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

Turkey's Controversial Reform Bill Giving Investors Jitters

Homeland security reform bill will give police new powers in search, seizure, detention and arrests, while restricting the rights of suspects, their attorneys More

Audio Slideshow In Kenyan Prison, Good Grades Are Path to Freedom

Some inmates who get high marks could see their sentences commuted to non-custodial status More

'Rumble in the Jungle' Turns 40

'The Champ' knocked Foreman out to regain crown he had lost 7 years earlier when US government accused him of draft-dodging and boxing officials revoked his license More

Featured Videos

Your JavaScript is turned off or you have an old version of Adobe's Flash Player. Get the latest Flash player.
Victorious Secularists Face Challenge to Form Government in Tunisiai
X
Henry Ridgwell
October 30, 2014 11:39 PM
Official results from Tunisia show the Islamist Ennahda party has failed to win the second free election since the so-called "Arab Spring" uprising in 2011. Ennahda, which handed power to a government of technocrats pending the elections, lost out to the secular party Nidaa Tounes. Henry Ridgwell reports from London that the relatively peaceful poll offers some hope in a volatile region.
Video

Video Victorious Secularists Face Challenge to Form Government in Tunisia

Official results from Tunisia show the Islamist Ennahda party has failed to win the second free election since the so-called "Arab Spring" uprising in 2011. Ennahda, which handed power to a government of technocrats pending the elections, lost out to the secular party Nidaa Tounes. Henry Ridgwell reports from London that the relatively peaceful poll offers some hope in a volatile region.
Video

Video Africa Tells its Story Through Fashion

In Africa, Fashion Week is a riot of colors, shapes, patterns and fabrics - against the backdrop of its ongoing struggle between nature and its fast-growing urban edge. How do these ideas translate into needle and thread? VOA’s Anita Powell visited this year’s Mercedes Benz Fashion Week Africa in Johannesburg to find out.
Video

Video Smugglers Offer Cheap Passage From Turkey to Syria

Smugglers in Turkey offer a relatively cheap passage across the border into Syria. Ankara has stepped up efforts to stem the flow of foreign fighters who want to join Islamic State militants fighting for control of the Syrian border city of Kobani. But porous borders and border guards who can be bribed make illegal border crossings quite easy. Zlatica Hoke has more.
Video

Video China Political Meeting Seeks to Improve Rule of Law

China’s communist leaders will host a top level political meeting this week, called the Fourth Plenum, and for the first time in the party’s history, rule of law will be a key item on the agenda. Analysts and Chinese media reports say the meetings could see the approval of long-awaited measures aimed at giving courts more independence and include steps to enhance an already aggressive and high-reaching anti-corruption drive. VOA’s Bill Ide has more from Beijing.
Video

Video After Decades of Pressure, Luxembourg Drops Bank Secrecy Rules

European Union finance ministers have reached a breakthrough agreement that will make it more difficult for tax cheats to hide their money. The new legislation, which had been blocked for years by countries with a reputation as tax havens, was approved last week after Luxembourg and Austria agreed to lift their vetoes. But as Mil Arcega reports, it doesn’t mean tax cheats have run out of places to keep their money hidden.
Video

Video Kobani Refugees Welcome, Turkey Criticizes, US Airdrop

Residents of Kobani in northern Syria have welcomed the airdrop of weapons, ammunition and medicine to Kurdish militia who are resisting the seizure of their city by Islamic State militants. The Turkish government, however, has criticized the operation. VOA’s Scott Bobb reports from southeastern Turkey, across the border from Kobani.

All About America

AppleAndroid