A drop in HIV testing, along with an increase in risky behaviour associated with HIV spread, has sparked fears that a spike in HIV infections could be going undetected in Manitoba.
Manitoba Health reports that 10,000 fewer HIV tests were performed in 2020 over the previous year, but HIV infections reported in 2020 (116) were about the same as 2019 (119). As of September 4 this year they are at 99.
"With 10,000 fewer tests, that number is probably higher," said Owen Black, community engagement coordinator at Nine Circles Community Health Centre, a West Broadway clinic that provides services for people living with HIV, Hepatitis C and other sexually transmitted infections.
Black says the largest mode of HIV transmission in Manitoba is drug injection. He worries that a decline in walk- in and pop-up tests due to pandemic interruptions, combined with the increase of injection drug use, means HIV could be spreading undetected among vulnerable populations.
The increase in drug use and risky behaviour during the pandemic has been documented. Manitoba's Chief Medical Examiner's office reported an 87 per cent increase in drug overdose deaths from 2019 to 2020. Drug overdose deaths this year continue at a pace equal to 2020.
Black says stigma levelled against people with HIV is alive and well, and the damage caused by that stigma is often worse than the disease itself. HIV cannot be transmitted by touch, kissing, sneezing or sharing a glass of water. As well, people living with HIV can often manage it by taking just one pill a day, which makes their HIV undetectable and non-transmissible.
"Many people who are living with HIV can live long, happy and fruitful lives. A lot of Canadians and Manitobans aren't aware of that."
Nine Circles is promoting a petition to make PrEP—a medication that prevents HIV infection—free for all Manitobans. The medication costs about $250 a month, or about one-sixth of the anti-retroviral drug used to treat HIV that the province does fund.
"As we continue to see a rise in the opioid crisis, we know that harm reduction is the method forward to reduce deaths and to make sure people are OK," said Black, adding that people using drugs may not be in a position to stop.
"If we can target people who are at risk of contracting HIV and get them on the PrEP regimen, that would definitely be helpful in reducing the transmission of HIV...we need to meet them where they are and ensure that whatever they do they do as safely as possible."
The Leaf requested comment from Health Minister Audrey Gordon. A government spokesperson replied that the province, "is actively considering the needs of the community at high risk of HIV infection and coverage of PrEP is an important part of that consideration. We expect a decision to be announced in the coming weeks."
Nine Circles just wrapped up their annual Red Ribbon Walk & Run in September. The virtual event included seven days of fundraising, HIV awareness and education activities. Nine Circles' PrEP petition is accessible through "News and Events" on their website.
Sean Ledwich, Local Journalism Initiative Reporter, The Leaf