Rising rates of HIV infection in northern Saskatchewan do not appear to be spreading to northern Manitoba, but the latter region’s medical officer of health is closely monitoring the situation.
As of 2013, northern Saskatchewan was reporting about 12 to 24 new cases of HIV a year, according to data provided by northern health regions, with rates on the province’s reserves particularly worrisome.
Dr. Michael Isaac, medical officer of health for Manitoba’s Northern Health Region, said data to date suggests the trend is not replicating in northern Manitoba.
“We actually don’t have a lot of HIV cases close to the Saskatchewan border,” he said. “In terms of it being a concern, I think it’s something that we really want to keep a close eye on because we do know that there’s a fair amount of HIV in northern Saskatchewan. The border is a political one – it doesn’t necessarily stop communicable disease, so we need to keep that in mind.”
Isaac said the most common ways people become infected with HIV differs between the two provinces.
In Saskatchewan – the entire province, not just the North – the leading mode of transmission is intravenous drug use, he said.
In Manitoba, sexual activity – gay sex for men and heterosexual sex for women – is the most common mode, with drug use further down the list, Isaac said.
According to tentative data, one person was diagnosed with HIV in Manitoba’s Northern Health Region in 2014. Confirmed data shows the region had an abnormally high number of infections, 11, in 2013.
Isaac said that over the past 14 years there has been “perhaps a slight increase” in HIV diagnoses in northern Manitoba, but it’s difficult to say because the numbers are so small.
What is apparent, he said, is that Manitoba is experiencing a shift toward more HIV cases in rural parts of the province. Historically HIV in Manitoba has been a predominantly urban infection.
“I think it’s probably a combination of things,” Isaac said. “I don’t know if you can pin it down to one thing. We have a lot of people that are transient or move between the city and rural areas, so they may go to Winnipeg and either have sex or inject IV drugs in Winnipeg and then bring it back to their home region.
“In some cases [transmission] is [happening in the northern region], but not all the time. I think probably what’s happened over time is we’ve had a reservoir of HIV that’s now spreading out into rural areas and we’re seeing more now in rural areas.”
Asked whether this trend is significant enough to warrant concern, Isaac said it certainly deserves attention, as does the matter of ensuring rural Manitobans with HIV receive proper care.
“It can be tricky to provide adequate care for individuals with HIV when they’re living in really geographically isolated locations,” he said.
Isaac said efforts are being made to improve care for those individuals, who currently work with public health nurses to connect with the province’s Winnipeg-based HIV Program.
Between 1985, the year records began, and 2013, a total of 59 people were diagnosed with HIV in northern Manitoba.
In Saskatchewan, the word “epidemic” has been used to describe HIV rates on First Nations communities in both the northern and southern parts of the province.
An online CBC report published last month showed that in 2012 Saskatchewan reserves had an HIV infection rate of 63.6 per 100,000 people – almost 11 times the national rate from 2013.
A separate CBC report noted the HIV rate in Prince Albert, Saskatchewan, which is not a reserve, is 3.5 times higher than the national rate.
Even with available data, it is impossible to determine how many people in a region have HIV since someone can be diagnosed in one health region and move to another.
Then there’s the fact that about 25 per cent of Canadians with HIV do not know they have it, according to a Public Health Agency of Canada estimate.
HIV can be spread through sexual activity or through the sharing or needles and other drug paraphernalia that has had contact with blood, even if blood is not visible to the naked eye.
Residents who wish to be tested for HIV may consult their doctor or the Primary Health Care Centre.
