The Nova Scotia Department of Health sent out an urgent advisory July 13 to primary care physicians, nurses, and emergency rooms throughout the area, warning of an uptick in new HIV cases. The memo said that the department is "closely monitoring the situation and has enhanced follow up and case finding efforts." The advisory is working, because it has already prompted immediate changes in the way the province handles HIV.
During the first six months of 2018, 16 new HIV diagnoses in the province were recorded — double the normal annual rate typically seen in Nova Scotia. Local health institutions are rightfully concerned about what it means for the future of men and women’s health in the area.
If the trend remains consistent, it could have bad consequences. "The concern is that we've already reached what we'd expect for an entire year after six months," Dr. Trevor Arnason, medical officer of health with the Nova Scotia Health Authority, toldThe Canadian Press. "We're heading towards a doubling of the number of reports over the year." According to Arnason, the province usually sees between 15 and 17 new cases of HIV infection each year, not within the first six months.
Per the advisory, up to 90 percent of people living with HIV will develop a fever within four to eight weeks after exposure to the virus. As most anyone who is HIV-positive will tell you, it is most often written off as a common flu, and they symptoms of the initial attack subside within the period of a day or two.
There are several ways of dealing with the problem. Some solutions have been presented, such as funding PrEP. The provinces of British Columbia, Quebec, Ontario, and Saskatchewan already publicly fund PrEP. Days after news broke of rising HIV rates in Nova Scotia, efforts are underway in Nova Scotia to expand access of PrEP to those who are at a high risk of HIV.
Announced on July 20, the provincial Pharmacare program of Nova Scotia will begin covering PrEP to do its part to combat the rising rates of HIV. The coverage begins July 23.
Dr. Robert Strang is the chief medical officer of health for Nova Scotia. "There is now clear evidence on the effectiveness of PrEP in preventing HIV. Any steps that increase access to PrEP are important contributions to reducing the impact HIV has on individuals, communities and our health care system," he said in a media release.
Proponents pointed out that the alternative is the cost of taking care of an individual living with HIV—approximately $1.3 million, and that’s a conservative estimate. In contrast, a year’s supply of PrEP is about $3,000.
Not everyone is convinced that providing access to PrEP will solve everything. “The reality of this measure is, in public health outcomes in the coming months, it will have very little impact on HIV cases,” said Matthew Numer, assistant professor in the School of Health and Human Performance at Dalhousie University in Halifax.
It’s comforting, however, to know that the provincial Pharmacare program has been modified to include coverage for PrEP in an effort to curb the rising HIV rates seen in Nova Scotia.