, fermented foods that go though further processing, such as pasteurization or baking do not contain as many microbes since they get destroyed during these heating processes. Thus, tempeh, sourdough breads, and storebought sauerkraut are no longer rich sources of probiotics.

In order to find fermented foods that contain probiotics, pay more attention to labels. Yogurt is often the best bet, and there is a lot of research on the probiotic benefits of yogurt. There are also products that have added probiotics, such as probiotic pickles, however they tend to be more expensive than regular products. Cheese can also contain probiotics, unless it is heated during production.

Remember to always consult your doctor or dietitian if you are immune-suppressed or –compromised before making any changes to your diet. 5 Yoon Heo is a registered dietitian working in the HIV/ AIDS program of St. Paul’s Hospital in Vancouver.

P5SITIVE LIVING | 7 | MAY •• JUNE 2017

Sister to Sister Family planning gap for women with HIV: Study anadian researchers have analysed a comprehensive survey of HIV-positive women living in British Columbia, Ontario, and Quebec. The survey focused on pregnancyrelated issues. The team found that about 25 percent of women disclosed that they became pregnant after their HIV diagnosis. About 60 percent of pregnancies were unintended.

As a result, the researchers suggested that “a gap in family planning specific to HIV-positive women exists.” The researchers say their findings, “underscores the need for improved integration of family planning care as part of comprehensive HIV care for women.”

Researchers with the Canadian HIV women’s Sexual and Reproductive Health Cohort Study (CHIWOS) used several methods—word of mouth, advertisements, community clinics, and Social Media (Facebook, Twitter)—to recruit 1,165 HIV-positive women. The average profile of women upon entering the study was as follows: Age: 41 years; Major ethno-racial groups: White, 41%; African/Caribbean/Black, 30%; Indigenous, 22%; Province: BC, 24%; Ontario, 52%; Quebec, 24%; 31% had a history of injecting street drugs.

The researchers found that 278 of the women reported a total of 492 pregnancies after being diagnosed with HIV. Here are the outcomes for most of the pregnancies reported by women: single or multiple live births: 57%; terminated: 21%; miscarriages or stillbirths: 19%.

Among the live births, here are the results of HIV testing on the infants: HIV-negative: 95%; HIV-positive: less than 1%; testing underway (at the time of the interview): less than 1%; Unknown: 3%.

Researchers studied 265 women who had a recent or current pregnancy. In this group, those who reported their pregnancy as unintentional were more likely to have the following factors (compared to women whose pregnancies were intentional): being single, being younger (at the time of conception), and born in Canada.

Furthermore, the researchers stated that women whose recent or current pregnancy was unintentional “were more likely to report

feeling unhappy about [that pregnancy] and identify the pregnancy experience as ‘one of the worst times of her life.’” The researchers found women whose pregnancy was unintentional were more likely to disclose that they had terminated their pregnancy.

Researchers noticed that the chances of a pregnancy increased over time, after women began ARV. See the chance of becoming pregnant in the graph below.

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Chance of becoming pregnant in %

C

By Sean Hosein

32%

30 27%

25 20 17%

15 10 5 0

3%

Year 1

Year 5

Year 10

Year 20

Years after HIV diagnosis

In the current era, there are several factors that play a role in the increased rate of pregnancy that the researchers found, which they suggested were as follows: Longer life expectancy due to ARV, improved overall health and fertility, and increased sexual activity.

One study from the United States that focused on 620 pregnancies in HIV-positive women found that nearly 70 of pregnancies were unplanned. Among HIV-negative Canadian women, researchers estimate that about 27 percent are unintended. 5 This information was provided by CATIE (Canadian AIDS Treatment Information Exchange). For more information, contact CATIE at 1.800.263.1638.

P5SITIVE LIVING | 9 | JAN •• FEB 2018

Navigating HIV peer networks

By Glen Bradford

R

ecently, Positive Living Society received funding to give technical support to agencies interested in starting their own peer navigation programs. In addition to our current work with Vancouver Coastal Health, there are now peer navigators in the Fraser Health region.

Many communities are working to build their own form of peer navigation. We are supporting the Peers4wellness Indigenous peer project within the Vancouver Coastal Health area. Interior Health and Vancouver Island are in the nascent stages of developing peer programming. Using best practices and the experience gained from working with these communities, we will reach out to other health authorities with models they can adapt to their needs.

