Canadian cities aren’t taking the necessary steps to end the HIV epidemic, advocates say

From Montreal to Vancouver, an over reliance on policing and other policy failures are top concerns

In 2014, 26 cities signed the Paris Declaration on Fast-Track Cities Ending the HIV Epidemic. In signing the Paris Declaration, a city’s mayor commits to ending the HIV epidemic by 2030 in their respective city. 

Today, over 500 mayors have signed on to the Fast-Track Cities program, a UN-led initiative. This includes Montreal mayor Valérie Plante, who signed the Paris Declaration during her first term in December 2017. 

By the next year, the city had established the Montréal sans sida initiative, tasked with developing and carrying out an action plan to “accelerate the fight against” HIV. As part of the plan, the group set out to meet 0-90-90-90-0 targets: zero new infections, 90 percent of people living with HIV knowing their status, 90 percent of those who know their status being on antiretroviral therapy, 90 percent of people on antiretroviral therapy having undetectable viral loads and zero discrimination or stigmatization. 

However, just over five years after signing the Paris Declaration, community members say that the city has not made progress on the targets outlined in the action plan. On Feb. 14, TOMS, a coalition of 31 local community groups participating in the program, announced that it would be cutting ties with Montréal sans sida, citing a “lack of commitment” on the part of elected officials. 

“To this day, only an awareness-raising campaign truly benefited from the city’s proactive involvement,” TOMS wrote in a press release. In fact, the city has neglected to sign the latest version of the Paris Declaration, as well as the Sevilla Declaration on the Centrality of Communities in Urban HIV Responses, introduced in October 2022. The Sevilla Declaration outlines ten commitments that cities can make “to ensure that communities are at the heart of our efforts” to eliminate HIV by 2030, and offers guidance on how to facilitate community participation in city-led HIV initiatives. 

Signing the amended Paris Declaration, adopted in 2021, “should have been a formality, as the signing…is a prerequisite for being part of the Fast-Track Cities initiative,” wrote TOMS. The City of Montreal did not respond to Xtra’s request for comment on whether Plante will sign the Sevilla Declaration.

In an interview with Xtra, TOMS General Coordinator Olivier Gauvin elaborated on the organization’s concerns. Gauvin says the city had told TOMS that it would sign the latest Paris Declaration by January 2023. When TOMS sent a final letter to Plante and city councillor Josefina Blanco asking them to follow through on this commitment in December 2021, the organization received no response: “When [the letter] went unanswered, we decided it was enough. So we decided to quit the initiative,” Gauvin said. He explained that the action plan was written by marginalized communities—such as people who use drugs, sex workers, gay, bisexual, queer and trans men and racialized people—and that “there was no way for [TOMS] to go back to them and ask them […] to keep working on this action plan when there was no political power backing the whole thing.”

 

Also among TOMS’ concerns with Montreal’s approach to combatting HIV was the continued criminalization of drug use and sex work. Although the Common Action Plan includes “eradicat[ing] prejudice caused by enforcement of criminal laws and judicial control of individuals from marginalized communities” as one of its areas of strategic intervention, the Montreal government has increased the budget for the city’s police force every year since 2020. In its December 2021 demands sent to the City, TOMS wrote that “discriminatory measures” such as dismantling encampments and raising the police budget were “in opposition with the principles and values of the fight against HIV.” 

In his interview with Xtra, Gauvin explained that “having more police in people’s lives ultimately make people go into hiding more […] it becomes harder for community organizations to do our jobs.” He continued, “We have to wonder at some point if increasing the money going to the police is the actual solution. And our opinion on the matter is that we don’t need more police in our lives, we need more community organizations.”

Montreal is not the only Canadian city facing these issues. Gauvin’s concerns were echoed by Jennie Pearson, who sits on the board of PACE Society, a peer-driven organization in Vancouver that advocates for and supports sex workers. Pearson pointed out that the City of Vancouver’s 2023 operating budget does not include funding for programs which offer alternatives for calling the police, which PACE Society and other organizations denounced in an open letter to Vancouver City Council. “When you’re [doing sex work] under police surveillance, you have less power to negotiate what’s going to go down, what services you’re going to provide, which harm reduction supplies you’re going to be using,” she explained. “All of which can increase the odds of having unprotected sex,” and make it more difficult to access services tailored to the needs of sex workers, she continued. 

In 2013, the Vancouver Police Department adopted new Sex Work Enforcement Guidelines, which Pearson said were meant to be “a bit more hands-off and be a bit more supportive of the actual workers.” However, she explained that giving the police greater funding is still at odds with supporting sex workers. “It’s one thing if the city budget is not going to give a bunch of money to PACE or to a sex work organization, but it’s another thing to be increasing spending on systems such as the police that actively harm sex workers.” Defunding the police, Pearson said, “would still benefit sex workers even if that money might not go back to them directly.”

Representatives of PASAN, a Toronto-based organization that advocates for incarcerated people and especially focuses on harm reduction, HIV and hepatitis C, expressed similar concerns in a written statement to Xtra. “Criminalizing HIV further stigmatizes people living with HIV and puts them at risk for violence and discrimination,” wrote Harm Reduction Manager Jennifer Porter and Programs Manager Claudia Medina. Porter and Medina wrote that drug users, sex workers and racialized people may experience more stigma and discrimination when accessing health care services. “Decriminalization would make it safer for people to access health care and receive the treatment they need,” they continued.

Despite the challenges of working within a system that criminalizes communities at risk for HIV,namely sex workers and people who use drugs,advocates are continuing their work. Pearson pointed to the Canadian Alliance for Sex Work Law Reform, of which PACE Society is a member, which is currently challenging the constitutionality of sex work laws in Canada.

As for TOMS, Gauvin says that their work is not done. In discussing the organization’s next steps after cutting ties with Montréal sans sida, Gauvin explains that TOMS plans to mobilize its members to build a new committee that will continue to work towards addressing HIV in Montreal. He hopes that the fight will continue similarly across the country. 

“We can’t let the fight against HIV be an afterthought. It’s been 40 years,” Gauvin says. “We have everything we need to … end this epidemic by 2030, and we just need political people in power to actually do something about it.”

Abigail Popple is a Montreal-based freelance journalist. She is interested in covering policing, agriculture, and labour.

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