Saskatchewan has the highest HIV rate in Canada, with cases more than three times the national average. New cases are emerging through what is known as vertical transmission (mother-to-child), which is not widely observed in richer countries, as such cases can be prevented with the use of antiretroviral drugs. Injecting drug use is the most common mode of transmission in the countryside and numbers are higher among indigenous peoples, where the continuing legacies of colonialism, policy-induced poverty, intergenerational trauma and substance use are combined. Indigenous peoples have faced these difficult conditions with resistance, mobilizing Indigenous-led reactions to HIV and promoting indigenous ways of knowing. But these efforts continue to be undermined by limited funding and the provincial government ‘s failure to provide adequate income assistance to those living in financial distress. HIV rates are rising in Saskatchewan. (Shutterstock)
syphilis epidemic
Rising HIV rates in Saskatchewan coincide with a new syphilis epidemic. This is not surprising, because syphilis increases susceptibility to HIV. is a harbinger of more HIV infections in the future. The incidence of syphilis is increasing exponentially, in more than 800 cases in 2021, from five cases in 2016. The disease is highly contagious in its less severe early stages and, like HIV, can be transmitted during pregnancy. When transmitted in pregnancy (congenital syphilis), syphilis can have devastating consequences, including stillbirth and babies born with a range of health problems, including skeletal and facial abnormalities, deafness, blindness and significant neurological problems. In 2016, there were four cases of congenital syphilis in Saskatchewan. four years later it was more than 50. Babies born with syphilis can have a number of health problems. (Pixabay) Both HIV and syphilis are opportunistic infections that are more likely to be caused by the reality of poverty. They are both asymptomatic in their early stages, so people may not know they are infected. Stress from poverty and substance use can help people engage in behaviors at risk for HIV and syphilis more than they could otherwise. Once infected, both syphilis and HIV can be treated, but treatment can be intense – syphilis during pregnancy can require multiple appointments and HIV requires daily medication. When people live without reliable housing and live on a meager income, they must devise creative strategies to survive, and screening, screening, or treating for new infections is not always a top priority.
Reduced benefits
Inadequate welfare rates in Saskatchewan have long contributed to the problem, which has now been exacerbated by changes that have recently reduced the total amount of benefits. Unlike its predecessor, the new program does not fund the actual cost of utilities, but provides an insufficient fixed amount. Other aid was reduced or abolished, such as clothing, furniture and school supplies. Saskatchewan Prime Minister Scott Moe speaks to the media after the Saskatchewan budget was tabled in March 2022. THE CANADIAN PRESS / Liam Richards The new plan also exempted direct payments to landlords, who had previously ensured that, no matter what, the rent was always paid. These changes mean more people are being evicted than ever before, with the Saskatchewan Homeowners Association reporting that 30 percent of welfare recipients did not pay or could not pay their rent in the months following the change. In November 2021, the Department of Social Services said it would pay rent and utilities directly to recipients at risk of becoming homeless, but housing agencies say this is still not the case.
More precariousness, less resources
Rising rates of syphilis and HIV are exacerbated by these changes in income support because people are more precarious and have fewer resources than in the past.
Although pregnant and young parents often use different strategies to get what they and their children need, their efforts are undermined by a fragmented care system, lack of culturally responsive services, and limited access to existing interventions. This includes screening and testing for asymptomatic, unrecognized and / or untreated infections.
Adequate rates of social assistance are the key to public health. We will not need any other reason to ensure that people have enough to live on other than reducing the rates of infectious diseases that can be prevented. But it also makes financial sense.
Read more: CERB was a luxury compared to provincial social assistance
The cost of treating people affected by these diseases, and especially children, costs significantly more over time than providing adequate social assistance. Reducing welfare rates is a costly mistake and the most marginalized pay more.
People living in poverty work hard to make ends meet and come up with creative strategies to make the most of every dollar, but there is a limit. Without sufficient social assistance to meet people’s basic needs, more people end up in precarious conditions, needing access to more intensive and long-term interventions.
There is a vicious circle in Saskatchewan cutting public funding for social assistance to support people in difficulty, only to intervene when things are much, much worse.