Interior Health Authority has engaged the Community Mental Health Association (CMHA) to develop a Peer Support Worker Training Toolkit.

Drawing on their mental health support worker experiences, CMHA have struck a working group of various HIV, Non-HIV community agencies, and local government health agencies to support their project. Vancouver Island People with HIV/AIDS Society has started a peer program and is seeking peer training and technical support from us.

We will partner with CATIE to promote and utilize the CATIE Best Practice Guidelines in Peer Health Navigation for PLHIV, a document developed by a national working group that included Positive Living. We will also team with Pacific Hep C Network, promoting their work with people who are hepatitis C-positive or co-infected with hepatitis C and HIV. Positive Living BC will support HIV-positive people interested in becoming peer navigators in their communities by helping with the recruitment of peers in each health authority. We will run training webinars for new recruits.

Being a peer navigator is a challenge. For peers who may be the only one in their community doing this work, we will provide a facilitated video conferencing support group where they can share successes and problem-solve. We will top off the year of training and support with an in-person skills-building workshop at next year’s Positive Gathering.

Positive Living BC contributes to the development of various peer support and peer navigation tools across BC. The larger vision is for each project to complement each other, and for each community to be able to mix and match the peer-to-peer tools they need for their own circumstances.

Peers offer a range of support activities from: explaining the basics of HIV/AIDS and self-care; promoting the value of treatment to prevent disease progression and transmission; teaching strategies for disclosure and understanding legal obligations; connecting clients with services in the community; assisting with appointments and transportation arrangements; accompanying clients to appointments; offering strategies for incorporating medications and diet changes into their daily routine; and serving as a voice of experience by listening and discussing shared issues.

If you are interested in peer navigation, please contact me at glenb@positivelivingbc.org. 5

Glen Bradford is the Manager of Peer Navigation and Prison Outreach at Positive Living BC.

P5SITIVE LIVING | 11 | JAN •• FEB 2018

PEP in BC Making HIV prevention safer

By Marianne Harris

P

ost-exposure prophylaxis for HIV (PEP) refers to taking a short course of antiretroviral drugs, or ARVs, by an HIV-negative person following a possible exposure to HIV. The purpose of PEP is to prevent that individual from becoming infected with HIV, the idea being that the ARVs kill off all the virus particles in the blood before they can get into the

cells and establish a new infection. This of course is most effective if PEP is started very quickly after the exposure, ideally within two hours. If more time has elapsed since the event, between 48 and 72 hours, then any virus that was transferred into the blood during the exposure would have already gotten into the cells, and it would be too late to prevent infection using PEP. continued next page

P5SITIVE LIVING | 13 | NOV •• DEC 2017

PEP has been available in BC for nearly 20 years, with the ARV medications provided free of charge through the British Columbia Centre for Excellence in HIV/AIDS (BC-CfE) for people experiencing a possible exposure to HIV in one of the following situations: Occupational exposures – for example, health care workers or first responders having an accidental needlestick with a recently-used needle, or a cut with a scalpel blade during surgery, or a splash of blood (or another body fluid with blood in it) into their eyes, nose, or mouth, where the source is HIV-positive or likely to be HIV-positive. Or sexual assaults, where it is known or felt to be likely that the perpetrator(s) is(are) HIV-positive



There have been no cases where a person has become HIV-positive after receiving PEP for an accidental occupational exposure in BC. 

A full course of PEP is 28 days. The BC-CfE PEP program is set up so that 5-day “starter kits” of medications are available throughout the province in emergency departments, outpost nursing stations, and provincial prisons. This allows people to start the PEP medications as quickly as possible after an exposure has occurred, following assessment of the event by a doctor or another health care professional. During the first five days, the situation is assessed in conjunction with expert pharmacists and physicians at the BC-CfE to determine whether the exposed person should receive the remaining 23 days of meds. For example, this time may be used to get the results of HIV testing that was been done on the source person (if he or she is known, available, and consented to having this testing done) – if the source person is found to be HIV-negative, the exposed person would not need to continue PEP. The 5-day starter kit also allows the exposed person a chance to see whether they can tolerate the PEP meds - if there are major side effects, the meds in the PEP regimen can be changed for the remaining 23 days, after consultation with the BC-CfE. Since 1998, more than 10,000 people have received PEP through the BC-CfE PEP program. During each year from 2002 to 2015, about 300-400 starter kits were given out in the province, and about 100 people (about a quarter of those who receive a starter kit) were prescribed the full 28 days. As far as

