DRUG USERS MAKE CITY THE NEW HIV HOTSPOT

EDMONTON - Among the paintings and quilts decorating the office of HIV Edmonton
are framed photographs, memorials to the city's early AIDS victims.

They are people such as Tom Edge, a gay rights activist and bookshop owner who
died in 1991 -- white men struck down in the prime of life.

This was the face of AIDS for a long time, the gay middle-class man epitomized
by Tom Hanks' poignant performance in the 1993 movie Philadelphia.

That face is changing as Edmonton becomes the hot zone for HIV in the province
and the virus continues to spread in Alberta.

Nearly half the 172 new HIV cases in Alberta last year were from Edmonton
because of a large injection-drug user population. The city had 82 cases.

The 2003 face of the disease is epitomized by the aboriginal couple sitting in
the HIV Edmonton offices on a recent afternoon, clutching a shopping cart of
their possessions.

The typical Edmontonian with HIV is an injection-drug user who is poor, often
homeless and often aboriginal.

The disease being tracked is now HIV, not AIDS. While a few people still die of
AIDS in Edmonton each year, the advent of protease inhibitor drugs is keeping
HIV-positive people alive, as long as they take their medications.

Sherry McKibben, executive director of HIV Edmonton, says the new HIV
population poses particular challenges.

"We deal with a population that is rejected and not acknowledged," Mc-Kibben
said. "If it was hard organizing services for gay men, at least they were
lovable, but it's not true of this population."

This new HIV population has many other problems, she said.

Housing is an enormous issue. A person without a home doesn't own a fridge to
store the HIV drugs they must take every day. Nor do they have a private place
to inject their street drugs, away from other drug users who convince them to
share needles.

HIV Edmonton and related agencies do what they can. One small agency holds the
HIV drugs of street people, so they can show up each day and get their pills.

HIV Edmonton has started running a methadone program, hoping to wean infected
people away from injection drugs.

A person using cocaine can do a dozen injections a day, said McKibben. If that
person is sharing needles, the risk escalates with each injection.

Roger Boulby knows that world. He openly admits he used a lot of cocaine until
giving it up in the mid-1990s. It was too late -- he had HIV.

Today, Boulby is getting his life on track, and he gives credit to HIV
Edmonton.

He came to the agency a year ago, looking for community service work to expunge
a court fine. He got into the methadone program and cut the painkillers.

Today he's on the agency's board, and hopes to go to NAIT to study aboriginal
mental health. "This has been my best year since I was diagnosed, because I've
got something to do now," said Boulby.

His dream is to work in northern communities. "There's people out there who are
infected and they don't know it."

McKibben shares that concern. "I think the potential for epidemics on the
reserves are really frightening," she said. In those closed communities, people
are afraid to talk even to their doctor, said McKibben. "There's lots of denial
in aboriginal communities."

McKibben considers the HIV situation in Alberta to be out of control.

Dr. Ameeta Singh, infectious diseases medical consultant for Alberta Health, is
more sanguine. The fact that the number of new cases in 2002 was the same as
the year before is a hopeful sign.

What worries her is that recent outbreaks of other sexually transmitted
diseases, such as syphilis and gonorrhea, could signal a new uptick of sexually
transmitted HIV.

A person with a sexually transmitted disease gets and spreads HIV more easily,
said Singh. Some of the new syphilis cases already have HIV, she said.

HIV today is no immediate death sentence, said Singh, but it does mean a
lifetime regimen of daily medications.

Those medications are often unpleasant. Boulby recalls one potent combination
that would make his stomach "bubble and boil".

"I would just puke and puke ... until everything was gone."

But when the alternative is death, said Boulby, you take the pills.

[Sidebar]

HIV IN ALBERTA

*- New cases in 2002:

Edmonton - 82

Calgary - 48

Northern Alberta - 37

Southern Alberta - 5

*- Accumulated cases 1998-2002:

Edmonton - 377

Calgary - 278

Northern Alberta - 113

Southern Alberta - 67