Health Committee on April 30th, 2019

[Jody Jollimore]

You can't get them here. It's my understanding that there are a couple of obstacles. One is the market. The companies behind it don't necessarily see it as marketable option to go through the regulatory regime in Canada. The federal government could expedite that regulatory regime, and some of these tests are actually being made in Canada. The company is in Richmond, British Columbia. They're making instant tests, and they're not being sold in Canada. They're selling them around the world, so there's also a little bit of an economic issue here where we could be supporting homegrown businesses to do more of that.

[Don Davies, NDP, Vancouver Kingsway, BC]

We hear of stigma, stigma, stigma all the time, and it's obviously a huge issue. You went through some of the federal government's—maybe I can put it this way—“contributions to stigma”. We know about the Criminal Code, the criminalization of HIV disclosure and other things, but one thing that was not mentioned is the continued ban on men who have sex with men from contributing blood. I've heard enough evidence at this point to come to my opinion that there is no scientific basis for that. In fact, to make a discriminatory assumption that a gay man is engaging in high-risk sex activities when, with a heterosexual man, that assumption is not made shows the absurdity of that, yet this government still has a one-year ban precluding men who have sex with men from donating blood.

Is that not a form of federal stigma that we could easily remove, particularly if it has no scientific basis? How does it impact gay men? Does that affect them? How do they feel about that ban?

[Jody Jollimore]

The data has not yet been made available, but it should be within a couple of weeks. It was a major part of our last Sex Now survey, which was actually funded by Canadian Blood Services to study just this question. I can tell you, without giving away anything, that overwhelmingly gay men are against this policy and feel that they should be able to donate blood as others do, and that will be witnessed in the data.

To say that there's no evidence for this is not accurate. There's certainly prevalence. I mentioned that they are 131 times more likely to have HIV, so there was a reason, particularly with the blood scare and whatnot. Is there evidence today? Probably not, but we need a better solution. My issue with this—and I probably would be going against some of my colleagues on this—is that I don't think it's a political issue. I actually don't want you all deciding who gets to donate blood and who doesn't. I'd rather the professionals at Canadian Blood Services make those decisions. While I think it's important that we move towards a non-discriminatory policy—and certainly I think that looks like a gender-blind, behaviour-based screening model—I wouldn't want to see that imposed as a political decision. I think that needs to remain a public health decision.

[The Chair, Liberal, Bill Casey]

The time's up.

I've been giving blood all my life. I went to give blood a little while ago and they said “You can't give blood. You're too old”, so there you go. I don't know if they've changed that or not, but they said they wouldn't take my blood, and my blood's good.

Mr. Ouellette.

[Robert-Falcon Ouellette, Liberal, Winnipeg Centre, MB]

I want to thank everyone for joining us today.

I have a few specific questions that may help to enlighten our analysts.

What's online mapping? Can you explain how this educational tool would work?

[Gabriel Girard]

We want to develop this tool for LGBT people, and MSM in particular, since we mainly work with that community. The tool would give them access, through a website, to a map of the points of service for LGBT people. This would provide a list of services for members of the LGBT community.

[Robert-Falcon Ouellette, Liberal, Winnipeg Centre, MB]

Does this tool exist?

[Gabriel Girard]

It doesn't exist. We currently have directories. Several community organizations have resources, but the resources are often made up of various pieces of information in our possession. We want to systematize the information and make it available to a broader public so that people can access the information more easily.

[Robert-Falcon Ouellette, Liberal, Winnipeg Centre, MB]

Should this tool also be available in English?

[Gabriel Girard]

Absolutely, yes.

[Robert-Falcon Ouellette, Liberal, Winnipeg Centre, MB]

The tool should be available across Canada.

Mr. Jollimore, you've conducted a great deal of research and collected many statistics.

Are drugs easily accessible to people who are, for example, unemployed or who don't have a drug plan at work?

[Jody Jollimore]

When you say drugs, I'm assuming you mean prevention drugs or treatment for HIV?

[Robert-Falcon Ouellette, Liberal, Winnipeg Centre, MB]

Yes, that's what I mean.

[Jody Jollimore]

It depends on the province. Some provinces have co-pays. Others have completely free access to medications. For instance, in British Columbia we have a very robust, well-funded program that allows anyone with HIV to access medications free of charge. There are actually some other anomalies about B.C. that allow you to access those through the BC Centre for Excellence in HIV/AIDS, so that increases confidentiality and things like that.

Outside of B.C., it depends on the province. If there's a co-pay, yes, we know that this can be prohibitive for folks who are looking to treat their HIV or prevent their HIV with PrEP. We're seeing that even a few hundred dollars a month is unaffordable for some people.

[Robert-Falcon Ouellette, Liberal, Winnipeg Centre, MB]

This can have a major impact on the health of Canadians.

[Jody Jollimore]

Absolutely, yes.

[Robert-Falcon Ouellette, Liberal, Winnipeg Centre, MB]

I have a question for Joël Xavier concerning education. Mr. Jollimore spoke about it.

I want to talk to you about the specific nature of educational needs. We've already heard testimony about the Centre of Excellence for Women's Health in Vancouver and the importance of the centre.

Obviously, the needs are different in terms of sex education, for example, for cisgender people, and in terms of the levels of education and needs of people who are not only gay and lesbian, but also minorities within those groups.

[Joël Xavier]

Yes.

The sexual health needs of many people aren't being recognized, including the needs of trans people, non-binary people, bisexual people and two-spirit people. There are very few resources for prevention, sexual health and education. Very little research is being conducted with trans people. It's often forgotten that we have a sexuality. At the Conseil, we provide some training. However, there are significant needs and very few resources to meet those needs across the country at this point.

I know that CATIE, Canada's source for HIV and hepatitis C information, provides two guides. The guide entitled PRIMED is for trans men, and the guide entitled Brazen is for trans women. These guides talk about our sexual health realities. The guides are available, but not everyone will pick one up.

[Robert-Falcon Ouellette, Liberal, Winnipeg Centre, MB]

Also, not everyone will read the guide.

[Joël Xavier]

That's right. It's not sufficient as a resource.

Right now, as you said, we really need funding for sexual health education and community-based participatory research with trans people to develop suitable tools that reflect our realities. One interesting thing about trans people is that, like non-trans people, we really do have a variety of sexual practices and genital organs. This must be taken into account.

[Robert-Falcon Ouellette, Liberal, Winnipeg Centre, MB]

My question may be a bit different.

[Joël Xavier]

This is the right place.

[Robert-Falcon Ouellette, Liberal, Winnipeg Centre, MB]

You're from the Conseil québécois LGBT.

[Joël Xavier]

Yes.

[Robert-Falcon Ouellette, Liberal, Winnipeg Centre, MB]

In Nunavik, in the far north of Quebec, do these same issues arise in the Inuit community?