– AIDS Committee of North Bay & Area - To assist and support all persons infected or affected by HIV/AIDS and/or Hepatitis C and to limit the spread of the viruses through eduction, awareness and outreach strategies.

HIV Update

HIV Disclosure Double Jeopardy

January 17th, 2017 at 11:32 am


Many people living with HIV in Canada live in fear of potential unfair criminal prosecutions. Their future is finally looking a little brighter.

In a statement that mostly flew under the radar, Minister of Justice Jody Wilson-Raybould declared, on World AIDS Day (December 1), her government’s intention “to examine the criminal justice system’s response to non-disclosure of HIV status,” recognizing that “the over-criminalization of HIV non-disclosure discourages many individuals from being tested and seeking treatment, and further stigmatizes those living with HIV or AIDS.”

Wilson-Raybould also stated that  “the [Canadian] criminal justice system must adapt to better reflect the current scientific evidence on the realities of this disease.”

This long-overdue statement was the first from the government of Canada on this issue since 1998, the year the Supreme Court of Canada released its decision on R v. Cuerrier, the first case to reach the high court on the subject.

That ruling established that people living with HIV could be criminalized for failing to disclose their HIV status to a partner prior to sex that could pose a so-called “significant risk” of HIV transmission.

In a subsequent 2012 decision, the Supreme Court changed the legal threshold by establishing a duty to disclose before sex that could pose a “realistic possibility” of HIV transmission.

In effect, the law was actually made harsher. In defining this new standard, the Supreme Court and most other courts, police and Crown prosecutors failed to properly consider current scientific evidence about transmission risks, which are far lower than most understand – especially when a condom is used or an HIV-positive partner has a low or undetectable viral load, usually as a result of effective treatment. It is now well established that HIV treatment not only allows people to live a long and healthy life, but also prevents new infection.

Wildly diverse interpretations of the law, however, have ended in people being convicted of aggravated sexual assault and going to prison for engaging in sex that in reality posed negligible to no risk to their partners.

Simple disclosure was thought to be an easy fix. But when being HIV-positive can still mark a person for overt discrimination and physical violence, disclosure remains anything but simple, especially for those on whom criminalization has a disproportionate impact: women, Indigenous peoples, migrants and members of African/Caribbean/Black communities.

Wilson-Raybould’s commitment to exploring change is important. Federal and provincial governments must take action to limit the scope and application of the criminal law in cases of HIV non-disclosure, in keeping with best practices and international recommendations. Canada is out of step with human rights principles and the broad scientific consensus surrounding HIV.

The use of the criminal law should be limited to cases of intentional transmission of HIV. Given what we know from science, in no circumstances should the criminal law be used against people living with HIV who use a condom, practise oral sex or have condom-less sex when they have a low or undetectable viral load.

We also need to do away with the practice of laying sexual assault charges in cases of HIV non-disclosure. It is misguided to equate HIV non-disclosure with the force and threats that normally define our understanding of sexual assault. Labelling people living with HIV as sex offenders is a stigmatizing misuse of this law.

In practical terms, there are some important ideas that the minister, and her provincial counterparts who are responsible for enforcing the law, can act on right now.

First, we’re calling for an immediate moratorium on all prosecutions in cases of HIV non-disclosure (unless there is alleged intentional transmission of HIV) while we’re exploring law reform options and working with the provinces to establish much-needed prosecutorial guidelines to limit the current misuse and overextension of the criminal law.

Second, the responsibility to recognize that things have gone seriously awry with our criminal justice system does not stop with the feds. Provincial attorneys general should immediately publicly state their commitment to ending the overly broad application of the criminal law in cases of HIV non-disclosure.

Third, we need ongoing meaningful dialogue that must always include people living with HIV, human rights advocates and scientific experts.

The minister’s commitment is one New Year’s resolution that we need to see come to fruition in 2017.

