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

Lion Cecil's Killing Sparks 'Canned Hunting' Debate in S. Africa

Conservationists believe incident, which triggered worldwide outrage, will reshape debate about practice in which hunters are allowed to target animals bred for hunting More

Taliban's New Leader Says Jihad Will Continue

Top US Afghan diplomat also meets with Pakistani, Afghan officials following news of Mullah Omar's death More

Environmentalists Issue Warning on Mekong Biodiversity

Scientists say decades of economic development, hydropower-dam construction, lax law enforcement and trafficking have taken their toll More

Featured Videos

Your JavaScript is turned off or you have an old version of Adobe's Flash Player. Get the latest Flash player.
Astronauts Train Underwater for Deep Space Missionsi
|| 0:00:00
...    
🔇
X
George Putic
July 30, 2015 8:59 PM
Manned deep space missions are still a long way off, but space agencies are already testing procedures, equipment and human stamina for operations in extreme environment conditions. Small groups of astronauts take turns in spending days in an underwater lab, off Florida’s southern coast, simulating future missions to some remote world. VOA’s George Putic reports.
Video

Video Astronauts Train Underwater for Deep Space Missions

Manned deep space missions are still a long way off, but space agencies are already testing procedures, equipment and human stamina for operations in extreme environment conditions. Small groups of astronauts take turns in spending days in an underwater lab, off Florida’s southern coast, simulating future missions to some remote world. VOA’s George Putic reports.
Video

Video Civil Rights Leaders Struggled to Achieve Voting Rights Act

Fifty years ago, lawmakers approved, and U.S. President Lyndon Johnson signed, the Voting Rights Act of 1965. The measure outlawed racial discrimination in voting, giving millions of blacks in many parts of the southern United States federal enforcement of the right to vote. Correspondent Chris Simkins introduces us to some civil rights leaders who were on the front lines in the struggle for voting rights.
Video

Video Booming London Property a ‘Haven for Dirty Money’

Billions of dollars of so-called ‘dirty money’ from the proceeds of crime - especially from Russia - are being laundered through the London property market, according to anti-corruption activists. As Henry Ridgwell reports from the British capital, the government has pledged to crack down on the practice.
Video

Video Hometown of Boy Scouts of America Founder Reacts to Gay Leader Decision

Ottawa, Illinois, is the hometown of W.D. Boyce, who founded the Boy Scouts of America in 1910. In Ottawa, where Scouting remains an important part of the legacy of the community, the end of the organization's ban on openly gay adult leaders was seen as inevitable. VOA's Kane Farabaugh reports.
Video

Video 'Metal Muscles' Flex a New Bionic Hand

Artificial limbs, including the most complex of them – the human hand – are getting more life-like and useful due to constant advances in tiny hydraulic, pneumatic and electric motors called actuators. But now, as VOA’s George Putic reports, scientists in Germany say the future of the prosthetic hand may lie not in motors but in wires that can ‘remember’ their shape.
Video

Video Russia Accused of Abusing Interpol to Pursue Opponents

A British pro-democracy group has accused Russia of abusing the global law enforcement agency Interpol by requesting the arrest and extradition of political opponents. A new report by the group notes such requests can mean the accused are unable to travel and are often unable to open bank accounts. VOA's Henry Ridgwell reports.
Video

Video 'Positive Atmosphere' Points Toward TPP Trade Deal in Hawaii

Talks on a major new trade agreement among 12 Pacific Rim nations are said to be nearing completion in Hawaii. Some trade experts say the "positive atmosphere" at the discussions could mean a deal is within reach, but there is still hard bargaining to be done over many issues and products, including U.S. drugs and Japanese rice. VOA's Jim Randle reports.
Video

Video Genome Initiative Urgently Moves to Freeze DNA Before Species Go Extinct

Earth is in the midst of its sixth mass extinction. The last such event was caused by an asteroid 66 million years ago. It killed off the dinosaurs and practically everything else. So scientists are in a race against time to classify the estimated 11 million species alive today. So far only 2 million are described by science, and researchers are worried many will disappear before they even have a name. VOA’s Rosanne Skirble reports.
Video

Video Scientists: One-Dose Malaria Cure is Possible

Scientists have long been trying to develop an effective protection and cure for malaria - one of the deadliest diseases that affects people in tropical areas, especially children. As the World Health Organization announces plans to begin clinical trials of a promising new vaccine, scientists in South Africa report that they too are at an important threshold. George Putic reports, they are testing a compound that could be a single-dose cure for malaria.
Video

Video 'New York' Magazine Features 35 Cosby Accusers

The latest issue of 'New York' magazine features 35 women who say they were drugged and raped by film and television celebrity Bill Cosby. The women are aged from 44 to 80 and come from different walks of life and races. The magazine interviewed each of them separately, but Zlatica Hoke reports their stories are similar.
Video

Video US Calls Fight Against Human Trafficking a Must Win

The United States is promising not to give up its fight against what Secretary of State John Kerry calls the “scourge” of modern slavery. Officials released the country’s annual human trafficking report Monday – a report that’s being met with some criticism. VOA’s National Security correspondent Jeff Seldin has more from the State Department.
Video

Video Washington DC Underground Streetcar Station to Become Arts Venue

Abandoned more than 50 years ago, the underground streetcar station in Washington D.C.’s historic DuPont Circle district is about to be reborn. The plan calls for turning the spacious underground platforms - once meant to be a transportation hub, - into a unique space for art exhibitions, presentations, concerts and even a film set. Roman Mamonov has more from beneath the streets of the U.S. capital. Joy Wagner narrates his report.
Video

Video Europe’s Twin Crises Collide in Greece as Migrant Numbers Soar

Greece has replaced Italy as the main gateway for migrants into Europe, with more than 100,000 arrivals in the first six months of 2015. Many want to move further into Europe and escape Greece’s economic crisis, but they face widespread dangers on the journey overland through the Balkans. VOA's Henry Ridgwell reports.
Video

Video Stink Intensifies as Lebanon’s Trash Crisis Continues

After the closure of a major rubbish dump a week ago, the streets of Beirut are filling up with trash. Having failed to draw up a plan B, politicians are struggling to deal with the problem. John Owens has more for VOA from Beirut.
Video

Video Paris Rolls Out Blueprint to Fight Climate Change

A U.N. climate conference in December aims to produce an ambitious agreement to fight heat-trapping greenhouse gases. But many local governments are not waiting, and have drafted their own climate action plans. That’s the case with Paris — which is getting special attention, since it’s hosting the climate summit. Lisa Bryant takes a look for VOA at the transformation of the French capital into an eco-city.

VOA Blogs