HIV Pre-Exposure Prophylaxis and Sex Work in Canada 2016

S Well I have concerns especially for people that live and breathe in the downtown
eastside of Vancouver. Even when they did the hep C treatment, a lot of times it was
stipend-based and they would give the person a stipend to receive their medicine. And,
I’m afraid that this is going to maybe happen again. I don’t think it’s a good thing because
I don’t think it’s ethical to tell you the truth. I wonder, too, if they do try to engage in
a population that lives more in poverty, or doesn’t have a telephone and doesn’t have
different things, whether they consent to something but it’s not truly informed consent.
Especially when stipends and money is attached to it. That happens over and over again in
different populations in Vancouver. It’s not really truly free and informed consent, right?
S We already see this in Vancouver with the B.C. Centre for Excellence. Basically offering
medication to people who are HIV positive but under the guise of treatment as prevention
and using that as a giant research study. The people who are participating in it don’t know
that they’re participating in research. Nothing’s free, but you’re getting the medication
for free.
S I think that if sex workers anywhere are forced, whether it be the government or
health care to take PrEP, clients of course are not going to want to use condoms. So, then
it’s a vicious circle. How will this play out in the post-antibiotic world? We are almost at
the post-antibiotic world right now.
M So you’re talking both about STIs and antibiotic resistance, and then super STIs like
multiple drug resistant gonorrhea?
S I’m actually just talking about regular gonorrhea, regular syphilis, and regular
chlamydia. WHO—the World Health Organization—says that syphilis, chlamydia, and
gonorrhea are rapidly becoming antibiotic resistant. There are super gonorrheas out
there, but we’re talking about regular gonorrhea now and if sex workers and other groups
are forced to take PrEP? Instead of in five years where we’re post-antibiotic, we’re going to
be post-antibiotic in two.