A few weeks ago, we had a workshop on diabetes here at Positive Women’s Network. Sandra from Vancouver Native Health Society, who coordinates the ADAPT (Aboriginal Diabetes Awareness Prevention and Teaching) program, came over to field questions about diabetes. PWN members had a lot of to ask about diabetes prevention for their children and themselves. Some women already have diabetes and wanted to know how to slow down the disease.

Diabetes = Blood Syrup

Diabetes, Sandra explained, is caused by an excess of sugar in the blood, which creates a syrup that damages small blood vessels. This’s why unchecked diabetes can lead to numbness or tingling in the feet, blurry vision or blindness, kidney problems, amputations, nerve damage, and sexual dysfunction.

Who’s At Risk? More Than You Think

Diabetes rates in the Aboriginal community are three to five times the national rate, and they’re also higher for Black, Southeast Asian, and Latin populations. Heart disease, Sandra said, “goes hand in hand with diabetes.” Smoking, being overweight, and having high blood pressure are risk factors. Those over 40 years are also more at risk for diabetes.

That was all straightforward to me. Then I learned that certain anti-psychotic medications and particular HIV medications (the ones that lead to extra fat around the middle), as well as schizophrenia, can put a person at risk. So can gestational diabetes or having a baby over 9 pounds.

Signs and Symptoms

Increased urination. Increased thirst. Tiredness. Weight loss.

Easy Nutrition Tips

How to prevent and manage diabetes? The answer of course is exercise and above all nutritious eating. In the past, some doctors had urged people with HIV to eat high-calorie foods and pack on weight. But with advances in treatment, and the general health that people with HIV can now attain, that’s not necessary and in fact can put people with HIV at risk for diabetes.

Sandra suggested eating every four to six hours, to keep the body’s metabolism working. She explained that the body digests different types of food at different rates, so it’s best to eat a variety of food types in a meal. And what should we be eating the most of? Veggies! Here’s a formula that’s easy to remember: Half your plate should be made up of vegetables. One quarter should be starch (the size of your fist) and one quarter should be protein (the size of your palm).

And stay away from the juice. A glass of juice, Sandra said, is equivalent to consuming several pieces of fruit, which means you’re getting a load of sugar but none of the fibre.

And what about treats that contain sugar substitutes? Diet soda? Are those okay?

No way. According to Sandra, sugar substitutes actually confuse the body and mess up its metabolism. Unfortunately, she said, “there’s no such thing as diet junk.”

- Erin

Earlier this week on my You Should Know Twitter feed, someone sent me a link reporting the results of a court case in the US-  a wrestler who knew his positive HIV status but didn’t disclose it to multiple sex partners that followed, putting them at risk for HIV infection. His defense was that he was a sex addict and couldn’t help himself.  Oh boy.

The question of sex addiction aside, let’s talk about the man’s failure to disclose his HIV status. This is a much debated topic in many fields these days- the law (obviously), public health, human rights, HIV prevention and education, health care, you name it. The Canadian HIV/AIDS Legal Network has some great information on the issues, and I’d urge readers to check it out. In particular, I’d urge you to look at their recent brief on an upcoming Supreme Court case.  Two important cases will be tried. 

Here at Positive Women’s Network the question of HIV and criminalization often comes up. We work with women who are infected with HIV, many of whom had no idea their sex partner had HIV. We’ve supported women going through legal proceedings where they are giving evidence against former partners that infected them. We’ve also supported women who themselves have been accused of non-disclosure. Our goal of supporting all women with HIV demands that we look at the issue of criminalization. We’ve been asked to develop policy that could be used by other organizations, as we’re one of only two organizations in Canada that focuses on women and HIV exclusively.

We’ve witnessed the pain and suffering for women on both sides of the criminalization fence.  To provide the most comprehensive support we can, here’s what we’ve come to about the issue at present.

There is no evidence that criminal law is effective at preventing HIV transmission.  People’s sexual decisions are dynamic, intimate and often spontaneous. Criminal laws and convictions haven’t changed that. For women in situations of abuse, coercion or assault, decisions can be about reducing harm, not enhancing it. (One of the cases to be heard February 8 involves a woman and her abusive former partner).

Criminalization may actually drive people away from public health initiatives like testing, counselling, and support. In this US case, the man knew he had HIV, but admits that he didn’t talk about it as he didn’t want his family to know. Why? Probably because HIV is still a highly stigmatized, misunderstood disease.  People with HIV often experience discrimination- even in this day and age when prevention, treatment and education are available.Criminalization can add to this, not diminish it. 

Criminalization gives people a false sense of security.  The idea that “he (or she) would tell me if they had HIV because the law says so” is obviously not the case.

We feel that a public policy response and public health laws are preferable to criminal law. How do we support people with HIV, and all people, to have comprehensive sex education and unbiased HIV prevention information?  How do we support people to gain the power to act on their knowledge and look after their sexual health? How do we address gender and relationship inequality to make this possible?

These are big issues and big challenges.

Their resolution isn’t likely found in a courtroom.

-  Janet

  Photo: IStock