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  • Bill C-2’s Roadblocks to Health Care

    March 27th, 2015

    By Janet Madsen  |  @janet_madsen

    How lucky we are in Vancouver- for the moment. On Wednesday the federal government ruled that Insite, the supervised injection site in the Downtown Eastside, could stay open. Insite’s dedicated staff have saved people from overdose deaths and helped others into treatment to deal with their addiction. But luck could be running out for Insite and is certainly not shining on other communities across Canada that could really benefit from similar services. syringe

    On Monday the House of Commons passed Bill C-2, also known as the Respect for Communities Act, a title Pivot Legal Society’s Adrienne Smith calls “cruelly ironic.” Smith says that Bill C-2 “could make it much harder for Insite to stay open, and it effectively prevents a similar health service from opening in any other Canadian city.” Many in the community will remember that the Conservative government’s fight against Insite went all the way to the Supreme Court of Canada. The 2011 result had the Supreme Court deciding unanimously in favour of Insite remaining open because not allowing the clinic to operate would be a violation of the Charter of Rights and Freedoms.

    Bill C-2 sets up serious roadblocks to establishing similar health services. “Bill C-2 undermines the rights of people who use drugs to access lifesaving and health-protecting services” says a 2014 background document from the Canadian HIV/AIDS Legal Network.  A piece from the Canadian Medical Association suggests “The legislation’s language appears to contravene the direction of a 2011 decision from the Supreme Court of Canada that upheld Insite’s exemption.” Smith’s blog for Pivot Legal Society echoes that: “What the Harper government is trying to do is wrong. It is also unconstitutional.”

    An article from last fall rightly identifies the government’s conflict between ideology, science and public health. Peer-reviewed research on Insite’s programs and impact on community show it works to improve community wellness and reduce risks. It is a form of health care delivered to vulnerable and stigmatized people.

    Perhaps Bill C-2 won’t get passed at its final hurdle, the Senate. If it does, it will be an uphill if not impossible battle for many communities to deliver care their citizens sorely need. The battle isn’t over.

     

     Photo: Alvimann, MorgueFile

    Self-stigma requires a personal approach

    March 20th, 2015

    by Erin Seatter | @erinlynds

    People living with HIV stigmatize themselves more than the outside world does, and there isn’t enough research looking at how to deal with this. On that basis, researchers interviewed a small group of people with HIV in Ireland for a study published last week in Swiss Medical Weekly.

    ShadowPeople with more self-stigma are less likely to disclose their status due to fears of rejection and betrayal. But the study revealed that avoidance of disclosure can also lead to isolation; participants described withdrawing from their social lives or feeling like they led a secretive life in the outside world. This sense of isolation extended to intimate parts of their lives as well, as they talked about not being able to have normal sexual relationships or enjoy sex. They also said that having HIV made them feel they couldn’t have kids, find a life partner, secure employment, or travel.

    What does self-stigma do for a person? The study showed that self-stigma preserves a personal sense of victimhood, protects against hurt from others, and justifies avoidance of disclosure.

    The participant’ coping strategies combatted all of these functions of self-stigma by providing a sense of agency, increasing social engagement, and encouraging connection with other people living with HIV. Getting involved in community (whether through schooling, employment, or volunteering), working on personal development, and connecting to others are ways to address feelings of loneliness and lack of agency. Participants shared the importance of having a space for people with HIV, where they could access support and find a sense of belonging with a community they would not have known without their HIV+ status.

    Given the individual experience of self-stigma, the researchers argue that a general program would not be appropriate. Instead, direct work with people is required to provide them with “the mental tools and strategies to mitigate self-stigma” and build a sense of their personal worth.