Cécile Kazatchkine is a senior policy analyst with the Canadian HIV/AIDS Legal Network. Ryan Peck is executive director of the HIV & AIDS Legal Clinic Ontario. Both are active members of the Ontario Working Group on Criminal Law and HIV Exposure ( | @nowtoronto

Petition to Have PrEP Listed on Ontario’s Public Drug Program

July 13th, 2016 at 10:55 am


SEE ADDED LINK: PrEP is a pre-exposure drug regimen which has proven effective in preventing HIV infection.  The only drawback is the cost of the drug used. Truvada, recently approved by Health Canada earlier this year, can cost as much as a $1,000 per month. Very few private insurance companies are covering its cost for clients. A provincial group of stakeholders has launched “List PrEP Now”, a push to have Ontario Minister of Health, Dr. Eric Hoskins, list Truvada on Ontario’s Public Drug Program, thereby covering the cost of the drug provincially. If you wish to support this petition or want more information go to

HIV Cure a Step Closer With Gene Editing Breakthrough

April 4th, 2016 at 1:51 pm


American scientists have made huge strides towards finding a cure for HIV using pioneering ‘gene editing’ techniques.

After years of research, the team from Temple University in Pennsylvania used their technique to eliminate the virus fromhuman cells by ‘snipping’ it out.

The successful experiments took place in the lab, but the team is confident the treatment could be trialled on humans within three years.

This time around, they used the same technology to remove it from infected T-cells, which play a major role in the immune system, in a more accurate simulation of how the virus would be treated inside patients’ bodies.

During their studies, the team drew blood from people living with HIV. Their T-cells were cultured in the lab, and then treated with the Crispr/Cas9 gene editing system, in which a targeted protein uses enzymes to remove genetic sequences (in this case, HIV DNA) from cells.

Their results definitively proved it is possible to eliminate the virus and prevent it from re-infecting cells using this treatment.

Gene editing is an important field for medical researchers, but there are fears that the process could have negative effects beyond the boundaries of the cells, resulting in further health problems.

However, using highly-detailed genome sequencing to analyse the treated cells, the scientists found they continued to grow and function normally, and didn’t appear to be suffering from any side-effects.

According to Kamel Khalili, the leader of the study: “The findings are important on multiple levels.”

“They demonstrate the effectiveness of our gene editing system in eliminating HIV from the DNA of T-cells and, by introducing mutations into the viral genome, permanently inactivating viral replication.”

Speaking to The Telegraph, Khalili said the study has “huge potential,” and added: “Based on the findings we should be entering into clincical trials within three years.”

A paper detailing their study has now been published in the high-profile Scientific Reports journal.

Independant | Doug Bolton @DougieBolton

Health Canada Approves HIV Drug as Pre-Exposure Preventative

March 1st, 2016 at 11:28 am


Health Canada has quietly approved an HIV drug as a preventative therapy to keep the virus at bay for people at high risk. Studies suggest that Truvada can cut the risk of HIV infection by 90 per cent, when taken before or after sex.

Gilead Sciences Canada, the makers of Truvada, say the federal agency approved the drug as a pre-exposure prophylaxis (PrEP). Doctors who run HIV/AIDS prevention clinics say the move is a leap forward in making therapy options more accessible.

“We should do everything in our power to enable the prevention of HIV, and that’s just the humane thing to do. It’s also the effective thing to do,” Dr. Isaac Bogoch, an infectious disease expert who runs one of Canada’s biggest HIV prevention clinics out of Toronto General Hospital, told Global News.

“I can’t tell you how happy I am. Now, we feel we have the blessing of Health Canada to do what we’ve been doing all along,” he said.

READ MORE: Pills before and after sex can help prevent HIV, study finds

Truvada is taken orally once per day. It contains two medications and it’s used as part of a drug cocktail regimen to treat HIV-positive cases. In this case, it’s being backed by Health Canada as a preventative measure.

If some patients are identified as “high risk,” they could use Truvada to stave off the virus. Those considered at high risk may have a partner who is HIV positive, or they could be engaging in “risky” behaviour such as unprotected sex with partners who may be exposed to HIV or sharing injection needles, Bogoch said.

It’s already been approved for PrEP in the United States as of 2012, as well as in Kenya and South Africa in 2015. It’s in the works in Australia, Brazil, Peru and Thailand, too.

READ MORE: HIV prevention drug approved in the US but not yet in Canada

Gilead Sciences told Global News last year that it applied for Truvada to be used as a prevention method in August 2015.

It was the first drug to be approved by the U.S. Food and Drug Administration to reduce the risk of HIV infection in high-risk populations. It’s also the first to receive the nod by Canadian officials.

