Over the last ten years (i.e., 1998 to 2008) the incidence rate of HIV in Saskatchewan has progressed from one of the lowest rates to the highest rate in Canada. Each year from 2000 to 2009 has seen a six-fold increase in the number of new cases reported. While the most recent findings (i.e., 2011) indicate that the prevalence rate in Saskatchewan is double the national rate, as recently as 2009 the rate was three times the national rate. Within Saskatchewan, Saskatoon is responsible for almost half of all new cases. The result is that the Saskatoon Health Region has seen some of the highest rates of HIV/AIDS related deaths in North America.
The main cause of the high prevalence of HIV in Saskatchewan is attributed to intravenous drug use (IDU), which has been found to be responsible for 77% of new cases. This is a highly transient population who report not having permanent employment or homes. Homelessness and unstable housing are consistently linked to greater HIV risk, inadequate HIV health care, poor health outcomes and early death (NAHHRS, 2011).
The majority of persons with HIV have been found to be of Aboriginal ethnicity (84%) and below the age of 50 years (Saskatchewan HIV Strategy, 2010). Aboriginal people have a long and traumatic history with provincial and federal government institutions that has lead to an inherent distrust and avoidance of the services offered through these institutions.
People with HIV and addiction issues are admitted for hospital services substantially more often and have longer stays than those who are HIV-negative. The main barriers that have prevented medical intervention with this population is the inability of public funded organizations to deal with addiction, mental illness, homelessness, poverty and cultural issues, while treating the often complex medical issues. This results in early discharge from hospital and sub therapeutic treatment resulting in fragmented care thus further perpetuating the overuse of the ER and over admission in to the ICU. Individuals who do not require a hospital setting but require supportive housing in order to manage their symptoms or adhere to their medication regimen, are severely underserviced and have limited options.