we know, there have been no cases where a person has become HIV-positive after receiving PEP for an accidental occupational exposure in BC. In May 2017, the BC-CfE PEP guidelines were updated from the previous version that had been in effect since 2009.

The major changes in the 2017 version involve the specific ARV medications used for PEP, the follow-up blood testing after PEP, and who is eligible to receive PEP though the program.

For several years, PEP regimens recommended to prevent HIV have included three ARV drugs, similar to the regimens used to treat HIV in people who are HIV-positive. The combination used for PEP in BC has been tenofovir DF, lamivudine, and lopinavir/ritonavir (Kaletra). This regimen is highly effective and as noted above, we are not aware of anyone becoming positive in BC as a result of an accidental exposure after taking this regimen. However, the Kaletra component did present some problems, and a fair number of people who took PEP were bothered by nausea, vomiting, and/or diarrhea, which may have led them to stop PEP early, before they were finished the full 28 days. Also, Kaletra is associated with drug interactions and may lower or raise the levels of other drugs that are taken at the same time, possibly making those drugs less effective or more toxic. There is one recorded instance in Canada of a death after receiving PEP containing Kaletra, in a man who was using a fentanyl patch for pain – it is thought that the Kaletra he received for PEP increased the levels of fentanyl to the point where he suffered an overdose.



After an exposure to HIV, if an individual becomes infected, it takes some time for their HIV test to become positive. 

Although this type of serious problem is rare, as a precaution the third drug in the PEP regimen in BC has been changed from Kaletra to raltegravir (Isentress). A highly effective ARV medication for HIV treatment, raltegravir has been used in many other jurisdictions as a component of PEP, with good results.

It is well-tolerated, with few side effects, and has few drug interactions to worry about. So the new regimen is expected to be more tolerable and, importantly, safer for people who need to take PEP.

P5SITIVE LIVING | 14 | JAN •• FEB 2018

After an exposure to HIV, if an individual becomes infected, it takes some time for their HIV test to become positive. That’s because the test used to diagnose HIV measures antibodies against HIV, i.e. the body’s response to the HIV infection, and it takes some time for those antibodies to develop. (The time between infection and the development of antibodies, when the HIV test becomes positive, is called the “window period.”) So after an accidental or occupational exposure where HIV might have been transmitted, even if the person receives PEP, it’s recommended that they have HIV tests to make sure they haven’t acquired the infection. In the past, we couldn’t say for sure that they hadn’t become positive until the HIV test came back negative six to 12 months after the exposure. As you can imagine, this caused a lot of anxiety while people were waiting for their final test results.



It is hoped that these changes to the BC-CfE PEP guidelines will help to make HIV prevention safer and more effective. 

Luckily, the tests used to detect HIV antibodies have become more sensitive, so it is now recommended that people who might have been exposed to HIV get tested three weeks, six weeks, and three months later. If the HIV test is negative after three months, they can be sure they haven’t been infected with HIV. For people who receive PEP, the clock starts at the end of PEP, in other words the HIV tests are done at three weeks, six weeks, and three months after they finish taking PEP. This is because PEP could, at least theoretically, delay the development of antibodies.

As described above, in the past, PEP has only been available free of charge in BC to people who were exposed to HIV in accidental occupational settings or as a result of sexual assault. PEP may have been medically indicated to prevent HIV in people who had an exposure as a result of consensual sexual activity or sharing needles or other injecting equipment during voluntary drug use, but the ARVs were not provided for free – and they are expensive (more than $1000 for the full 28-day course), so few people were be able to afford them. In recent years, PEP for these types of situations – also known as “non-occupational PEP”, or “NPEP” – has been shown to be an important part of the overall effort to prevent new HIV infections.

