Yes.
Evidence of meeting #139 for Health in the 42nd Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was testing.
A recording is available from Parliament.
Evidence of meeting #139 for Health in the 42nd Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was testing.
A recording is available from Parliament.
April 11th, 2019 / 4:15 p.m.
Executive Director, Gilbert Centre for Social and Support Services
Remember, I mentioned that those who were in their teens, as I was, when homosexuality was decriminalized in 1969 have a different life experience with regard to sexual orientation and gender identity. We grew up in a time when homosexuality was criminalized. That life experience at that age impacts a lifetime. It just doesn't go away.
There's a history of discrimination, exclusion and fear of stigmatization. Not all seniors wish to be open or to be included in the LGBTQ community. The effects of past discrimination can contribute to the invisibility of seniors. Many seniors have grown older convinced that it's better to keep their sexual orientation a secret. Even heterosexual men and women moving into long-term care facilities are often separated. Husbands and wives are kept in different rooms. Gay men, couples going in, are not given the same room and are not given the same courtesies of conjugal relationships that maybe heterosexual couples have. That's an issue—
4:15 p.m.
Liberal
4:15 p.m.
Executive Director, Gilbert Centre for Social and Support Services
Well, seniors don't tend to go that route. They've just been so accustomed.... In a lot of cases, too, that senior care within long-term care is difficult to come by, at least in our area. When you can get a long-term care home, you try to keep your mouth shut if it means keeping your mouth shut about your sexual orientation.
4:15 p.m.
Liberal
4:15 p.m.
Liberal
4:15 p.m.
Conservative
Marilyn Gladu Conservative Sarnia—Lambton, ON
I'm going to start with you, Mr. Gilbert. I'm very interested in your comments about testing.
Can you tell me what kinds of testing protocols we should have in place? Give me an idea of how much the equipment costs and how you would see that implemented if you could wave your wand across the country.
4:15 p.m.
Medical Director, Clinical Prevention Services, BC Centre for Disease Control
That's a great question.
Generally when I think about advances in testing and how we can harness new approaches, they fall into two camps for me.
One is around ways of streamlining access to existing testing, such as, for example, the program we have with Internet-based testing. Or now, increasingly, we see people who have fast routes to testing. You come in and you can be triaged, if you don't have any problems, to get a simple screening. Those are the things that don't make use of new test technologies per se. They're just different ways of making testing easier.
When it comes to test products, each of those has an associated cost. They vary between products. They can be anywhere in the order of $10 to $20 or higher. Those tests are usually screening tests. They are usually the first test in a testing process, which means that you need to do a confirmatory test as well.
I think the issue around point-of-care tests is that it's not just the cost of the test. You obviously need to have a whole wrap of things that go along with that point-of-care test. For example, you need quality assurance programs, training programs and resources around their delivery. It requires investing much more than just the cost of the test.
Really, I think, this is increasingly where we're going in the future. I'd say that probably over the next 10 years or so we're going to start seeing rapid genetic or molecular tests for HIV, other viruses and sexually transmitted infections, which can be done at the bedside or in a clinic or in non-traditional settings. Increasingly, I think, we're getting more tools, so we want to make sure that for Canada we're able to really take advantage of those news tools as they emerge.
4:20 p.m.
Conservative
Marilyn Gladu Conservative Sarnia—Lambton, ON
Okay. Very good.
Dr. Moore, you were talking about how in B.C. they provide PrEP without charge. Do you have a sense of what the overall cost of that program is? There are about 4,000 people in it, I think you said.
4:20 p.m.
Research Scientist, Epidemiology and Population Health Program, British Columbia Centre for Excellence in HIV/AIDS
Yes. I'm afraid that I don't actually know the overall cost of that, but one thing that's important to note is that one of the issues that makes this affordable now is in terms of the patent on the two drugs that are actually used for PrEP. One of them was already available as a generic formulation, but the patent on tenofovir actually ran out a year and a half ago.
Now, we're actually able to use generic antiretroviral medications not just for PrEP but also for HIV treatment. The costs of these medications have dropped dramatically. It really makes PrEP a much more financially feasible program now.
4:20 p.m.
Conservative
Marilyn Gladu Conservative Sarnia—Lambton, ON
Do people get it at the pharmacy or at a clinic, or where can they access it?
4:20 p.m.
Research Scientist, Epidemiology and Population Health Program, British Columbia Centre for Excellence in HIV/AIDS
Like antiretrovirals for HIV treatment in British Columbia, all of the medications are purchased centrally through the Centre for Excellence in HIV/AIDS. Then they are distributed to different regions around the province. Typically they can be delivered to specific pharmacies, and certainly that's the case for HIV treatment. We're still sort of working on that for PrEP. The default thing is that if somebody is in a location where the pharmacy isn't willing or able to receive PrEP medication from the centre for excellence, it can actually be couriered to their doctor's office so that they can receive it directly there.
4:20 p.m.
Conservative
Marilyn Gladu Conservative Sarnia—Lambton, ON
Okay, excellent. Thank you.
Now I'll turn to Gary from the Canadian AIDS Society.
In your comments, it sounded to me that funding to your agency was cut under this government. Was it?
4:20 p.m.
Executive Director, Canadian AIDS Society
For the federal community-based organizations or the NGOs, the funding shifted, so instead of nine organizations being funded, there were 17. There were three of us that were cut out, and a lot of other organizations. The contribution went down. We were not successful in gaining any funding. We just find that the funding envelope has not increased since 2008. The Liberal government had guaranteed that this funding envelope would go up, and it didn't. So that's what we're ticked off about, let's say. It would allow for a broader offer of services to people living with HIV across the country, because we have to remember that HIV is the only STBBI that does not have a cure. The rest of STBBIs do have a cure, and the exceptionalism should stay there.
4:20 p.m.
Conservative
Marilyn Gladu Conservative Sarnia—Lambton, ON
What is the actual tangible result of not receiving the funding for your organization?
4:20 p.m.
Executive Director, Canadian AIDS Society
For us, we survive. That's great. We have other programs that compensate for the loss of funding from the federal government.
Tangibly, there are resources that were more centred on a community approach that aren't produced anymore. Our national HIV/AIDS walk was cancelled because of funding cuts there and other opportunities that were cut. There's a lot of awareness that came from community, and that's cut out of the landscape completely, and this government does not believe in awareness. So that's something that is there. But overall, I would think that we also have to understand that the landscape for philanthropy is that philanthropists don't want to spend money on things that the government should be paying for.
4:25 p.m.
Executive Director, Canadian AIDS Society
That's a huge roadblock for our organizations.
4:25 p.m.
Conservative
Marilyn Gladu Conservative Sarnia—Lambton, ON
All right.
Now I'll turn to Gerry.
When you're talking about people trying to access a gay doctor, I know there is a doctor shortage across the country that's gone unaddressed, so I can only imagine that it must be even more difficult. Do you have a sense of the availability of gay doctors or clinics across the country where people could be received?
