ADDICTIONS A MAJOR GATEWAY TO HIV

Addictions through injection drug use account for more than 65 per
cent of the new cases of HIV in Saskatchewan.

Herald photo by Angela HillAddiction and injection drug use is the
main reason for the province's increasing HIV rate.

" There has to be more emphasis put on the area of addictions. As you
know, a lot of the HIV is still connected to intravenous drug use and
as a result addictions also has to be a part of the equation when
coming up with a solution," said Glen Pratt, third vice-chief for
health and social development with the Federation for Saskatchewan
Indian Nations.

These numbers are partially due to increased testing in those
so-called "at-risk populations," said Dr. Leo Lanoie, an addictions
specialist in Prince Albert.

" We've gotten so aggressive with case finding that we've found a lot
more people," he said.

" There is no doubt in my mind that this problem is going to get
worse before it gets better."

The case detection rate is going to go up before it is going to go down.

It's just part of the epidemiology. When the problem is small, it
stays that way.

But when it starts to get bigger - it gets bigger fast, Lanoie said.

"It's what an epidemiologist studying the problem would fully expect.
The problem we need to deal with is the root causes," he said.

It can be difficult for these people with HIV to access health care
because many of them don't trust the health system.

" The reason they don't access treatment is they feel stigmatized .
We're looking at all the aspects that stop people using the system,"
said Dr. Moira McKinnon, chief medical health officer for the
province, about the ongoing HIV working group.

Also, people with addictions can be difficult clients for doctors, said Lanoie.

"People with addictions problems often have a lot of problems - they
require a lot of work, are demanding and they're not always nice," he said.

With addictions comes what Lanoie refers to as SPAM: stigma,
prejudice and misunderstanding.

"People have made up their minds. They operate out of complete
ignorance, but are convinced they are right," he said.

Lanoie added that some people in the general public seem to think
that people with addictions issues, "woke up one morning and decided
addictions was the career for them."

There needs to be more education around addictions, and subsequently
HIV, to reduce this stigma and prejudice.

"One of the huge factors of addictions is childhood sex abuse," said Lanoie.

Two-thirds of women who are addicted to drugs were sexually abused as
children, he said.

"If someone could give me a quick fix for that one, then I'd be
happy. . It's fairly naive to expect a quick or simple solution to
what is a tremendously complex problem.

" The more people know, the more they understand and the less they
fear." Tomorrow: When health becomes political, a look at the role of
needle exchanges and resources for addressing HIV. Also, the Saturday
Extra has a look at the provincial HIV strategy and the working
groups trying to develop a new report.