Therefore, as of this year, PEP is also available free of cost to people who have had a possible exposure to HIV through consensual activities. This is being merged into the main PEP program, using the same medications and similar procedures (e.g. the 5-day starter kit and the 23-day refill), so PEP will be available to everyone in the province for whom it is medically indicated, regardless of the circumstances of the exposure.

A word about “U=U.” We now know that Undetectable = Untransmittable. That is, the risk of acquiring HIV is negligible from having sex with an HIV-positive person who is consistently taking ARVs and has an undetectable viral load. How does this inform our recommendations for PEP? For consensual sexual exposures, if the HIV-positive partner is known to be on ARVs and has had a recent viral load which was undetectable, PEP may not be required. Since this information is often not available in an emergency situation, in most situations we would recommend the exposed person (who has had sex with a person known to be HIV positive) start PEP, and if the source person is available and agrees, blood be drawn for a viral load test. If the viral load is confirmed to be undetectable, the exposed person may safely be advised not to continue PEP (after consultation with the BC-CfE).

However, in situations where there has been direct blood to blood contact, for example, an accidental needlestick or cut that bleeds, we don’t have complete evidence to say with certainty that “U=U”. This is because viral load testing measures the amount of free HIV floating in the blood, but does not measure virus within blood cells – and these could theoretically be transferred from an HIV-positive to an HIV-negative person during a direct blood to blood exposure. On the other hand, having an undetectable viral load would certainly decrease the risk of transmitting HIV in these situations, and the amount of blood needed to transmit HIV would be considerable.

It is hoped that these changes to the BC-CfE PEP guidelines will help to make HIV prevention safer and more effective, and contribute to further reducing the number of new HIV infections in the province. 5 Dr. Marianne Harris is the Chair of the Post-Exposure Prophylaxis Committee at the BC Centre for Excellence in HIV/AIDS.

P5SITIVE LIVING | 15 | JAN •• FEB 2018

The naturopath will see you now

N

By Heidi Standeven

aturopathic Medicine is a holistic health care approach that believes in individualized care in prevention, treatment, and wellness through naturopathic methods, encouraging the body’s ability to heal itself.

Students from Boucher Institute of Naturopathic Medicine run a free weekly clinic at Positive Living’s Seymour Street location. There we treat a variety of conditions aimed at health promotion, prevention, and optimizing quality of life. The clinic is open to all, and welcoming of diversity. We team with health professionals in a patient-centered, team approach to health care.

Naturopathy is guided by Five Naturopathic Principles.

The Healing Power of Nature: we believe that the body, mind, and spirit have an amazing ability to heal themselves as well as prevent further illness, if provided the right circumstances.

Identify and Treat the Cause as opposed to looking for band-aid solutions: we work with you to get to the heart of what is going on.

First Do No Harm: this includes harmful suppression of symptoms, using treatments that minimize side effects, and working within the therapeutic order.

Doctor as Teacher: our job is to not only work with you towards health and wellness, but also to ensure you understand health, illness, and the factors that affect them.

Treat the Whole Person: we do not just look at the physical symptoms of a main concern, but also the mental, emotional, environmental, and genetic factors.

Some of the modalities that we use in naturopathic care include Traditional Chinese/Asian medicine (acupuncture, cupping), botanical medicine (herbs), physical medicine (manipulations, muscle work, gait/posture assessments), and nutrition.

Often our patients find that their first appointment with us is the most thorough history that has ever been taken of them. We sit with new patients for 1h15min in the first appointment to get a detailed history of their health history. The next appointment is a comprehensive, non-invasive physical exam. On the third appointment, full treatment sessions begin.

You will be given a diet diary so we can get a window into how you eat (No judgement. We love our chocolate and french fries too). Expect to be asked about your bowel movements (“What your poo says about you!”), energy, stress and sleep.

Our goal is to prevent people from getting sick and needing to come to see us. However, if that cannot be the case, we work with you to find the underlying cause of your main concern. There is a lot that we can do to help manage not only day-to-day symptoms, but also side effects from medications and chronic illness. We can help you boost your immune system, help with libido, insomnia, sciatica, neuropathy, digestive issues, mental health, and chronic pain.

We take the time to get to know you and understand your health journey to ensure that we put together a treatment plan that is tailored to your needs. We look forward to seeing you.

