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The Province - www.theprovince.com

A life stained by stigma,
now rich in love

A positive HIV diagnosis left Bradford McIntyre ostracized and isolated; but because of St. Paul's pioneering research and treatment, he can now lead an almost normal life


Sunday, October 21, 2012
By Cheryl Chan, The Province

Photo: Bradford McIntyre and Deni Daviau in their Vancouver home. Photo Credit: Arien Redekop, PNG, The Province
Bradford McIntyre, right, is HIV-positive, but still found love. He stands with husband Deni Daviau and their marriage certificate in their Vancouver home.
Photograph by: Arlen Redekop, PNG ,

October 21, 2012 - At first blush, Bradford McIntyre and Deni Daviau appear to have an ordinary love story.

The Vancouver couple met online, dated for a year, were married in church and have been happily married for 11 years.

A run of the mill love story, except for one thing. McIntyre and Daviau are a mixed couple: McIntyre is HIV-positive; Daviau, HIV-negative.

"We are a serodiscordant couple, we are a lot of things, but the No. 1 thing is we are in love," an exuberant McIntyre said in their West End home.

"We are more in love today than we have ever been."

McIntyre was diagnosed with HIV in 1984, at age 33. He contracted the virus from the first person with whom he was intimate after getting out of a 10-year relationship.

His prognosis was bleak: his doctor told him to go home, inform his family, arrange his finances and his funeral because he had six months to live.

He had two relationships fall apart. Both partners told him they did not want to watch him die, recalled McIntyre.

"Due to the stigma associated with HIV, people usually ran as fast as they could when I told them I was HIV-positive," said McIntyre. "You could say it had a negative effect on having a relationship," he added wryly.

McIntyre wouldn't be alive - much less have a love life - had it not been for the groundbreaking research and treatment developed at St. Paul's Hospital.

Today, the tanned, handsome McIntyre looks fit and healthy, one of 13,000 people known to be living with HIV in B.C.

McIntyre wasn't sick immediately after his diagnosis. He began taking medication to keep the cunning virus at bay, but the pills had brutal side-effects, including neuropathy, headaches, fatigue and lipodystrophy - facial wasting that made him look gaunt and dying.

In 1997, McIntyre developed PCP, or pneumocystis pneumonia, a life-threatening lung infection that typically assails people with HIV. "I was dying," said McIntyre. "I was not able to tolerate the treatment for the pneumonia."

He was put on a new drug regimen, a combination therapy pioneered at St. Paul's Hospital, in the hopes it would eradicate enough of the virus to let his ravaged immune system fight off the opportunistic infection.

Within four weeks, McIntyre's white blood cell counts started to rise. He eventually recovered, got out of hospital and went on to live his life.

"They all died"

It wasn't always that way. Jane McCall, who used to work in St. Paul's emergency department, remembers admitting the first person in B.C. known to have HIV, a 30-year-old named Brian.

"He died," she said. "Because they all died."

After Brian, scores more young men began coming to St. Paul's - sick, symptomatic, suffering from PCP and sarcomas and infections.

"They were often blind, having lost their sight," said McCall. "They had horrible diarrhea. They looked like concentration camp victims. They'd weigh 50 kilograms. It was awful."

Many of the patients worked at St. Paul's and knew the grim outcome. Some committed suicide, said McCall.

The West End hospital became synonymous with HIV/AIDS care in Vancouver - by virtue of its location in the epicentre of Vancouver's gay community, but also because the nuns, guided by its mission of compassionate care, insisted the hospital's doors be thrown wide open at a time when other hospitals turned patients away.

At the time, HIV/AIDS was a death sentence, an illness shrouded in fear and misconception. Care was nothing more than palliative, monitoring patients during their decline toward death. But in 1996, a new triple drug cocktail, known as highly active antiretroviral therapy, changed the game.

Triple Drug Cocktail life-saver

"When we introduced HAART, the death rate decreased and life expectancy improved markedly," said Dr. Julio Montaner, director of the B.C. Centre for Excellence in HIV/AIDS, who helped pioneer the drug cocktail.

