HIV war gets a transfusion and bold plan

The Vancouver/Richmond health board last night approved a plan to spend
$3.7 million to help curb the HIV epidemic in Vancouver's downtown eastside.

The B.C. health ministry is to kick in $3 million, the health board $700,000.

The board unanimously endorsed a report calling for hiring 42 more workers
to ease the crisis caused by 1,500 HIVinfected eastsiders, and for five
needle exchange sites.

But Ron Yuen, past chairman, who prepared the report, stopped short of
recommending ``safe houses,'' buildings where users could be assured a
clean fix.

``Some of members of the board have asked me, `Where is it? Are you hiding
that?' he said.

Health board staff were asked to produce a report by December on the issue
of ``harm reduction,'' including a look at everything from
decriminalization of drugs to making cocaine and heroin available to
addicts at special clinics.

There are about 6,000 to 10,000 intravenous drug users in the downtown
eastside. Vancouver has the highest known rate of HIV among injection drug
users in the Western world.

Transition health network director Nancy Kotani said, ``We know more about
measles than we do about HIV . . . there's a long waiting list and you end
up losing people. When people want to change, we have to make sure that we
have the services for them.''

Kotani said onthespot tests are one way of identifying drug users who may
quickly spread the disease. A simple pinprick and people would know
immediately.

But she said it's not enough just to identify users. Patients shouldn't
simply be given the devastating news and sent home in a state of shock
without posttest counselling.

``There have to be safeguards in place before those tests are set up.''

``There has been limited funding for medical services, community projects
and counselling,'' said Dr. Trevor Corneil, a St. Paul's hospital physician
who volunteers with the YouthCo AIDS Society. ``They have definitely added
the counselling services which are integral to dealing with addiction. And
the decision to open more needle exchanges is positive.

``But there isn't a huge commitment here for physicians' services, although
they have expanded dropin clinic hours.''