StarPhoenix: HIV Rise Sparks Warning

HIV rise sparks warning
Recent jumps linked to usage of injected drugs
BY HANNAH SCISSONS, THE STARPHOENIX APRIL 7, 2010

The number of newly diagnosed HIV cases in Saskatoon jumped again in 2009, prompting warnings from the health region's top physician that action is needed so the outbreak doesn't become unmanageable.

There were 94 new cases of HIV in the Saskatoon Health Region in 2009, up 22 per cent from 77 a year earlier. The number is also up 141 per cent from five years earlier, in 2005, when there were 39 new cases.

Dr. Cory Neudorf, chief medical health officer for the Saskatoon Health Region, said the increase is partly attributable to more aggressive screening for HIV in the city after the region increased its followup with newly diagnosed cases in 2005-06 to find out who they may have interacted with.

Prior to 2005, the number of new cases each year held steady between 10 and 16.

"So we're actively trying to find cases through (clients') social networks, and . . . as you test more people that are in high-risk categories, you are going to find more cases," he said.

"But we also do feel there has been an increase in transmission occurring."

Numerous risk factors have been identified, such as being exposed to infected blood, having unprotected sex with someone who is HIV-positive and having multiple sex partners. But in recent years in the city, the increase in HIV cases has been associated most closely with intravenous drug use, and that trend is continuing, said Neudorf.

"What we're finding is very rarely are we seeing a newly diagnosed case of HIV that has not reported injection drug use as one of their risk factors," he said.

He called the trends during the last few years "worrisome," including that there have been a small number of cases reported among teenagers, which the region hadn't seen before.

AIDS Saskatoon, which provides outreach and support services for people infected with HIV and hepatitis C, has been seeing a higher demand for its services, said executive co-ordinator Nicole White.

"We definitely have been dealing with people and giving support and counselling services more," she said, noting the organization just recently added a new support group on Wednesday nights for people newly diagnosed with HIV.

White noted the extremely high proportion of injection-drug users among new HIV cases in the city is an anomaly in Canada. Nationally, the HIV-positive population is split roughly into three groups: People who've come to Canada from countries with high infection rates; men who have sex with men; and intravenous drug users.

The need for education and prevention among intravenous drug users is high in the city, as well as the need for long-term support for those living with HIV.

To that end, groups in the province, including AIDS Saskatoon and the Saskatoon Health Region, have been working with the government on a provincial HIV strategy, said White. It's reaching its final form but a release date has not been set.

In Saskatoon, that will ideally involve more primary-care services offered in centralized locations, said Neudorf, although details will depend on the levels of funding made available.

In times of budgetary restraint and program cuts, he said what really scares him is that prevention services will be shortchanged, rather than enhanced like they need to be.

Neudorf expects the numbers of new HIV cases to continue increasing in the near future before levelling off once most of those at a high risk have been tested.

The region hasn't yet started seeing transmission due only to heterosexual contact, but if that starts showing up in the population, it would mean the epidemic would have grown much larger than before.

"Now is not the time to let up on prevention," he said. "And we do need to get on top of this outbreak and implement the strategy or we'll be looking back a few years from now and seeing a much larger problem that we have to deal with."

HIV CASES

Newly confirmed HIV cases in the Saskatoon Health Region
Q 2004 16
Q 2005 39
Q 2006 53
Q 2007 57
Q 2008 77
Q 2009 94

HIV incidence rate in the SHR, per 100,000 people
Q 2004 5.6
Q 2005 13.5
Q 2006 18.2
Q 2007 19.6
Q 2008 25.8
Q 2009 31.3

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