Northern advocates say new HIV guidelines a win

Northern advocates for people with HIV and people in theLGBT community are applauding changes to how HIV-positive people in the territoriesare treated by the law.

In Canada, it's illegal to have sex with someone and not tell them if you have HIV, if the sex acts pose a realistic possibility of passing on the virus. But on Dec. 1, World AIDS Day, Canada's attorney general announced more precisestandards for what's considered a realistic risk.

• Justice Department issues new guidelines on prosecution for non-disclosure of HIV status

The directive, which guides prosecutors, states charges won't be pursued in cases where the person has maintained a suppressed viral load.Scientific evidence showspeople who take their medications regularly they may be able to keep the traces of the virus so low in their blood that it becomes undetectable, and people with these extremely low viral loads don't have a realistic possibility of transmitting the virus to others.

The directive also notes non-disclosure before oral sex or sex with condoms shouldn't lead to prosecution, unless there are other risk factors. And it encourages prosecutors to consider whether it's in the public interest to prosecute.

In the southern Canada, Crown attorneys respond to their own provincial attorneys general. So this directive for federal Crown attorneys only affects the territories, where rates of HIV transmission are relatively low.

Patricia Bacon, executive director of the Whitehorse street outreach group Blood Ties, says the announcement is a win.

"We sort of put [HIV] in this realm of nefarious criminality," she said.

Bacon believes the new directive will reduce the stigma around testing and getting treatment for HIV. It will combat "the idea people with HIV deserve what they get," she said.

In the Northwest Territories, spokespeople for sex-ed groups FOXY, SMASH and the Rainbow Coalition also said the move would help open up difficult conversations about HIV.

Nunavut did not share the numbers of HIV cases for this story, citing privacy reasons.

In Yukon, sevencases of HIV were reported between 2010 and 2014. Between 2001 and 2014, rates of HIV in that territoryremained stable with zero to three new cases announced a year.

The Northwest Territories shared the most details.

Fewer than 35 N.W.T. residentsare living with HIV today, said health department spokesperson Damien Healy. That means HIV prevalence in the N.W.T. is 73 per 100,000 population. For people in Canada, that rate is higher 173 per 100,000 people living in Canada, according to 2016 numbers from advocacy group Community AIDS Treatment Information Exchange.

Between 2001 and 2017, the number of cases reported in any given year ranged from zero to five in the N.W.T.

Outbreak possible in the N.W.T., says expert

Carmen Logie, an adjunct scientist at Women's College Research Institute who has done research on the N.W.T. with sexual education groupsFOXY and SMASH, told CBC the move makes northern public health providers better equipped to respond if a future outbreak occurs.

"We're just waiting for a possible epidemic in the North," she said.

Other sexually-transmitted infections, like chlamydia and gonorrhea, are prevalent in the North, and can increase susceptibility to the virus.

Food insecurity can make it difficult for people to take medications that can be hard on their bodies. Close-knit sexual networks can allow a virus to be passed on to several people. And for people in poverty or without stable housing, stress can limit the efficacy of medications meant to keep the virus undetectable.

It can also be difficult to ascertain exactly how many people in the North have HIV, because people who do get the virus may move south for testing and treatment for better care and to avoid shame.

Relevant case in the North

A criminal case around HIV non-disclosure went through a Northerncourtin the early 2010s.

In 2011, Bobby Kaotalok was accused of having sex with multiple women in Yellowknife with whom he did not disclose his HIV-positive status.

• HIV-positive man sentenced for aggravated sexual assault

He pled guilty and was sentenced in 2013 for two counts of aggravated sexual assault. Crown prosecutors did not respond on Friday whether under the new guidelines he may have received fewer or less serious charges.

Kaolatok is once again facing a charge for aggravated sexual assault. His attorney, Jay Bran declined comment on the case.