Press briefing by Mr. Vincent Marissal, spokesperson for the second opposition group on health

(Twelve hours six minutes)

The Moderator: So, hello and welcome to this Québec solidaire press briefing. Will speak Vincent Marissal, MP for Rosemont, Valérie Samson, who is CEO of Réplique Estrie, and Marie-Hélène Hébert, who is the general director of MIELS-Québec. Mr Marissal.

M. Marissal : Thank you, Camille. So, hello. First, I want to greet our guests, who are here today obviously to talk about prevention and the fight against HIV-AIDS, the people of Réplique Estrie, the people of Montreal too. Thank you, first of all, for your extraordinary work. We welcome you here every year, and every year, we make somewhat the same observations. And then these years, unfortunately, we have made a rather serious observation, that the situation is not improving, on the contrary, we are detecting more and more cases, there seems to have been a certain relaxation regarding screening, regarding resources on the ground too.

This morning, I tabled a motion which was unanimously approved and adopted by the National Assembly. I am happy to have heard the Minister of Health, who recognized that we have given up a little, and I think he was telling the truth, I think he is sincere, we have given up a little in our fight against HIV-AIDS. I also heard him say, after this observation, that we need to make more efforts, and therefore more resources. This is what we want, this is what we must do. We can achieve a Quebec without HIV-AIDS. Unfortunately, in recent years, we have actually let our guard down a little. But I’m going to continue to fight the battles here, we’re going to continue to fight the battles here. I take it for granted that all government and opposition parties are in the same place regarding this absolutely essential fight. Then, without delay, I will let the specialists on the subject tell you about it.

Mrs. Samson (Valérie): Good morning. In fact, I have come to present to you the issues and barriers to access to screening throughout the territory of Quebec, the issues of access to screening, care and treatments. In fact, we…

Mrs. Samson (Valérie): …Really. Then, in fact, it is a fact that, to identify HIV, it absolutely requires screening. This is the only way to know your status, given that there are no symptoms as such in HIV. If there is no screening, obviously, well, transmission is really very present. This is what we try to avoid as much as possible.

There are different barriers, actually. And, for the barriers to screening, there is, among other things, the fact that there are not enough… screening offers throughout the country. This is mainly for priority populations. So, when we seek screening, sometimes we don’t know which door to knock on or how to get it. There are very specific places, but they are often unknown to the population in order to have access to screening. There is actually a lack of diversity of service points, whether in GMFs or SIDEPs. There are family doctors who also offer it. Sometimes it can be embarrassing to be able to ask for screening when it is not systematically offered. There is even screening that can be done privately. So obviously, that generates costs, which is not always easy for people to be able to do. And maybe it becomes less of a priority at that point.

There is also the fact that schedules are often complicated or inaccessible, either for workers… this means that there are very few evening schedules. So, this again creates a barrier for screening. Not to mention the lack of staff. We understand that prevention, at certain times, is not always the priority, and that there are other emergencies which are very important, but, if we do not put forward prevention such as screening then If we don’t replace nurses when they are either on leave or maternity leave, for example, well, that really creates a gap in services. Then, at that point, well, we really miss out on a lot of possibilities for being able to treat HIV.

Now, when it comes to access to care, it is not always as simple as you might think. Accessibility to infectious disease specialists, depending on the region you are in, can be a challenge. Sometimes, in the regions… regions, well, already, there is mobility, to be able to have a means of transport to go see your doctor in order to be able to have the treatment and then to have adequate follow-up also to be able to have. .. The result, ultimately, that we want is to become undetectable, there, in the situation and no longer transmit HIV.

Often, infectious diseases specialists are located in large centers, as I mentioned. So, people often have less access to that. Then, when we are lucky enough to be in a large center, we have large teams surrounding the infectious disease specialists, at that time, well, it’s really a great advantage, but sometimes, family doctors, despite their good will, perhaps do not have all the information, perhaps are not aware of all the issues related to HIV when they support treatment.

