Development of state and local plans to End the epidemic
Abstract Format : Saskatoon, Saskatchewan is in the midst of an anomalous and critical human immunodeficiency virus (HIV) crisis with an incidence rate twice the national average. The aim of this research was first to formalize common knowledge about injection drug use in the city, and secondly to gather data from harm reduction experts on the best way to proactively and reactively reduce the spread of HIV in Saskatoon’s population of people who inject drugs (PWID).
Methods : Four, one-hour, semi-structured interviews with purposefully sampled HIV and addictions service providers were conducted. Demographics of participants included; two managers and two service providers, two men and two women, and one indigenous person. Interviews were recorded, transcribed, and analyzed using interpretive description methods.
Results : Crystal methamphetamine is the most commonly used drug in Saskatoon’s population of PWID. Public health implications include high rates of HIV transmission, death from opportunistic infections, and high monetary costs associated with healthcare disengagement. While there are many services available for PWID, many barriers to access exist. These barriers include: lack of programming for stimulant use, discrimination in healthcare institutions, and lack of appropriate supports due to over-capacitated support workers. Suggestions to reduce the spread of HIV include: creating more streamlined care with more points of access including safe consumption sites, longer residential treatment programs that are culturally and trauma-informed, more involvement of PWID peers, and more education for the public, PWID, and healthcare workers.
Conclusions : While minor differences in opinion exist on the implementation of strategies, all interview subjects agreed that harm reduction measures are critical to reducing the spread of HIV in Saskatoon. Further interviews with service users about the best steps moving forward will strengthen the conclusions drawn from this study; this data can inform policy makers and service providers about what services would be the most effective in combating this epidemic.