Réjean Thomas’s 400 Words

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With the permission of Dr. Réjean Thomas, Director General of the l’Actuel Clinic in Montreal

 Image: AI ©Gay Globe

In recent months, a public health situation has raised significant concerns among medical authorities and public health officials across the country, including in Quebec. For example, a catastrophic first finding is that the rate of new HIV infections has surged by 120% just in Montreal. While 310 new HIV infections were reported in Montreal in 2022, other sexually transmitted infections (STIs) are also on the rise. Syphilis has increased by 100%. « Children are being born in Canada and dying from syphilis in 2023-2024; it’s truly staggering, » said Dr. Réjean Thomas from the l’Actuel Clinic to Agence QMI.

Syphilis is a serious, potentially fatal disease caused by a bacterial infection, Treponema pallidum. If untreated, it progresses through various neurological and cardiovascular stages. Eventually, it attacks several internal organs such as the brain, heart, liver, bones, or skin. Without antibiotic treatment, syphilis can lead to death. The same is true for HIV. The increase in infections indicates that the causes are not being controlled and that education is facing significant barriers due to a lack of resources. Several specialists mention that the heavy presence of crystal meth is literally killing the gay community and that chemsex is a significant vector for new infections. They also criticize the public health response to this crisis. « There’s a lot of talk about the fight against opioids but very little about the ravages of crystal meth, which is even more devastating. NGOs and clinics in the Village are doing the work but with limited resources, » explains Dr. Réjean Thomas. « As for immigrants and refugees, it’s essential to welcome them and provide the necessary care promptly if needed. Indeed, they and their families can sometimes face terrible news, such as an HIV diagnosis, » adds Dr. Thomas.

Another obstacle to addressing HIV is the sometimes difficult access to PrEP, which is highly effective and constantly improving, particularly with the possibility of receiving an injection every six months, with an efficacy measured at nearly 100%. However, in Quebec, unlike many other countries, PrEP is only partially covered by drug insurance. The treatment can therefore cost between $100 and $250 per month depending on coverage. LGBTQ+ communities are relatively well-informed about the existence of PrEP, but the rest of the population suffers from a lack of information, which contributes to the continued spread of the virus.

According to Dr. Marina Klein from the McGill University Health Centre, obstacles to accessing healthcare and changes in the infections themselves also explain these increases. For this reason, the Canadian HIV Trials Network will expand its research to include sexually transmitted infections in order to explore new treatment avenues. Dr. Klein adds that clinical trials will be conducted across the country on Mpox (monkeypox), syphilis, and hepatitis B.

The shortage of doctors is also a cause of difficulty in accessing treatments. Waiting times for consultations are longer, making infections spread more easily. According to Dr. Réjean Thomas, the state is not investing enough in screening and access to treatments, which jeopardizes the goal of eradicating HIV in Montreal by 2030, a goal that Montreal’s key economic and social stakeholders had committed to.

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