British Columbia

'We dropped the ball': Some Indigenous people had access to HIV drug for years without knowing

Truvada has been free for registered First Nations and Inuit people in B.C. for at least three years.

'It shows gaps and fissures within our heath-care delivery system,' activist says of Truvada coverage

Two-spirit activist Harlan Pruden says First Nations organizations failed Indigenous people by not disseminating enough information about a groundbreaking HIV/AIDS treatment.

When two-spirit organizer and HIV/AIDS activist Harlan Pruden heard the news that the preventative drug PrEP was now available cost-free in B.C. he was elated.

"It's phenomenal news that B.C.'s community now has access to this evidence-based, effective HIV prevention intervention," Pruden said.

But he said very few Indigenous people know that the brand name version of the drug, Truvada, has been free for First Nations people in the province for several years.

"What is astonishing about this is that First Nations and Inuit rarely have first access to anything, and where was the news story about this three years ago?" Pruden asked.

First Nations have had free access since 2013

The B.C. Centre for Excellence in HIV/AIDS recently procured an affordable generic brand of PrEP, also known as pre-exposure prophylaxis treatment, that enabled the province to provide it for free to those at a high risk of contracting the virus. It can reduce the risk of HIV infection by more than 90 per cent.

Meanwhile, the First Nations Health Authority confirmed that First Nations in this province have had free access to Truvada since the end of 2013. Over the last three years, only 23 people have made use of the free drug.

Pruden blames Indigenous organizations for not getting the word out. 

"I think that we dropped the ball given that the community could have been accessing this intervention if they chose, but nobody knew about it," Pruden said.

In its defence, the FNHA said decisions related to specific health treatment options occur between clients and care providers.

"We do encourage clients living with risk factors to talk with their health-care provider or doctor where treatments like PrEP and other options can be discussed," a FNHA spokesperson said.

Starting on Jan. 1, the province of British Columbia began covering the costs of pre-exposure prophylaxis treatment (PrEP) for at-risk people. (CBC)

But Pruden argues there should have been promotional material displayed in communities or on social media, similar to how the recent news about universal access was disseminated.

"It shows the gaps and the fissures within our heath-care delivery system," he said.

'I feel it was a missed opportunity'

Indigenous people only represent five per cent of the total population in B.C., yet account for 15 to 17 per cent of new positive HIV tests each year, according to the Provincial Health Officer's Annual Report.

PrEP user and Community-Based Research Centre director Jody Jollimore said he feels there was not enough awareness and education created in First Nations communities about PrEP being free to them.

"I feel it was a missed opportunity. There are a number of barriers, and as activists we left behind a population, and we are trying to rectify that," he said.

Dr. Julio Montaner of the B.C. Centre for Excellence for HIV/AIDS blames the lag in communication on the nature of fragmented Indigenous communities.

"I think it would be fair to say that when you have programs that are available to a particular community and not the larger community, the knowledge translation that happens in the community is limited," he said.

Harlan Pruden was a Barack Obama appointee to the U.S.'s Presidential Advisory Council on HIV/AIDS from 2014 to 2017. (Harlan Pruden)


Angela Sterritt

CBC Reporter

Angela Sterritt is an ​award-winning investigative journalist. She is the host of Land Back, a six-part CBC British Columbia original podcast that uncovers land theft and land reclamation in Canada. Sterritt is known for her impactful journalism on the tensions between Indigenous people and institutions in Canada. She is a proud member of the Gitxsan Nation.