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

As US Strikes Syria, China Sees Parallels at Home

Beijing is debating how much support to give international coalition against IS militants and trying to figure out how many Chinese nationals may have joined group overseas More

CDC: Ebola Could Infect 1.4 M by 2015

US health officials say if efforts to curb the outbreak are not increased, cases will soar dramatically by early next year More

Video USAID Provides $231 Million for Girls Education in 5 Countries

US Agency for International Development partners with celebrities to call attention to importance of education for girls worldwide More

Featured Videos

Your JavaScript is turned off or you have an old version of Adobe's Flash Player. Get the latest Flash player.
Washington to Pyongyang: 'Shut This Evil System Down'i
X
Scott Stearns
September 23, 2014 10:52 PM
U.S. Secretary of State John Kerry is calling on North Korea to shut down prison camps and other human rights abuses following a United Nations Commission of Inquiry into "widespread and systematic human rights violations." VOA State Department Correspondent Scott Stearns reports from the United Nations.
Video

Video Washington to Pyongyang: 'Shut This Evil System Down'

U.S. Secretary of State John Kerry is calling on North Korea to shut down prison camps and other human rights abuses following a United Nations Commission of Inquiry into "widespread and systematic human rights violations." VOA State Department Correspondent Scott Stearns reports from the United Nations.
Video

Video US, Gulf Allies Strike Islamic State Militants in Syria

United States forces have carried out strikes against Islamic State or ISIL militant positions in Syria - the first time Western forces have taken action on Syrian soil. Five U.S. allies from the Gulf joined the military action. Local reports suggest dozens of militants were killed. The U.S. also carried out unilateral missile strikes against a Syria-based terror group which Washington says poses an imminent threat to the West. Henry Ridgwell reports from London.
Video

Video High Intensity Focused Ultrasound Used to Kill Cancer Tumor

There is a new way of killing certain cancer tumors that allows the patient to go home on the same day. Surgeons at the Keck Medical Center of the University of Southern California became the first doctors to use this procedure on a patient with the help of high intensity focused ultrasound, or HIFU, and new robotic technology. Elizabeth Lee reports from Los Angeles.
Video

Video USAID Provides $231 Million for Girls Education in Five Countries

Hollywood stars Alicia Keys, Jennifer Garner and 30 others have voiced their support for a U.S.-backed initiative called "Let Girls Learn." The $231 million program, funded by the U.S. Agency for International Development, is aimed at ensuring public and quality education for girls worldwide. As VOA's Mariama Diallo reports, this new program will focus on five countries in Africa, South Asia, Latin America and the Middle East.
Video

Video UN: Relocation of Bedouins in Israel Weakens Two-state Solution

Rural Bedouins living in disputed lands east of Jerusalem could soon find themselves forcibly relocated. VOA's Sharon Behn reports from Jerusalem that while Israel defends the move as in the Bedouins’ best interests, the United Nations says the plan threatens the survival of the two-state solution with Palestinians.
Video

Video NASA’s MAVEN Probe Enters Mars Orbit

NASA’s newest Mars probe, called MAVEN, has successfully entered its designated orbit around the Red Planet. Scientists will use its sophisticated instruments to try to learn what happened to the atmosphere Mars had a few billion years ago. VOA’s George Putic has more.
Video

Video Prolonged Drought Plagues SW Oklahoma Farmers

Parts of western Texas and southwestern Oklahoma have been in drought conditions for several years running and the deficit in rainfall has taken a heavy toll on cotton and grain production. Oklahoma Governor Mary Fallin says the state has suffered $2 billion in agricultural losses since 2011. There has been rain in recent weeks, but, as VOA’s Greg Flakus reports from Altus, Oklahoma, for most farmers it has been too late.
Video

Video For West Ukraine City, Conflict Far Away Yet Near

The western Ukrainian city of Lviv prides itself on being both physically and culturally close to Western Europe. The Russian-backed separatists in the eastern part of the country are 1,200 kilometers away, and seemingly even farther away in their world view. Still, as VOA’s Al Pessin reports, the war is having an impact in Lviv.
Video

Video Saving Global Fish Stocks Starts in the Kitchen

With an estimated 90 percent of the world’s larger fish populations having already vanished, a growing number of people in the seafood industry are embracing the concept of sustainable fishing and farming practices. One American marine biologist turned restaurateur in Thailand is spreading the word among fellow chefs and customers. VOA Correspondent Steve Herman reports from Bangkok.
Video

Video Chinese Admiral Key in China’s Promotion of Sea Links

China’s President last week wrapped up landmark visits to India, Sri Lanka and Maldives, part of a broader campaign to promote a new “Maritime Silk Road” in Asia. The Chinese government’s promotion efforts rely heavily on the country’s best-known sailor, a 15th century eunuch named Zheng He. VOA's Bill Ide reports from the sailor’s hometown in Yunnan on the effort to promote China’s future by recalling its past.
Video

Video Experts Fear Ebola Outbreak ‘Beyond Our Capability to Contain’

Each day brings with it new warnings about the deadly Ebola outbreak already blamed for killing more than 2,600 people across West Africa. And while countries and international organizations like the United Nations are starting to come through on promises of help for those most affected, the unprecedented speed with which the virus has spread is raising questions about the international response. VOA's Jeff Seldin has more from Washington.
Video

Video Migrants Caught in No-Man's Land Called Calais

The deaths of hundreds of migrants in the Mediterranean this week has only recast the spotlight on the perils of reaching Europe. And for those forunate enough to reach a place like Calais, France, only find that their problems aren't over. Lisa Bryant has the story.
Colonel Steve ‘Spiros’ Pisanos left Greece and came to the U.S. to learn to fly. He flew fighters for the Allies in World War II, narrowly escaping death multiple times.Colonel Steve ‘Spiros’ Pisanos left Greece and came to the U.S. to learn to fly. He flew fighters for the Allies in World War II, narrowly escaping death multiple times.

AppleAndroid