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The article presents the discussion on group of public health researchers and practitioners. Topics include aware of the devastating impact the drug toxicity crisis has had across North America and the challenges faced by health care providers; and drug toxicity crisis is impacting the spectrum of PWUD across demographics and socioeconomic status.

Food insecurity is widely documented among people living with HIV (PLWH) worldwide, and it presents significant challenges across the spectrum of HIV care and support. In North America, the prevalence of food insecurity among PLWH exceeds 50%. In the province of British Columbia (BC), it exceeds 65%. It comes as no surprise that food has become an essential tool in supporting and engaging with PLWH. Over the past decade, however, a shift has taken place, and food has become an incentive to boost uptake and outcomes of prevention, testing, treatment, and support. To explore this practice, we drew on a qualitative case study of incentives in the care and support of PLWH. This paper presents the findings of a targeted analysis of interviews (N = 25) that discuss food incentives and explores two main themes that shed light on this practice: (1) Using food to engage versus to incentivize and (2) Food is more beneficial and more ethical. Providers perceived food more positively than other incentives, despite the goal remaining somewhat the same. Incentives, such as cash or gift cards, were considered ethically problematic and less helpful (and potentially harmful), whereas food addressed a basic need and felt more ethical. [ABSTRACT FROM AUTHOR]

The authors comment on research by Molldrem and Smith on molecular HIV surveillance and the implications of phylogenetic analysis and cluster detection. It cites imperfections of the science of molecular surveillance due to concerns raise about discrimination, health disparities and criminalization. The authors also explore the issues of ethics, data justice and oppression to examine the global COVID-19 pandemic.

Background: In October 2018, Canada became the second country in the world to legalize cannabis. However, at this stage in the implementation process, it can be challenging to get a sense of the outcomes of this policy shift – hence why we turned to media. Purpose/objectives: We present the results of a qualitative content analysis conducted on the media coverage between October 2018 and April 2019. Methods: We used Google News and ProQuest database to complete our search. We included online media articles published between October 2018 and April 2019 in English. This left us with 81 eligible articles. These articles were analyzed by blending deductive and inductive approaches. Results: The articles were grouped into 5 categories: 1) housing, 2) access, 3) workplace, 4) driving, and 5) public consumption. Each category was then analyzed to identify emerging themes across news stories. Overall, we found that non-governmental actors such as landlords and employers were given a great deal of flexibility to introduce overly broad and restrictive regulations that disproportionately impact various communities. We also found that emphasis was placed on banning cannabis in various spheres of life as opposed to adapting to the new reality that cannabis is now legal. Conclusion: Real-time observations are critically needed to better understand the impact of policy implementation across the three levels of government: federal, provincial and territorial, and municipal. Our findings suggest that media coverage analysis can help us understand and track issues as they arise. [ABSTRACT FROM AUTHOR]

Side effects are central to the experience of living longer with HIV but rarely have they been studied alone. Unlike other aspects of that experience, like quality of life, treatment adherence, chronicity, episodic disability, aging, health, and viral load suppression, side effects have not benefited from the same level of empirical and theoretical engagement from qualitative researchers. In this paper, we draw on syndemics theory and 50 qualitative interviews to better understand the experience of HIV treatment side effects. Two main categories were identified in the data: side effects as a product and side effects as a risk factor. The first category suggests that side effects are not just the product of taking antiretroviral drugs. They are also the product of particular conditions and tend to cluster with other health problems. The second category puts forward the idea that side effects can act as a syndemic risk factor by exposing PLWH to a greater risk of developing health problems and creating conditions in which psychosocial issues are more likely to emerge. The paper concludes by calling for more research on the complex nature of side effects and for the development of comprehensive approaches for the assessment and management of side effects. [ABSTRACT FROM AUTHOR]

HIV plasma viral load testing has become more than just a clinical tool to monitor treatment response at the individual level. Increasingly, individual HIV plasma viral load testing is being reported to public health agencies and is used to inform epidemiological surveillance and monitor the presence of the virus collectively using techniques to measure ‘community viral load’. This article seeks to formulate a critique and propose a novel way of theorizing community viral load. Based on the salient work of Michel Foucault, especially the governmentality literature, this article critically examines the use of community viral load as a new strategy of government. Drawing also on the work of Miller and Rose, this article explores the deployment of ‘community’ through the re-configuration of space, the problematization of viral concentrations in specific micro-locales, and the government (in the Foucauldian sense) of specific bodies which are seen as ‘risky’, dangerous and therefore, in need of attention. It also examines community viral load as a necessary precondition – forming the ‘conditions of possibility’ – for the recent shift to high impact prevention tactics that are being scaled up across North America. [ABSTRACT FROM PUBLISHER]

Fear appeals are once again popular in public health campaigns aimed at preventing unhealthy behaviors and dangerous life practices such as smoking, unsafe sexual practices, drug use, alcohol abuse, impaired driving, etc. Every year in the province of Quebec (Canada), a new prevention campaign for sexually transmitted infections is launched by the SLITSS (Service de lutte contre les infections transmissibles sexuellement et par le sang). In 2006-2007, the SLITSS created a fear-based campaign entitled 'Condoms: They aren't a luxury' for the prevention of sexually transmitted infections in young adults. The purpose of this paper is to share the results of a discursive analysis of the documents retrieved from this campaign, which was developed using commercial advertising and marketing strategies. Using situational analysis and the mapping process proposed by Clarke (2005), we critically examine the use of fear appeal in the campaign. Drawing on Michel Foucault's concepts of governmentality and bio-power, we assert that fear should be understood as a bio-political technology deployed to manage/govern young adults' sexual practices. In doing so, we critique the use of fear as a strategy to create a state of permanent (in)security and challenge the adoption of commercial advertising and marketing strategies to develop public health campaigns. [ABSTRACT FROM AUTHOR]