Our clinics are available on Wednesday and Thursday evenings throughout the year. Visit our website for clinic times, or contact the Wellness Desk at 604.893.2203 or email clinic@ positivelivingbc.org. 5 Heidi Standeven is a student with the Boucher Institute of Naturopathic Medicine.

P5SITIVE LIVING | 16 | JAN •• FEB 2018

Giving Well

A DONOR PROFILE

By Jason Motz

© Ester Tóthová

empowers our artists to meet the needs of every person they encounter and personalize the experience just for them

M

any thanks to Elizabeth Layton, Regional Trainer at M.A.C Cosmetics, for sharing both her personal and her corporate reasons for donating to Positive Living.

Q. How did M.A.C Cosmetics get involved with Positive Living BC? The M.A.C AIDS Fund has long partnered with the annual AIDS Walk, and matches the donations made to our team of walkers to double the impact for organizations like Positive Living. It’s a proud moment for our teams to walk in the annual event, and to know we have been doing so in walks all over the globe for decades! I have been involved in the Walk to Thrive for most of my career with M.A.C—be it fundraising, walking, or both. It’s an event we fundraise for and think of all year round.

Q. Explain the relationship between M.A.C and PLBC. The relationship between PLBC and M.A.C

is mutually beneficial—through our fundraising efforts for the Walk to Thrive, PLBC benefits from funding through the M.A.C AIDS Fund. By fundraising for the Walk to Thrive, our artists have the opportunity to give back to the community, beyond the sale of the Viva Glam products—they get to really see the Fund in action, and have a lot of fun doing it. This past Walk to Thrive, we were crowned Top Team, raising over $10,000 for PLBC! Q. What does the term ‘diversity’ mean to M.A.C? Diversity is built in to our brand credo—All Ages, All Races, All Genders. Makeup is a very powerful tool in empowering oneself to face the world, and we truly believe in creating a safe place in which all are welcome—to express themselves however they choose. We also express our Diversity in a few other ways: the range of shades offered by M.A.C is second to none. It P5SITIVE LIVING | 18 | MAY •• JUNE 2017

Q. Do organziations have a corporate responsibility to “give back”?

Absolutely. The M.A.C AIDS Fund is the heart and soul of M.A.C Cosmetics—100 percent of the retail selling price of our Viva Glam products goes to help all ages, all races, all genders living with and affected by HIV/AIDS. It really gives business a human side, knowing an organization has a link to the community. We like to frequent businesses that have a mission that aligns with our own. Whether you yourself have been touched by HIV/AIDS, like the celebrity spokespeople we feature or simply love the shades of lip colour, the M.A.C AIDS Fund is a way to keep the conversation around the epidemic going.

Q. What would you say to encourage other companies to partner with PLBC? We have also forged friendships with the team at PLBC and truly enjoy being a part of their work. I would encourage organizations to visit PLBC and speak with the team—to find out about the programs, funding gaps and who they serve. The epidemic is not over, and we need everyone to join in the fight against HIV/AIDS. 5 Jason Motz is the managing editor of Positive Living magazine.

In grateful recognition of the generosity of Positive Living BC supporters Gifts received November – December 2017

$5000+ LEGACY CIRCLE

Peter Chung Providence Health Care

$1000 - $2499 CHAMPIONS

Bramwell Tovey Cheryl Basarab Don Evans Fraser Norrie Harvey Strydhorst Jackie Yiu Paul Goyan Paul Gross Scott Elliott

$500 - $999 LEADERS

Blair Smith Christian M. Denarie Cliff Hall Correctional Services Canada Darrin D. Pope Dean Mirau Dena R. Ellery Emet G. Davis James Goodman Janice Lam Leslie Rae Mike Holmwood Pierre Soucy Rebecca Johnston Robert Capar Ross Harvey Silvia Guillemi Stan Moore