“Multiple clinical trials have demonstrated that Truvada for PrEP is effective at reducing the risk of HIV infection acquired through sexual exposure,” Dr. Cecile Tremblay, of the University of Montreal’s department of microbiology, said in a statement.

“The number of new HIV infections in Canada has remained steady over the past several years and it is exciting to consider the potential impact of a new tool to help lower the rate of HIV infections in the future,” Tremplay explained.

READ MORE: Why the United Nations is adopting Canadian scientist’s HIV strategy

Right now, patients pay out of pocket or through private insurance for Truvada therapy, according to Dr. Jason Brunetta, who runs a prevention lab out of Maple Leaf Medical Clinic.

The drug comes with a hefty price tag – about $12,000 to $15,000 annually.

A Health Canada approval ushers in potential for provinces to provide funding to cover the drug.

“The official approval may improve access for patients. It may expand the reach and the availability of the drug,” Brunetta said.

READ MORE: A made-in-Canada health strategy is making waves worldwide – just not in Canada

There were about 2,570 new HIV infections reported in Canada in 2014, according to the Public Health Agency of Canada.

Canadian studies have suggested that Truvada taken daily as a precautionary measure could reduce the risk of HIV infection anywhere from 90 to 100 per cent.

“We know that if people are able to adhere with it pretty well, take their pill on most days, that it can achieve extremely high levels of protection, north of 95 per cent reduction in risk. One study even estimated something closer to 100 per cent reduction in risk,” Dr. Darrell Tan, an infectious disease physician, from St. Michael’s Hospital told Global News.

READ MORE: HIV isn’t easily transmitted by sex, Canadian doctors say

Past studies have looked at those who take a daily pill and what impact that daily dose has on prevention. Tan’s study, released last December, looked at what happened in high-risk populations that took the medication on an “on-demand” basis.

Participants took two pills hours or days before sex and two pills after, one at 24 hours and the next at 48.

The results suggested that those who took Truvada “on demand” were 86 per cent less likely to get infected.

How Far AIDS Has Come, How Far it Must Go to Get to Zero

February 17th, 2016 at 9:10 am


There is no story in global health as transformative, awe-inspiring, and yet as tragic as the AIDS pandemic. The disease was unknown only a generation ago — a medical curiosity among young gay men in New York and San Francisco in June 1981.

Within a few short years, AIDS could be found on every continent, enveloping the world to become one of the most devastating pandemics in human history. It has caused untold human suffering, social disintegration, and economic destruction.

In the early days of the pandemic, public health officials relied on prevention strategies devised for other sexually transmitted diseases. This includes testing, counselling, education, condoms and partner notification.

Newly diagnosed people had an average survival period of six to eight months. And their weakened immune systems made them vulnerable to rare cancers, pneumonias, chronic fatigue and horrific wasting until death ensued.

The early years of fear, pain and despair

The socio-political response was, at best, denial, ignorance, and silence. Ronald Reagan, US President at the time, did not utter the word “AIDS” in public until 1986. At worst, it was social marginalisation, discrimination, and punishment. People were blamed for their own suffering and criminalised for their behaviour. The fear, pain, and despair faced by people living with AIDS and their loved ones cannot be overstated.

But by 2010, UNAIDS announced a goal that was once unimaginable: getting to zero. Zero new infections, zero AIDS-related deaths and zero discrimination.

The 2012 International AIDS Conference was held in the US for the first time in 22 years because the US restricted entry of persons living with HIV between 1990 and 2011. At the conference, then Secretary of State Hillary Clinton called for an AIDS-free generation. To be sure, these high hopes provoked a skeptical response, with experts saying the goal was unrealistic and open-ended. What exactly is the definition of “zero” or “AIDS-free,” and which generation are we talking about?

But stepping back from perennial debates about aspiration tempered by realism, it is impossible not to marvel at the technological advances that enabled global health leaders to say the unthinkable: that we may one day see the end of the scourge of AIDS.

Powerful technological interventions

The technological advances that made all this possible include, first and foremost,antiretroviral treatments. A newly diagnosed 25-year-old today can expect to live another 50 years on treatment. But it also includes combination prevention, which extends well beyond traditional methods of testing, counselling, condoms and education. These do remain vital.

