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

Multimedia Obama, Modi Break Nuclear Deal Deadlock

Impasse over liability issues had been stalling bilateral civilian nuclear cooperation; deal reached at start of US president's three-day visit to India More

WHO's Late Efforts in Tackling Ebola Highlight Need for Reform

Health experts debate measures to reform agency’s response to global public health emergencies in special one-day session on deadly outbreak More

One Tumultuous Year in Power for CAR's President

As sectarian violence raged across Central African Republic, interim President Catherine Samba-Panza has Herculean task: to end civil war and put country back on right track More

Featured Videos

Your JavaScript is turned off or you have an old version of Adobe's Flash Player. Get the latest Flash player.
Worldwide Photo Workshops Empower Youthi
X
Julie Taboh
January 23, 2015 11:08 PM
Last September, 20 young adults from South Sudan took part in a National Geographic Photo Camp. They are among hundreds of students from around the world who have learned how to use a camera to tell the stories of the people in their communities through the powerful medium of photography. Three camp participants talked about their experiences recently on a visit to Washington. VOA’s Julie Taboh reports.
Video

Video Worldwide Photo Workshops Empower Youth

Last September, 20 young adults from South Sudan took part in a National Geographic Photo Camp. They are among hundreds of students from around the world who have learned how to use a camera to tell the stories of the people in their communities through the powerful medium of photography. Three camp participants talked about their experiences recently on a visit to Washington. VOA’s Julie Taboh reports.
Video

Video US, Japan Offer Lessons as Eurozone Launches Huge Stimulus

The Euro currency has fallen sharply after the European Central Bank announced a bigger-than-expected $67 billion-a-month quantitative easing program Thursday - commonly seen as a form of printing new money. Henry Ridgwell reports for VOA from London on whether the move might rescue the eurozone economy -- and what lessons have been learned from similar programs around the world.
Video

Video Nigerian Elections Pose Concern of Potential Conflict in 'Middle Belt'

Nigeria’s north-central state of Kaduna has long been the site of fighting between Muslims and Christians as well as between people of different ethnic groups. As the February elections approach, community and religious leaders are making plans they hope will keep the streets calm after results are announced. Chris Stein reports from the state capital, Kaduna.
Video

Video As Viewership Drops, Obama Puts His Message on YouTube

Ratings reports show President Obama’s State of the Union address this week drew the lowest number of viewers for this annual speech in 15 years. White House officials anticipated this, and the president has decided to take a non-traditional approach to getting his message out. VOA White House correspondent Luis Ramirez reports.
Video

Video S. Korean Businesses Want to End Trade Restrictions With North

Business leaders in South Korea are calling for President Park Geun-hye to ease trade restrictions with North Korea that were put in place in 2010 after the sinking of a South Korean warship.Pro-business groups argue that expanding trade and investment is not only good for business, it is also good for long-term regional peace and security. VOA’s Brian Padden reports.
Video

Video US Marching Bands Grow Into a Show of Their Own

The 2014 Super Bowl halftime show was the most-watched in history - attracting an estimated 115 million viewers. That event featured pop star Bruno Mars. But the halftime show tradition started with marching bands, which still dominate the entertainment at U.S. high school and college American football games. But as Enming Liu reports in this story narrated by Adrianna Zhang, marching bands have grown into a show of their own.
Video

Video Secular, Religious Kurds Face Off in Southeast Turkey

Turkey’s predominantly Kurdish southeast has been rocked by violence between religious and secular Kurds. Dorian Jones reports on the reasons behind the stand-off from the region's main city of Diyarbakir, which suffered the bloodiest fighting.
Video

Video Kenya: Misuse of Antibiotics Leading to Resistance by Immune System

In Kenya, the rise of drug resistant bacteria could reverse the gains made by medical science over diseases that were once treatable. Kenyans could be at risk of fatalities as a result if the power in antibiotics is not preserved. Lenny Ruvaga has more on the story from Nairobi.
Video

Video Solar-Powered Plane Getting Ready to Circumnavigate Globe

Pilots of the solar plane that already set records flying without a drop of fuel are close to making their first attempt to fly the craft around the globe. They plan to do it in 25 flying days over a five month period. VOA’s George Putic reports.
Video

Video How Experts Decide Ethiopia Has the Best Coffee

Ethiopia’s coffee has been ranked as the best in the world by an international group of coffee connoisseurs. Not surprisingly, coffee is a top export for the country. But at home it is a source of pride. Marthe van der Wolf in Addis Ababa decided to find out what makes the bean and brew so special and how experts make their determinations.
Video

Video Yazidi Refugees at Center of Political Fight Between Turkey, Kurds

The treatment of thousands of Yazidis refugees who fled to Turkey to escape attacks by Islamic State militants has become the center of a dispute between the Turkish government and the country's pro-Kurdish movement. VOA's Dorian Jones reports.
Video

Video World’s Richest 1% Forecast to Own More Than Half of Global Wealth

The combined wealth of the world's richest 1 percent will overtake that of the remaining 99 percent at some point in 2016, according to the anti-poverty charity Oxfam. Campaigners are demanding that policymakers take action to address the widening gap between the ‘haves’ and the ‘have nots’, as Henry Ridgwell reports for VOA from London.

Circumventing Censorship

An Internet Primer for Healthy Web Habits

As surveillance and censoring technologies advance, so, too, do new tools for your computer or mobile device that help protect your privacy and break through Internet censorship.
More

All About America

AppleAndroid