$150 - $499 HEROES

Adrian Smith Barry DeVito Bonnie Pearson Brian Anderson

Bruce Grant Carmine Digiovanni Christopher Koene Colin Macdonald Dennis Parkinson Edith Davidson Elizabeth Briemberg Erik Carlson Glyn A. Townson Glynis Davisson Gretchen Dulmage James Ong Jane Talbot Jean Sebastian Hartell John Bishop Kate McMeiken Katherine M. Richmond Keith A. Stead Ken Coolen Lawrence Cryer Len Christiansen Lisa Bradbury Lorne Berkovitz Margaret Warbrick Marilyn Ludwig Mark Mees Mary C. Burpee Matthew Hinton Maxine Davis Mike McKimm Pam Johnson Patricia Dyck Patricia E. Young Patrick Carr PEA-HESU Chapter Penny Parry Ralph E. Trumpour Ralph Silvea Rob Spooner Ron J. Hogan Ronald G. Stipp Ross Thompson Sandra Bruneau Sergio Pereira Stephanie Tofield Stephen French P5SITIVE LIVING | 20 | JAN •• FEB 2018

Susan C. Burgess Thomas Fowle Tiko Kerr Vince Connors Wayne Avery William Granger

$20 - $149 FRIENDS

Adrienne Wong Andrea Reimer Angela McGie Bonnie Poole Carol Molley Chris G. Clark Chris Kean Colleen Carline Daryl Kochan Doug Clavelle E. Paul P. Beagan Frank Levin Gerry Kasten Harold W. Gillette Heather Inglis Jamie Dolinko Jeff Anderson Joel N. Leung John Yano Karl Eberle Kathleen Gammer Linda Lind Lindsay Mearns Lisa Raichle Miranda Leffler Patricia Hepplewhite Sharon E. Lou-Hing Tobias Donaldson Tracey L. Hearst Zoran Stjepanovic To make a contribution to Positive Living BC, contact the director of development, Jason Hjalmarson.  jhjalmarson@positivelivingbc.org  604.893.2282

By Tom McAulay

A

THE ROLE OF PLHIV/AIDS IN HEALTH PROMOTION ccess to treatment and research is a fundamental human right. This fundamental human right enables us to maximize our health potential and to move ahead from our current condition so that we can give new quality to our life and health.

The core concept of health promotion is working with people instead of for people. The guiding principle of health promotion is maximizing people’s health potential.

The Ottawa Charter defines health promotion as the process of enabling people to increase control over and to improve their health. This concept highlights health as an essential element of the quality of life both personal and social, which can always be promoted. At whatever point of life … a way of life can be found that sustains hope, diminishes fear, and preserves a quality of living whatever the limitations of an illness.

In relation to HIV/AIDS, this involves a process of creating and developing potentials of healing and health for, with and by people living with HIV/AIDS. Maximizing health potential further requires joint action by those of us living with HIV/AIDS, the disability community, and professionals engaged in different disciplines. The identification of successful strategies such as treatment strategies, as well as planning of short-term and long-term research agendas demand a constant exchange of experience and knowledge.

As we enter the second decade of HIV/AIDS, it is our obligation to look back and ask the question: have we succeeded in maximizing the existing health potential of PLHIV? There

is little doubt that this has not been maximized. In part this is because our voice has not been heard with equal respect within the current structures established in the field of AIDS. Since the beginning, we have identified and articulated our role as active participants in designing and planning, implementing and evaluating HIV/AIDS policies, programmes, and services. We wanted to assist in shaping the perceptions and realities surrounding AIDS. And we wanted a partnership built on credibility and equality. Many organizations … have become too institutionalized and have tended to lose sight of why they exist in the first place.

Ten years have gone by since we first raised our voice. Many of our forerunners have died. … Let us never forget that we, PLHIV worldwide, constitute a unique and critical resource. The time is long overdue to acknowledge this and to incorporate us in AIDS-related strategies.

We are the ones living on the front line and we can offer expertise that cannot be learned elsewhere. We are men and women with knowledge and skills, experience and abilities, talents and creativity, courage and commitment, hopes and dreams, and yes, health.

Dr. Jonathan Man of Harvard University stated … that the scientific medical method is not able to evolve enough to address the many issues of HIV/AIDS. Perhaps what is necessary is a revolution in biomedical and social sciences.

And you can’t have a revolution without the people. This is the challenge we must share.

Pei Lim, Board Member 5 Tom McAulay is a member of the History Alive Committee.