Research has shown remarkable reductions in HIV transmission from male circumcision, pre-exposure prophylaxis (PrEP), and antiretroviral therapy.

At the 2011 International AIDS Conference, scientists announced a jaw-dropping 95% plus reduction in sexual transmission among heterosexual couples adhering to antiretroviral treatment.

What if it were possible to reach every person at risk, or already infected, with these powerful interventions? What if the next discovery could empower women to protect themselves, such as with a vaginal microbicide, which is on the horizon? Given the political will, isn’t it imaginable that the international community could “get to zero”?

How did all these technological advances come about, and why did this particular disease forge a pathway toward unprecedented scientific discoveries? Very sadly, science has not been able to match these technological advances for most global health challenges. Not mental illness, cancer, or tuberculosis.

It has been said that these are all highly complex, multi-factorial diseases, while AIDS is not. But this is far from the truth.

Social mobilisation like never before

AIDS is one of the most complicated and stubbornly persistent diseases the world has ever known. Yet the sociopolitical dimension of AIDS has galvanised perhaps the greatest social mobilisation around a health crisis that the world has seen.

From the AIDS Coalition to Unleash Power (ACT UP) and Lambda Legal Defense in the US to the Treatment Action Campaign in South Africa, courageous individuals and organisations have literally transformed the politics of AIDS, turning neglect and derision into empowerment and social action.

This vast social mobilisation was targeted not only at fighting the social dimensions of this disease with poignant calls for dignity, nondiscrimination, and justice. It was perhaps principally about access to medicines.

AIDS campaigns had crisp clarity, appealing to a basic sense of social justice: the rich have access to life sustaining medicines while the poor do not. This message resonated in developed countries where the poor often were denied access to antiretroviral medication. But it also resonated in developing countries where most people could not afford a life-saving pill that the majority of those in the developed world could access.

The access-to-medicines campaigns brought AIDS advocates to pursue solutions beyond the health sector. Activists directly attacked the prevailing trade liberalisation paradigm, which protects intellectual property, and asserted the higher priority of the right to health.

In South Africa the TAC successfully challenged the government’s restrictions on access to perinatal treatment before the Constitutional Court. At the international level, the AIDS movement energised the World Health Organisation to take access to medicines seriously. This prompted campaigns such as the World Health Organisation’s 3 by 5 initiative. It forced the World Trade Organisation to change course, introducing Doha Declaration flexibilities to soften a harsh intellectual property regime.

A global effort

This social mobilisation also unleashed unprecedented resources in global health — new funding for biomedical research, vaccines, and treatment. Moreover, social mobilisation around AIDS literally transformed global health governance. It fundamentally altered the foreign assistance of the most powerful countries. For example PEPFAR in the United States, and UNITAID, formed by Brazil, Chile, France, Norway, and the United Kingdom.

For the first time, the major powers began to frame an infectious disease as a national security threat, addressed at the highest political levels at the G8. Social mobilisation drove the United Nations’ response, prompting the first high-level summit ever held on a health issue to be devoted to AIDS.

A novel public-private-partnership emerged, outside the UN/WHO structure, to generate and pool resources — the Global Fund to Fight AIDS, Tuberculosis and Malaria.

Although the international community has rallied to fight AIDS, fierce debates have raged within the movement. Initially, advocates worried that traditional public health strategies such as testing and reporting would undermine privacy or foster discrimination. At the same time, policy makers debated which interventions — and in what combination — were most effective. And then there was the divisive issue of cost-effectiveness. Could governments afford expensive interventions such as lifetime treatment with antiretrovirals?

If not, how could the benefits be fairly allocated among the large population of persons at risk or living with HIV? And should the same level of resources devoted to AIDS be made equally available for other pressing health conditions, such as child/maternal health, injuries, or non-communicable diseases?

These battles ensued within both domestic health sectors and foreign health assistance budget debates. They remain topics of lively debate.

*This is the first of three articles drawn from the book Global Health Law, released by Professor Lawrence Gostin.

The Conversation

Lawrence O. Gostin, Prof. Global Health & Dir. O’Neill Institute, Georgetown University

This article was originally published on The Conversation. Read the original article.