HAART suppressed HIV to undetectable levels, stopped its progression into full-blown AIDS and turned the killer disease into a chronic condition.

"After years of people coming here and dying routinely, we couldn't believe it," said McCall. "It was a miracle - plain and simple."

Montaner and St. Paul's campaigned for the expansion of HAART, offering it to patients earlier instead of waiting until they show symptoms. It resulted in a 90 per cent decrease in the mortality rate, and 80 per cent decrease in the number of AIDS cases.

HAART also had an unexpected benefit: It suppressed the virus to a degree it reduced transmission by a whopping 96 per cent. Recent studies have indicated it is closer to 100 per cent.

"It's better than a vaccine," said Montaner. Today HAART is the gold standard in HIV treatment. Its early use with a goal of decreasing transmission, dubbed Treatment as Prevention, has been embraced by former U.S. president Bill Clinton, the World Health Organization and countries such as China and Swaziland, which are battling the spread of the epidemic.

Thanks to the approach, as well as aggressive outreach to high-risk populations and widespread testing, B.C. is the only province in Canada where the rate of new infections declined since 1996.

"I have every expectation it will be lower in 2012, 2013, 2014 and thereafter," said Montaner.

It was three years after getting on HAART that McIntyre met Daviau. After the two failed relationships, McIntyre stayed single for nearly a decade. He wasn't looking for a relationship when he met Daviau in an online chat room on spirituality. The pair met up when they found out they lived only five blocks away from each other.

McIntyre, an HIV/AIDS activist, was frank about his status from the start. The diagnosis did not faze Daviau, who fell in love with McIntyre's "positively positive" attitude.

"He was full of life and joy. He has this amazing zest for life, even having to deal with a disease like this," said Daviau, 57.

Even though McIntyre is HIV-positive and Daviau negative, transmission is not an issue because HAART has reduced McIntyre's viral load to almost nil. The couple also practice safe sex.

On June 2, 2001, a year after dating, McIntyre and Daviau got married at St. John's United Church. Gay marriage was not legal in Canada at the time, so last year, the couple made it official by renewing their vows.

McIntyre said living with HIV is still not easy. He has to adhere to a drug regimen twice a day. There are side-effects and occasional health problems and the niggling worry he might develop resistance to the drugs.

But the ups and downs and stresses that came along with being HIV have made their relationship stronger, he said.

"Two weeks before we got married, I said to Deni, 'If we could have a year,'" said McIntyre.

"Now here we are. And I'm not ready to stop."

TIMELINE

  • 1982
    The first known HIV patient in B.C. was admitted to St. Paul's Hospital

  • 1985
    70 reported AIDS cases in the province, mostly treated at St. Paul's.
  • 1986
    St. Paul's opened its first dedicated clinic for people with HIV/AIDS, now called the immunodeficiency clinic, which has about 1,100 patients

  • 1987
    The research program that will eventually become the internationally recognized B.C. Centre for Excellence in HIV/AIDS was founded by Dr. Julio Montaner.
  • 1987
    The first treatment against AIDS, zidovudine, AZT went on the market.

  • 1988
    368 reported AIDS cases to date.

  • 1990
    The Canadian HIV Trials Network, a federally funded national network of researchers, is set up at St. Paul's.

  • 1996
    Debut of highly active antiretroviral therapy, HAART, transforming the treatment of the once-lethal disease
  • HIV SNAPSHOT

    2009 numbers from B.C.

    Unknown: 5 % (17 cases)

    Male-male (MSM) contact 45.6 per cent (154 cases)

    Other: 3.9 % (13 cases)

    Intravenous Drug Use (IDU) 18.9 % (64 cases: 43 male, 21 female)

    Heterosexual contact 26.6 per cent, 90 cases (50 male, 40 female)

    DISCLOSURE

    The Supreme Court of Canada recently rules HIV carriers with low viral loads who wore condoms do not have to disclose their HIV status to their sexual partners.