P5SITIVE LIVING | 21 | JAN •• FEB 2018

Assessing HIV prevention strategies in gay and bisexual men By Sean Sinden

B

iomedical technologies like treatment as prevention (TasP), pre-exposure prophylaxis (PrEP), and post-exposure prohpylaxis (PEP) have changed the way we prevent the transmission of HIV. However, access to and availability of these interventions varies across the country.

The Engage Study, one of the CTN’s newest studies, will measure how the factors that affect HIV and STI transmission differ between Vancouver, Toronto, and Montreal. These factors can include access to testing and treatment but also uptake and exposure to socio-behavioural prevention strategies, such as educational, counselling, and safer sex programs.

The study will focus on gay, bisexual, and other men who have sex with men, a group which has a much higher prevalence and greater risk of acquiring HIV than the heterosexual population. Over 2400 HIV-positive and HIV-negative participants will be enrolled between the three cities; the Vancouver site will use the ongoing Momentum Health Study to recruit 720 participants.

“Essentially what we are doing is creating a pan-Canadian study that we can use to plan, implement, and evaluate current HIV and STI prevention strategies,” said Dr. Trevor Hart, the study’s lead investigator.

The study team includes a number of community members and knowledge users at each site and the study is supported by a number of community organizations, including the Health Initiative for Men, the Pacific AIDS Network, and Positive Living BC. The Engage Study will use a series of biological tests and questionnaires to measure recent HIV and STI infections and prevalence, sexual risk taking behaviour, and knowledge of and access to educational and biomedical HIV preventions programs.

The data will be collected at baseline and 12 months and compared across cities and time points. The study design will allow the researchers to identify which programs are being utilized and which programs are associated with a drop in HIV and STI transmission.

“Not only will this study allow us to estimate the prevalence of HIV and STIs and how they are impacted by access to and uptake of prevention programs but will also allow us to identify gaps in

care, advocate for related policy change, and design more effective community interventions,” said Dr. Hart.

For more information about the Engage Study please visit engage-men.ca. 5 Sean Sinden is the Communications & Knowledge Translation Officer 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 | MARCH •• APRIL 2017

Volunteer with

Positive Living BC! Be part of something inspiring and join our enthusiastic volunteer team.

Your contribution will support people living with HIV. Our members are working towards a healthy future with HIV!

For more info contact us at 604.893.2298 marcs@positivelivingbc.org www.positivelivingbc.org

đ&#x;“ą đ&#x;”ż î?ś

P5SITIVE LIVING | 24 | JAN •• FEB 2018

PROFILE OF A VOLUNTEER Ever since he started working for us, Doug has been a joy. Everybody likes him, and enjoys the time when he is the host of the Lounge. Doug is easy to talk to, he is always willing to help out, and people just seem to be in a better mood after interacting with him. If I could clone him, I would. Congratulations, Doug, on this well-deserved honour.

Richard Harrison Engagement Coordinator

*Doug Gillis*

When did you start with Positive Living BC? I started volunteering in 2014 in the iCafé, where I helped people with computer problems.

What is our strongest point?

The fact that people have a place where they can come and hang out comfortably without judgment is a great selling point.

Why did you pick us?

I had just finished volunteering at AV and I wanted to continue in a similar agency. I enjoyed the services offered at Positive Living, and wanted to give back I offered my help because I enjoy the social interaction. Volunteering helped me to because I tended to be on my own and not really part of the community.

What do you see in the future for Positive Living BC? I hope that the programs can continue to be offered. We offer a lot of services, like massages, the naturopath, and other holistic services, that people might not be aware of. Information is crucial for newly diagnosed and people struggling with addiction, and Positive Living can be a resource for them.

P5SITIVE LIVING | 25 | JAN •• FEB 2018

Where to find

HELP

If you’re looking for help of information on HIV/AIDS, the following list is a starting point.

For more comprehensive listings of HIV/AIDS organizations and services, please visit www.positivelivingbc.org/links

bA LOVING SPOONFUL

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

cAIDS SOCIETY OF KAMLOOPS

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

bAIDS VANCOUVER

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 | JAN •• FEB 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”.

