News / Health

Addicts’ Safe Haven in Vancouver Helps Control HIV

Addicts’ Safe Haven in Vancouver Helps Control HIVi
X
July 21, 2014 7:16 PM
Insite, is a supervised injection facility on the worst block of Vancouver’s heroin district. Here, nurses give clients clean needles to inject illegal drugs. Researchers have proven the facility is effective at cutting HIV infection rates in the area. But the facility is not without controversy. Critics argue Insite only promotes illegal drug use.

Vancouver has been called the jewel of the Pacific Northwest. But the largest city in British Columbia, Canada, has a darker side. More than 4,000 intravenous drug users live in its downtown Eastside area, turning alleys around Hastings Street into open-drug markets and shooting galleries.

“This alley has a lot of memories,” says Richard Teague, a former heroin addict, gesturing at the garbage-strewn space as he leads a VOA camera crew around his old haunts.

Richard Teague, infected with HIV as a heroin user in Vancouver's alleys, has been clean for six years. He praises supervised injection.Richard Teague, infected with HIV as a heroin user in Vancouver's alleys, has been clean for six years. He praises supervised injection.
x
Richard Teague, infected with HIV as a heroin user in Vancouver's alleys, has been clean for six years. He praises supervised injection.
Richard Teague, infected with HIV as a heroin user in Vancouver's alleys, has been clean for six years. He praises supervised injection.

“When you’re an addict and you wanna get your hit in you, you go to the closest spot. And this is it, this alley right here,” he remembers. “… You wouldn’t wait to try and find a room. You went to the nearest place where you could be kinda out of sight, you know, and do your fix and get your high.”

Amid the hazy camaraderie and desperation in such places, people share drugs, needles, diseases and sometimes death. Vancouver reported the world’s highest HIV infection rate among drug users in the 1990s. Teague was one of them, diagnosed with HIV more than 20 years ago.  

The community responded to the crisis by opening Insite, North America’s first supervised injection facility, in 2003.

Within two years of the facility’s opening, deaths by illicit drug overdose dropped by 35 percent within 500 meters or a third of a mile, researchers from the University of British Columbia and the British Columbia Centre for Excellence in HIV/AIDS found. Responding to a critique of their work, they later wrote in The Lancet medical journal that "Vancouver's supervised injecting facility had a localized yet significant effect on overdose mortality."

Other research found that, because users there did not share needles, rates of HIV and hepatitis C declined.

Insite’s mission

Andrew Day, manager of Insite’s HIV/AIDS and other harm-reduction programs, explains its mission.

When dealing with people who are addicted and determined to take drugs, “your focus then becomes: ‘If you’re going to use this drug, how can we do it in a way that is safer, reduces the risk of infection, reduces a risk of getting significant wounds, reduces the risk of actually this individual putting demands on other aspects of health care?’ ”

Dr. Julio Montaner directs the British Columbia Center for Excellence in HIV/AIDS.Dr. Julio Montaner directs the British Columbia Center for Excellence in HIV/AIDS.
x
Dr. Julio Montaner directs the British Columbia Center for Excellence in HIV/AIDS.
Dr. Julio Montaner directs the British Columbia Center for Excellence in HIV/AIDS.

Insite has 12 injection booths, where clients use their own illegal drugs under the supervision of healthcare professionals. Clients get clean needles, pure water and supplies to clean their wounds. The facility, operating near capacity, averages 600 clients a day. Most come for supervised injection, though others come for counseling or other services.  

When Teague was using heroin, Insite was his safe haven. Now he visits its peer-counseling sessions to help users get off drugs and deal with HIV.

“I know Insite’s been a godsend for Vancouver, and for a lot of people,” says Teague, who says he’s been off heroin for six years. “Because I know, some weeks at Insite… they probably save 10, 15 people from OD’ing. Because they got nurses on hand, they got professionals that can take care of people like that.”

Supervised injection draws critics

But Insite has its detractors. Canadian Prime Minister Stephen Harper and Conservatives in parliament have sought to close the site, which operates through an exemption of federal law so clients avoid drug possession charges. 

“There have been multiple studies on these types of institutions … and some suggest that there are public health benefits. Others suggest there are significant health detriments, in terms of increasing rates of addiction,” says David T. Johnson, a former diplomat and a member of the International Narcotics Control Board. He’s also a senior member of the Center for Strategic & International Studies’ Americas program.

Even the healthcare professionals who created Insite initially were skeptical that it would reduce HIV infection, one of its founders says.

“We set ourselves [up] to evaluate whether or not a supervised injection site could help us to control HIV, as well as a whole lot of other issues around injection drug use,” says Julio Montaner, a physician who directs the British Columbia Centre for Excellence in HIV/AIDS.  “And time and time again, the data came in saying yes, it helps, and no, none of the concerns that me, and my colleagues, and the community at large have expressed have materialized.”

Disclosure and discrimination

While HIV infection has been better controlled, Montaner says in a follow-up phone interview, he’s still concerned about the spread of stigma. He contends mandatory disclosure laws like those in Canada and in many U.S. states discriminate by requiring people with HIV to share that information with any prospective sex partner “even if they’re not infectious.”

"HIV exposure has been criminalized" unfairly, Montaner says. When a person with HIV infection has a low viral load and uses a condom during sex, the risk of infection is minimal, he adds. The CDC reports the combination can greatly reduce but not eliminate risk.   

Canada is among the top 10 countries in arresting and prosecuting HIV-positive people, the online site Slate reports. It also notes that though the United States has no federal standard, “34 out of 50 states have some law against people with HIV, criminalizing behaviors from nondisclosure to spitting. …” 

Teague says he has personally felt the sting of HIV stigma and sees it among some of Canada’s First Nation or indigenous people. “I know a lot of them who feel they can’t go back to the reserve. They feel they’ve been tainted somehow,” he says, adding some have grappled with drugs and prostitution. “… They get HIV, then their elders or parents don’t want them back on the reserve.”