Some older gay men (50+) experience diminished quality of life (QOL) due to historical and ongoing discrimination in addition to living through a collective trauma—the pre-HAART era of the HIV/AIDS epidemic—characterized by the absence of treatment and rampant discrimination targeting gay men. A growing body of literature, however, illustrates that older gay men demonstrate remarkable resilience but little is known about how QOL is conceptualized and how these conceptualizations are potentially shaped by pre-HAART experiences. The current study drew on constructivist grounded theory methods to examine how QOL is conceptualized in light of the sociohistorical relevance of pre-HAART. Twenty Canadian based gay men aged 50+ participated in semi-structured interviews via Zoom. Ultimately, QOL is understood as experiencing contentment, which is made possible by the development and implementation of three key processes: (1) developing and cultivating meaningful connections, (2) growing into and embracing identity, and (3) appreciating the capacity to do what brings joy. QOL for this group is greatly informed by a context of disadvantage, and the demonstrated resilience warrants further investigation to meaningfully support the overall well-being of older gay men. [ABSTRACT FROM AUTHOR]

Since the start of the COVID-19 pandemic, a steady stream of propositions from tech giants and start-ups alike has furnished us with the idea that GPS- or Bluetooth-enabled contact tracing apps are a vital part of the pandemic response. This commentary considers these apps as 'corporate contact tracing', emphasizing the private-sector role that such developments imply. We first discuss corporate contact tracing's potential to de-center the power of public health authorities. Then, using the frames of surveillance capitalism and disaster capitalism, we suggest how corporate contact tracing might feed the rise of corporate power in the public sphere. We question its capacity to address structural inequalities and to foster a social justice vision of public health. And, we wonder whether corporate contact tracing might intensify the effects of discriminatory design and algorithmic oppression. We conclude by calling for a discussion of this technology beyond questions of privacy and efficacy. [ABSTRACT FROM AUTHOR]

The article focuses on the moral and ethical aspects of telecare and telemedicine and on the article "Telecare, Surveillance and the Welfare State" by Tom Sorell and Heather Draper. In the article the authors offer their opinions on several points which are raised in Sorell and Draper's article and on the moral and ethical issues that are raised with the use of technologies which are used in telemedicine to remotely monitor patients.

Public health experts in the US and Canada are increasingly mobilizing molecular-based surveillance techniques in seeking to identify and control HIV. Both countries are also leading in the world to criminalize HIV exposure, transmission and non-disclosure, as well as having pervasive ongoing criminalization regimes toward drug use, sex work and migration. Molecular surveillance aims to rapidly identify 'risk network' clusters of people normally out of reach to public health (e.g. drug taking sexual networks of gay men, rural people living in poverty), in the near real-time, where transmissions are taking place, and to then intervene with enhanced public health approaches. This commentary critically interrogates the seemingly benign new technology that is being presented by leading public health authorities evacuated of social and political context. We outline a series of concerns facing people living with HIV related to molecular surveillance as it intersects with consent and criminalization. [ABSTRACT FROM AUTHOR]

The article discusses digital medicine panopticon's impact on issues of autonomy and trust in marginalized communities in the article by Klugman et al. in 2018. Topics covered include questions on the neutrality of digital technologies, and concerns on smart pharmaceuticals' surveillance of patients with the human immunodeficiency virus (HIV) or psychiatric disabilities. Also noted are the technologies' potential in eroding the duty to care and in integrating within larger governance systems.

The article presents a commentary in response to the article "Our Life Depends on This Drug: Competence, Inequity, and Voluntary Consent in Clinical Trials on Supervised Injectable Opioid Assisted Treatment" (siOAT). Topics discussed include concern about the ethics of conducting further trials on the efficacy of siOAT, the need for siOAT as a health care intervention in the context of the North American wide opioid overdose epidemic and a different research direction for siOAT.

Persistent Human Immunodeficiency Virus (HIV) prevalence rates remain a challenge, particularly because health care providers (HCP) are not fully prepared to engage in HIV care. This hesitancy to engage creates access to care barriers for people living with HIV (PLWH). We conducted a systematic review to identify educational interventions focused on developing HIV competencies in higher education across health science disciplines. We searched databases for primary studies focused on interventions. Using PRISMA guidelines, we identified 20 articles from 19 distinct studies. While there was an overwhelming body of literature that assessed knowledge, skills, and attitudes in health sciences students on HIV and AIDS, the low number of intervention studies was notable. With the exception of two studies, PLWH were not included in the interventions. This finding stands in sharp contrast to the well-established Greater Involvement of People Living with HIV and/or AIDS (GIPA) and Meaningful Engagement of People Living with HIV and/or AIDS (MEPA) principles. The primary means of the educational intervention was focused on delivering lectures to address HIV and AIDS knowledge for HCP. There was a significant lack of focus on historical, cultural, policy and legal contexts of HIV and AIDS care; theoretical justifications for the interventions were absent. No study focused on the impact of an intervention on the care provided to PLWH by HCP after graduation. There is an urgent need to develop long-term sustainable and scalable interventions that address the consistently identified lack of knowledge and skills, and stigmatizing attitudes of HCP and students. [ABSTRACT FROM AUTHOR]