    However, HIV/AIDS advocates say the decision did not go far enough because people with HIV are still criminalized.

    "This comes from an era where there was a real fear that people with HIV can transmit and real ignorance for what the consequences are," said Dr. Julio Montaner of the B.C. Centre for Excellence in HIV/AIDS.

    The Heartbeat series is an eight-month special feature for which The Province has been granted special access to St. Paul's hospital. The series runs one week each month until November.

    SUSAN'S SECRET: SHE'S HIV-POSITIVE

    Susan loves the time she spends with her family, especially her 18-month-old grandson. "He's

    "He's my life," she said. "I spoil him like crazy."

    But Susan, 52, carries a secret she hasn't been able to tell her family: that she is HIV-positive.

    The Downtown Eastside resident was diagnosed five years ago following unprotected sex. She goes to St. Paul's every two months to get blood tests and X-rays. She gets her antiretroviral drugs and support from the Portland Hotel Society, which runs Woodwards social housing where she lives.

    She feels healthy and "normal," said Susan, and doesn't want to risk the stigma HIV/ AIDS can confer.

    "I'm really scared of telling them," she said. "I feel like they are going to see me different."

    Susan, which is not her real name, has not been in a relationship since her diagnosis, and doesn't plan to get involved with anyone any more. She'd rather stay single, she said, than have that awkward conversation.

    She credits having stable housing and proper supports with enabling her to focus on taking care of herself.

    "When you have somewhere to live, someone to help you with it, it's much better."

    Vera Horsman, Wood-wards clinic nurse, said HIV-positive patients need to take their pills every day or else their body can develop a resistance to the drugs. In the Downtown Eastside, however, patients can often have other pressing issues to deal with, whether it's food or housing or other health conditions.

    "Once everything is settled, and they don't have to worry about their lower tier of needs, that's when they can focus on their health and taking medications every day."

    EXPERIMENTAL DRUGS SAVED THIS OLD DOG

    Vancouver artist Tiko Kerr described himself as a "tough old dog" when it comes to dealing with the side-effects of HIV drugs.

    "I've never really had a problem," said Kerr, who was diagnosed with HIV in 1985. "They can throw anything at me and I'd be fine."

    But the immunodeficiency virus had a sneakier way of bringing Kerr to his knees.

    After two decades of taking medication, his body developed resistance to every HIV drug on the market.

    By 2005, nothing was working. Kerr's viral load shot up. He fell prey to various opportunistic infections.

    "They were throwing everything at me," he said. "I was starting to fade quickly."

    There were two new antiretroviral drugs that looked promising still in the clinical trial phase.

    Dr. Julio Montaner of the B.C. Centre for Excellence in HIV/AIDS had been trying to get Kerr and four equally desperate HIV-positive patients on the drugs for 10 months, but the federal government refused.

    "We were getting sicker, and angrier," said Kerr.

    In November, Kerr took the fight public. Within two months, the government granted him and the other patients compassionate access to the experimental drugs.

    It was too late for one patient, who died waiting. But Kerr got it in time: within five days, his viral load dropped 90 per cent; within a month, it became undetectable.

    Today, at 60, Kerr is fit and appears healthy. He rows and goes to the gym - and he still takes the pills, 10 a day, five at 8 a.m., five at 8 p.m. He will be on them forever.

    "I don't mind," he said. "Frankly, most of the time I don't think about it until someone asks me about it."

    By Cheryl Chan

    GET TESTED

    "The message is: If you have had sex - ever - get an HIV test. It's the right thing to do," said Scott Harrison, program director of St. Paul's immunodeficiency clinic.

    The province has pushed to normalize testing, encouraging everyone to get tested for HIV, even though they may not be in a category considered high-risk.

    There is a pool of about 3,000-4,000 people believed to have HIV who are not aware and do not access treatment and who are highly likely to transmit the virus to their partners.

    ###

    Posted with the express permission of: "The Province",
    a division of Postmedia Network Inc.

    Reproduction Prohibited

    Related Post: Watch Video: Heartbeat: Love in the time of HIV/AIDS


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