Pubdate: Mon, 17 May, 1999 Source: Vancouver Sun (Canada) Copyright: The Vancouver Sun 1999 Contact: http://www.vancouversun.com/ Author: Ian Bailey HEALTH CANADA SAW VANCOUVER SKID ROW HIV CRISIS AS A TEST: DOCUMENT VANCOUVER (CP) - Health Canada saw the disturbing spread of HIV among injection drug users in Vancouver's skid row as a test of its ability to fight similar outbreaks it expected in other Canadian cities, a report suggests. As the federal health department rallied other federal agencies to deal with the situation in early 1998, department officials in B.C. hoped their work would yield relevant lessons, suggests a document obtained by The Canadian Press through federal access to information legislation. "It is believed that our success developing a comprehensive model of intervention for interrupting the HIV epidemic among injection drug users in the (downtown eastside) would be of great importance in preventing similar crises, which are looming in other major urban centres in Canada," said the January, 1998 memo. Vancouver has become notorious among HIV experts because of its gritty downtown eastside neighbourhood - a poverty-stricken, high-crime quarter of the city that is home to hundreds of addicts. Estimates vary, but many addicts in the tough neighbourhood are thought to be infected with HIV acquired by shooting up cocaine and heroin with contaminated needles. "We have always thought that what is going on in Vancouver, when documented, will be very useful for other regions in terms of what worked and what didn't work," said Lisa Mattar, manager of Health Canada's Office of Alcohol, Drugs and Dependency Issues. The 1998 Health Canada memo, prepared to bring 11 other departments up to speed on the issue, does not list other urban centres where the problem is said to be looming. But Dr. Don Sutherland of Health Canada's Laboratory Centre for Disease Control offered some examples in an interview. "You have some cities that have got the lid on the epidemic and other cities where it's not under control - Ottawa, Quebec City and in Montreal," he said. "I think other cities in Canada need to be paying a lot of attention to what is happening in Vancouver." Downtown eastside advocates have been expressing their concerns about the issue in Vancouver since the early 1990s. But Sutherland suggested new infections among addicts may be greater in Montreal than Vancouver. Toronto figures for 1998 were not immediately available. Some have said infections of Vancouver addicts have hit a saturation point. But Health Canada officials are especially concerned about the spread of a practise focused on the downtown eastside. Addicts are switching from injecting heroin to injecting cocaine, said Elaine Scott, a regional Health Canada director. Cocaine use tends to be more frenzied than heroin, with addicts shooting up to 20 times a day at a rate that causes many to ignore safety rules about using clean, unused needles to avoid being infected with HIV. One 1998 report by a coalition of Canadian addiction experts notes that the troublesome heroin-cocaine mix has become the "dominant pattern" of drug use in Vancouver which could spread to other cities. "Is there another city that has exactly the same problem as Vancouver? The simple answer is No," said Scott. "But we did know there were certain practises that were beginning to move east." In Vancouver, Health Canada has put up $1 million for a drop-in centre and housing. It is also negotiating with Vancouver and the B.C. government on an Urban Development Agreement that would yield more money for other programs. Some have described the response as inadequate. "It's a drop in the bucket," said eastside spokesman John Turvey, head of the Downtown Eastside Youth Activities Society. But a May 1999 update from Sutherland's department provides a blunt reason for all Canadians to care about infected addicts in Vancouver and elsewhere. The report notes that the virus that causes AIDS can creep beyond addicts because drug users travel, socialize with non-addicts and have sex with them. It's a situation "that ultimately affects all of Canadian society," says the report. "It's certainly going to part of the insidious way in which this virus spreads," said Sutherland. "People should be aware that the edges of the epidemic are not always so easy to detect." - --- MAP posted-by: Ken Russell