Reports to be presented >> January 10 Set CHF Amount | Written Executive Director Report | Director of Communications | Standing Committees | Events Attended | Complete Board Skills Chart (1) | Quarterly Department Reports – Half-year | Financial Statements – September | Financials

January 24

Reports to be presented >> Quarterly Department Reports - 2nd Quarter | Executive Committee | External Committee Reports | Financial Statements – October | Director of HR | Events Attended

February 7

Reports to be presented >> Written Executive Director Report | Fund Development Corporate Sponsorship Matrix | AccolAIDS Nominations – in 2018 | Complete Board Evaluation Chart (1) | Director of Fund Development | Executive Committee | Events Attended

February 21

Reports to be presented >> Standing Committees | Financial Statements - November | Membership Statistics | Events Attended

Board & Volunteer Development_ Marc Seguin  604.893.2298

 marcs@positivelivingbc.org

Education & Communications_ Adam Reibin  604.893.2209

 adamr@positivelivingbc.org

History Alive!_ Adam Reibin  604.893.2298

 adamr@positivelivingbc.org

Positive Action Committee_ Ross Harvey  604.893.2252

 rossh@positivelivingbc.org

Positive Living Magazine_Jason Motz  604.893.2206

 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 | JAN •• FEB 2018

Last Blast

Editor’s Note: The following is an excerpt of the Community Consensus Statement from the Canadian Coalition to Reform HIV Criminalization (CCRHC) entitled End Unjust HIV Criminalization.

We will have more coverage of this topic in our next issue.

C

anada’s approach to HIV criminalization is unscientific, unjust, and undermines public health. PLHIV in Canada continue to be singled out for criminal prosecutions, convictions, and imprisonment for allegedly not disclosing their HIV status to sexual partners. People have been charged and convicted even when there has been little to no possibility of HIV transmission. Canada has the third-largest absolute number of recorded prosecutions for alleged HIV nondisclosure in the world, and one of the highest rates of prosecution in the world.

Police and prosecutors rely mostly on the charge of aggravated sexual assault, one of the most serious offences in the Criminal Code. Convictions carries a maximum penalty of life imprisonment and mandatory designation as a sex offender. Canada’s approach has come under repeated criticism domestically and internationally, including from United Nations expert agencies, human rights bodies, judges, women’s rights advocates and scientists.

In the very rare case in which someone intentionally transmits HIV, criminal charges may be appropriate. However, in the vast majority of cases, other interventions, including under existing public health law, may offer a better alternative, meaning there is no need to resort to the criminal law. Unlike criminal charges,

these other interventions can and should be tailored to individual circumstances, should involve community organizations with expertise in HIV issues, and should be supportive rather than punitive. To be consistent with human rights, any such interventions must be based on the best available evidence, be proportionate to an objectively reasonable assessment of risk, and be no further intrusive or restrictive than necessary.

In accordance with international guidance, criminal prosecutions should be limited to cases of actual, intentional transmission of HIV. We call upon the federal, provincial and territorial AttorneysGeneral to take the measures necessary, within their respective areas of jurisdiction and in consultation with PLHIV, HIV organizations, service providers, women’s rights advocates and scientific experts, to limit the unjust use of the criminal law against PLHIV. These measures must include: Federal and provincial Attorneys-General should develop sound prosecutorial guidelines to preclude unjust HIV prosecutions. Such guidelines must reflect current scientific knowledge and the principle of the least intrusive, most effective response.

The federal government should reform the Criminal Code to limit the unjust use of the criminal law against PLHIV. All three levels of government should support the development of resources and training to address misinformation, fear, and stigma related to HIV. Training should be conducted by experts in HIV and be extended to judges, police, Crown prosecutors and prison staff nationwide. 5

P5SITIVE LIVING | 28 | JAN •• FEB 2018

POSITIVE

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A CONFERENCE DEVELOPED FOR AND BY HIV+ PEOPLE IN BRITISH COLUMBIA

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A bi-annual awards gala honouring heroes in the BC HIV/AIDS movement

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

APRIL 22 • Vancouver Convention Centre ISSN 1712-8536

JAN • FEB 2018 VOLUME 20 • NUMBER 1

2018 accolaids.ca

Nominate YOUR hero for an AccolAIDS award!

Closing Date for Nominations: FRIDAY • MARCH 2 • 5 PM

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PHAC fallout

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Expanding peer services