Ken MacQueen of MacLean’s writes about the emergence of a serious HIV epidemic in Saskatchewan, concentrated in disadvantaged populations.\
Sometimes when Dr. Alex Wong wants to draw the attention of government policy-makers to the HIV epidemic in his home province of Saskatchewan, he entitles his statistical presentation “Africa on the Prairies.” Here in Vancouver, at the International AIDS Conference on HIV Pathogenesis, Treatment and Prevention, he took a more scholarly tone: “The Developing World in Our Own Backyard: Concentrated HIV Epidemics in High Income Settings.” He was sharing the stage with an AIDS worker from Ukraine and doctors from the hard-hit American regions of Appalachia and southeastern U.S., but the point was made. While Ukraine is coping with a tenuous economy and Russian incursion, the fact that regions of two of the world’s wealthiest countries are coping with Third World levels of HIV infection rates reflects, in his view, a sad failure of policy, planning and political will.
At its peak five years ago Saskatchewan had an infection rate of more than 19 people per 100,000 population, 2½ times the national average—by far the highest rate in Canada. While that provincial rate has since fallen to about twice the national average, those numbers don’t address the racial disparity or the potential disaster looming on the horizon, says Wong, an infectious diseases physician, researcher and a clinical director of the HIV provincial leadership team.
The infection rate for Saskatchewan’s non-Aboriginal population is below the national average. Yet, while First Nations and Metis account for about 16 per cent of Saskatchewan’s population, they represented about 80 per cent of all new cases of HIV diagnosed in 2011, Wong told a workshop attended by a few hundred of the 6,000 delegates here. “The incidence rate in our Aboriginal population is about 88 per 100,000 [population], which is 14 times the national average, on par with various African countries.”
The primary cause of the HIV and hepatitis C outbreak is an epidemic of injection-drug use in the urban centres like Regina and Saskatoon, and of injected prescription drugs in rural regions and isolated reserves.
But the blame itself runs deeper, including the legacy of colonialism, residential schools and discrimination, Margaret Poitras, a Cree and CEO of the All Nations Hope AIDS Network, told the panel.