Teague thinks he’s been snubbed for being HIV positive, he says, but he’s upfront about his status “because I’ve been living with it so long.” “When I cleaned up,” the ex-heroin user says, “I learned to be very honest and open.

“I still deal with stigma because of my HIV and I’ve been very open about it. But, best advice that I can give somebody is you have to have a tough skin.”

VOA's Carol Guensburg contributed to this report.

You May Like

Video VOA EXCLUSIVE: Iraq President Vows to Fight IS 'Until They Are Killed or We Die'

In wide-ranging interview with VOA Persian service reporter, Fuad Masum describes conflict as new type of fight that will take time to win More

Video Russian Anti-Corruption Campaigner Slams Putin’s Crackdown on Dissent

In interview with VOA Alexei Navalny says he believes new law against 'undesirable NGOs' part of move to keep Russian president in power More

Video On The Scene: In Ethiopia, 'Are You a Journalist?' Is a Loaded Question

VOA's Anita Powell describes the difficulties faced by reporters in fully conveying the story in a country where people are reticent to share their true opinions More

Featured Videos

Your JavaScript is turned off or you have an old version of Adobe's Flash Player. Get the latest Flash player.
Expelled from Pakistan, Afghan Refugees Return to Increased Hardshipi
X
Ayesha Tanzeem
May 28, 2015 6:48 PM
Undocumented refugees returning to Afghanistan from Pakistan have no jobs, no support system, and no home return to, and international aid agencies say they and the government are overwhelmed and under-resourced. Ayesha Tanzeem has more from Kabul.
Video

Video Expelled from Pakistan, Afghan Refugees Return to Increased Hardship

Undocumented refugees returning to Afghanistan from Pakistan have no jobs, no support system, and no home return to, and international aid agencies say they and the government are overwhelmed and under-resourced. Ayesha Tanzeem has more from Kabul.
Video

Video Britain Makes Controversial Move to Crack Down on Extremism

Britain is moving to tighten controls on extremist rhetoric, even when it does not incite violence or hatred -- a move that some are concerned might unduly restrict basic freedoms. It is an issue many countries are grappling with as extremist groups gain power in the Middle East, fueled in part by donations and fighters from the West. VOA’s Al Pessin reports from London.
Video

Video Floodwaters Recede in Houston, but Rain Continues

Many parts of Texas are recovering from one of the worst natural disasters to hit the southwestern state. Heavy rains on Monday and early Tuesday caused rivers to swell in eastern and central Texas, washing away homes and killing at least 13 people. As VOA’s Greg Flakus reports from Houston, floodwaters are receding slowly in the country's fourth-largest city, and there likely is to be more rain in the coming days.
Video

Video 3D Printer Makes Replica of Iconic Sports Car

Cars with parts made by 3D printers are already on the road, but engineers are still learning about this new technology. While testing the possibility of printing an entire car, researchers at the U.S. Department of Energy recently created an electric-powered replica of an iconic sports roadster. VOA’s George Putic has more.
Video

Video Al-Shabab Recruitment Drive Still on In Kenya

The al-Shabab militants that have long battled for control of Somalia also have recruited thousands of young people in Kenya, leaving many families disconsolate. Mohammed Yusuf recently visited the Kenyan town of Isiolo, and met with relatives of those recruited, as well as a many who have helped with the recruiting.
Video

Video US Voters Seek Answers From Presidential Candidates on IS Gains

The growth of the Islamic State militant group in Iraq and Syria comes as the 2016 U.S. presidential campaign kicks off in the Midwest state of Iowa.   As VOA’s Kane Farabaugh reports, voters want to know how the candidates would handle recent militant gains in the Middle East.
Video

Video A Small Oasis on Kabul's Outskirts Provides Relief From Security Tensions

When people in Kabul want to get away from the city and relax, many choose Qargha Lake, a small resort on the outskirts of Kabul. Ayesha Tanzeem visited and talked with people about the precious oasis.
Video

Video Film Festival Looks at Indigenous Peoples, Culture Conflict

A recent Los Angeles film festival highlighted the plight of people caught between two cultures. Mike O'Sullivan has more on the the Garifuna International Film Festival, a Los Angeles forum created by a woman from Central America who wants the world to know more about her culture.
Video

Video Kenyans Lament Losing Sons to al-Shabab

There is agony, fear and lost hope in the Kenyan town of Isiolo, a key target of a new al-Shabab recruitment drive. VOA's Mohammed Yusuf visits Isiolo to speak with families and at least one man who says he was a recruiter.
Video

Video Scientists Say Plankton More Important Than Previously Thought

Tiny ocean creatures called plankton are mostly thought of as food for whales and other large marine animals, but a four-year global study discovered, among other things, that plankton are a major source of oxygen on our planet. VOA’s George Putic reports.
Video

Video Kenya’s Capital Sees Rise in Shisha Parlors

In Kenya, the smoking of shisha, a type of flavored tobacco, is the latest craze. Patrons are flocking to shisha parlors to smoke and socialize. But the practice can be addictive and harmful, though many dabblers may not realize the dangers, according to a new review. Lenny Ruvaga has more on the story for VOA from Nairobi, Kenya.
Video

Video Iowa Family's Sacrifice Shaped US Military Service for Generations

Few places in America have experienced war like Waterloo. This small town in the Midwest state of Iowa became famous during World War II not for what it accomplished, but what it lost. As VOA’s Kane Farabaugh reports, the legacy of one family’s sacrifice is still a reminder today of the real cost of war for all families on the homefront.

VOA Blogs