Londoners take a step towards supervised injection services

published on February 10, 2017 by Chris Montanini in Strathroyagedispatch

London broke a record in 2016: the Middlesex-London Health Unit confirmed 58 new cases of HIV, the most ever reported in one year.

About 70 per cent of those cases, according to the Health Unit, are due to injection drug use at a time when HIV rates are declining elsewhere across Ontario.

The provincial rate of new HIV cases in 2016 “” which has been pretty steady over the past three years “” was 5.2 for every 100,000 people, numbers the Health Unit pulled from the Public Health Ontario Infectious Disease Query. In Middlesex-London, the ratio last year was 12.2 cases per 100,000.

The region’s rate was as low as 4.5 cases per 100,000 in 2008 but it has steadily increased since 2009. The Health Unit raised concerns on World AIDS Day last December before Gayane Hovhannisyan, London’s associate medical officer of health, described the problem again at a news conference February 8.

New HIV cases aren’t the only issue. Hovhannisyan also said 231 new hepatitis C cases were reported in Middlesex-London last year, or 48.7 per 100,000 people. The provincial rate in 2016 was 30.3 per 100,000.

“Hepatitis C is also an important indicator of unsafe injection practices because it’s easily transmissible and, usually, people get (hepatitis C) before they get HIV,” Hovhannisyan said. “Unfortunately it doesn’t get a lot of attention, however it’s quite significant as we have seen increasing hepatitis C in our community.”

The same can be said about invasive group A streptococcal disease, another type of infection on the rise in London. The Health Unit counted 18 new cases in 2015 and 60 in 2016, an increase Hovhannisyan described as “unprecedented.”

Of course, unreported cases of these infections are missing from the numbers.

“We often get questions about what’s the size of the injection drug use population (in Middlesex-London),” Hovhannisyan said. “The short answer is, we don’t know.”

This is the local context behind a feasibility study of supervised injection services in London by the Ontario Treatment Network and Regional HIV/AIDS Connection. Following Hovhannisyan, principal investigator Thomas Kerr, also the co-director of the Urban Health Research Initiative at the BC Centre for Excellence in HIV/AIDS, presented the study’s results at the February 8 news conference and made a compelling argument for supervised injection services in London.

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