Saskatchewan's HIV rate highest in Canada, up 800% in 1 region

A year after Saskatchewan doctors called on the provincial government to declare a public health state of emergency over HIV and AIDS, the incidence of both are nearing an all-time high.

Dr. Kris Stewart, a physician in Saskatoon who is part of the Saskatchewan HIV collaborative, said slight progress has been made, but he's not sure if it was a result of the request.

Government representatives have been meeting with the doctors regularly, he says, but funding hasn't escalated. When inflation is accounted for, Stewart says those in the field are actually dealing with a bit of a funding decrease.

According to Stewart, it has been determined that people with HIV who are on treatment do not transmit the disease, and therefore it's a good investment for the province. Despite this knowledge, he said he still sees advanced HIV resulting in death.

"Very often these are young people, their whole lives ahead of them," he said. "Sometimes they have children."In this time and place in the world, we should be doing better than this. And we're not."

The number of new HIV cases in the province peaked in 2009 at 199. A preliminary report released this year by the Government of Saskatchewan found that after decreasing for five consecutive years, the number of new cases in 2016 was back up to 170, an increase of six per cent over 2015.

Saskatchewan has the highest rates of HIV in Canada with 2,091 cases reported between 1985 and 2016. In fact, the number of new cases in Saskatchewan is almost triple the national average, Stewart said.

"We're the only jurisdiction where the incidence has gone up recently. So that should be a cause for alarm," he said.

Only Regina and Saskatoon saw fewer new cases in 2016 than usual. HIV cases in the Prince Albert Parkland Health Region rose by 73 per cent and by 80 per cent in Prairie North.
Stewart said it's more difficult to lower the numbers now because the increases are being seen in more remote, northern areas, as opposed to the urban locations the HIV strategy has been implemented in.
3 southern First Nations face outbreak

Out of the 170 new cases of HIV in the province, 79 per cent of those with the disease self-identified as Indigenous.

The First Nations of Cote, Key and Keeseekoose, near Kamsack, Sask., are facing what's being classified as an HIV outbreak.

They fall into the Sunrise Health Region, which saw a 800 per cent spike in HIV cases in 2016. From 2006 to 2015, there was an average of two new cases a year in the area. In 2016, 18 new cases were identified.
New Saskatchewan HIV cases by region

New HIV cases in Saskatchewan, by region. (Government of Saskatchewan)

Dr. Ibrihim Khan, Health Canada's regional medical health officer responsible for Saskatchewan First Nations, said injection drug use is a major health issue in the area and has been a driver of HIV, especially among local First Nations.

In Saskatchewan, 16 out of 100,000 people have HIV, according to Khan. Among residents of the three First Nations around Kamsak, there are 117 cases out of every 100,000 people.

Khan said Health Canada has been working with Sunrise Health Region, the province, local doctors, nurses and First Nations leadership in the area.

The community recently held three dedicated HIV testing sessions nurses testing a record number of patients.

"Stigma is quite a huge barrier in that area, and a lot of people just don't feel comfortable, particularly women. So these … sessions give them easy access to testing, counselling and treatment."
Underlying issues
New Beginnings Outreach Centre opened in Kamsack last fall, offering support for those living with HIV, addictions and mental health issues.

Khan said it's important to target the underlying issues that have led the HIV outbreak.

"The rates are alarming, but I think the leadership is doing an incredible job in terms of accepting the fact that it is a problem and doing something about it," Khan said.

There were 76,675 HIV tests in the province in 2016, the highest on record. Khan said this accounts for part of the increase in cases.

Khan said there are now 18 programs on Saskatchewan reserves addressing the disease along with 13 mobile nursing teams and 25 HIV point-of-care testing sights. He said he wants to double those numbers in the next year.