So, obviously, in our demands, another of the issues is the financial costs related to treatments. We are really demanding free treatment, whether HIV treatment, PrEP which is a more preventive treatment or post-exposure prophylaxis. These are all treatments that are really very effective, which cause people to no longer transmit the HIV virus. But there are costs associated with that, and sometimes it can be a barrier to being able to access it. Without forgetting all the people who may not have access to RAMQ. These are procedures that are nevertheless complicated, service corridors that can sometimes be very confusing. Then, when we don’t have access to RAMQ, well, obviously, we are not able to pay for our treatment, which means that HIV can still be transmitted. So, really, there is a lack of information and support, whether from community organizations or even there is financial support, among others from pharmaceutical companies, which are very little known, which can also really facilitate adherence to treatments. So, that’s what concerns screening for the greater Quebec region. I’ll give you the floor, to Marie-Hélène, who is more for MIELS Québec.

Ms. Hébert (Marie-Hélène): So, hello. Yes, I am co-director of the MIELS Québec organization. So, as my colleague Valérie said, at the moment, there are several barriers in terms of screening, particularly in terms of accessibility times, in terms of costs which can… be part of that. Then, for my part, I wanted to be able to talk about the experiences of prejudice, discrimination, stigma that people who need access to HIV testing can experience or fear experiencing, and that, in the context of together, there, the stages of the process of access to screening. So, starting off, at…

Ms. Hébert (Marie-Hélène): …at the time of greeting, reception, when making an appointment, so ensure that it remains confidential. Everything that is also at the level… in reception, to get a screening, to have to name factors, there, to… lead them to identify with a key population, which can give them access at this screening.

Also, there are events of stigma and prejudice that also take place during contact with different health professionals. Then without forgetting also the fear that people may have of experiencing prejudice in all the future medical follow-ups that they will be able to have, since it is sensitive information which will be entered in their file. And this whole reality, for us, is linked to the fact that it is only certain specific populations that currently have free access to screening, rather than the entire population.

Obviously, we know it, we see it with the latest data, the pandemic has had an impact on access to screening. We are just starting to see the impacts. We cannot afford for the next health emergency to cancel screening activities for the population, but particularly for people in vulnerable situations or who are further away from the health system.

Some good news, my colleague Valérie has named certain solutions, we also have some, in particular being able to offer screening campaigns accessible to the entire population, also offering mass screenings in the same way as we already do for vaccination campaigns. We also propose, you know, to organize information and awareness campaigns for the general population, to make HIV and the risks associated with it well known, as it is always a struggle. , there, which is current, these days.

We also hope that there will be a strengthening or, in fact, an implementation of continuing training for all professionals regarding good practices related to intervention related to HIV and STBBIs. Earlier, I spoke to you about stigma. We do not believe that it is individually linked to health professionals to make missteps in this direction. However, there is a great lack of training at this level and there are different organizations, at the moment, which exist, like ours, which offer training to professionals and which even set up online platforms continuing education for all professionals, both at the community level and in the health sector. So, we already have the tools to be able to equip our teams. We also hope that there will be methods to facilitate access to an appointment for screening because at the moment, for certain populations, succeeding in having an appointment is already a first step. which is very complex.

As we were talking about earlier, my colleague Valérie mentioned, in terms of screening time slots, for our part, evening screening time slots are, by far, the most popular. So, we really favor a greater diversity of time slots in order to allow the entire population to have easy access to these screenings.

Also, as Valérie mentioned, improve the screening offer outside the health network, which makes it possible to diversify, once again, the people we reach, and also improve access to follow-up after screening in order to allow for a cascade of care that is coherent and then promote rapid support in terms of treatment, according to the results of this screening. Thank you so much.

M. Marissal : So, thank you both for speaking out. So, very quickly, I just want to conclude, we were on the right trajectory, we deviated a little, we recognize it, we are correcting this trajectory, we must, we can do much better, we have a duty to do much better, in Quebec. I believe it is possible. I take the minister at his word and I will certainly follow up to ensure that we are able to resume the role we had as a leader in the fight against HIV-AIDS. Thank you once again to our guests. THANKS.

(Ends at 12:17 p.m.)