New HIV screening method leads to apparent spike in testing at Sask. First Nations

"Dried blood spot testing" is a needle-prick test, which is similar to having a blood sugar test for diabetes.

Doctor says problems with racism in healthcare system deter people from getting tested

The Saskatoon Tribal Council has introduced dried blood spot testing in an effort to reduce stigma and improve anonymity for people who want to get tested for HIV. (Ron Boileau/CBC)

A new type of HIV test appears to be dramatically increasing the number of First Nations people getting tested in Saskatchewan.

"Dried blood spot testing" is a needle-prick test, which is similar to having a blood sugar test for diabetes.

The method is being piloted in First Nations communities as a way to increase the number of number of people getting tested.

Ceal Tournier is the general manager of Saskatoon Tribal Council Health and Family Services, which is leading the project.

She said the number of people tested for HIV in STC partner communities in the past six weeks — 114 — is four times higher than the number for the previous six months. The STC is in the process of analyzing the results of the pilot project.

It was non-discriminatory and it was non-judgmental and it was not like the conventional test.- Dr. Ibrahim Khan, regional medical health officer for First Nations, Inuit Health Branch of Health Canada

"It's much more readily accepted and we believe — and we haven't done all the research — but we believe it's because it's coming from a multitude of areas and not just from the nurse at the health centre or the nurse at the community centre," said Tournier.

Tournier said that makes it easier for people who want to be tested but worry about being seen at a clinic.

Rates of HIV infection are much higher in First Nations populations in Saskatchewan than the general population. (Manjunath Kiran/AFP/Getty)

Another benefit, said Tournier, is that people do not have to wait onsite for their test results. The lag time between the test and the results allows health workers to help prepare patients for the possibility of a positive result.

If the blood spot results are positive, the person will then have to return to do a conventional test.

Testing on the rise

Dr. Ibrahim Khan, the regional medical health officer for First Nations, Inuit Health Branch of Health Canada, said the number of HIV tests performed in Saskatchewan First Nations jurisdictions increased by 11 per cent in 2016. The number of new cases of HIV increased by 10 per cent.

Khan said that in 2016, Saskatchewan had the highest rate of new infections among First Nations people living on-reserve: 45 per 100,000 people. The provincial rate is 16 per 100,000.

"The focus in the past couple of years was to improve testing in First Nations because there is a lot of undiagnosed infection in the community," said Khan.

"There has been a lot of focus and investment on improving access to HIV, Hepatitis C and sexually-transmitted infection."

He said the dried blood spot testing was breaking down the barriers to getting tested because people felt more comfortable getting this test than the conventional one.

"People felt comfortable doing it, people felt comfortable getting the results, and the timing and the process was easy for them," he said.

"It was non-discriminatory and it was non-judgmental and it was not like the conventional test."

Racism a factor: Health Canada officer

Khan said one of the problems Health Canada is trying to address is racism in the healthcare system, which he said can be a deterrent to getting tested for HIV.

The virus can progress to the advanced stage of AIDS, which is potentially fatal, if it is not diagnosed and treated. Khan said AIDS should never be fatal because HIV is treatable, but he noted that treating the virus requires prolonged trust in the system.

If First Nations people experience racism, discrimination or judgment when they seek care or diagnosis, he said they are less likely to return for treatment.

Khan said Health Canada is working to train its healthcare workforce to be more culturally sensitive and non-judgmental.

'Harm reduction' focus

He said the health provider is focusing on "harm reduction" as a means to reducing the high rates of HIV among First Nations people in Saskatchewan.

In 2017, it gave out 450 Naloxone kits, and trained 828 people for emergency treatment of opioid overdoses.

Khan said 19 First Nations sites are operating those harm reduction programs, which include access to clean needles, counselling and testing. Another two are expected to be added soon.