Sadly, I've had to give up some of my regular Friday columns, due to cutbacks to the freelance budget at the Times Colonist. I won't be writing for the first Friday of the month anymore.

It's bothering me more than I would have expected, but so it goes. Change always ends up being a positive thing, in my experience, but that's not to say it ever starts out pleasantly.

I've never seen the media industry in such a state. Where's it all going? Nowhere good for the immediate future, and for the industry as it currently exists. But something new will rise from the ashes, and perhaps it's time.

My wish would be for a return to smaller, locally owned media. I never got to experience that during my career, because the Thompson corporation owned all the small papers I was working at in my early years, and since then it's been Southam, Hollinger and Canwest in rapid succession. But I've always thought that would be the model with the most potential for understanding the kind of news that a particular community needs to know.

If there does end up being a fire sale of Canadian media properties, what's stopping a few locals from coming together to start their own media outlet? The business is still profitable for the most part. I can see from the chaos in the industry that things are really going to have to change, but the business of media is far from a lost cause.

People are always going to need information. Communities are always going to need a way for their citizens to talk to each other about issues of shared concern. The Internet is a marvelous place, but it can't meet all our needs. I've always thought the best thing about a good newspaper is that it tells you about things you didn't know you wanted to know about, something that a self-directed Internet news search simply isn't as likely to do.

I've met a lot of young people who don't read any news media. That scares me. But at the same time, I'm as tired of "the news" as anybody else.

Mostly that's because it's the wrong news for me. If it were up to me, I wouldn't choose to be kept up to date on every death, fire, car crash, grotesque act, and tragic turn of event in Canada. I get that I need to know about foreign wars and politics, but surely there's a better way of doing it.

But in between the irrelevant stories, I still find great, compelling, important information in our media. I still love newspapers. So I'm sure hoping that what comes out of all of this crashing about in the industry at the end of the day is more of what's great about it and much, much less of what's not.

Anyway. Hang in for the transformation.

If you see this Vancouver Sun article in YOUR local paper, please write a letter to the editor!

I'm an advocate for the rights of sex workers, and one of the biggest problems out there is that all the study, research and reporting is almost exclusively about the experiences of marginalized "survival" sex workers - who make up just 10-20 per cent of all sex workers - yet is presumed to be the experience of all sex workers.

Case in point: an article from the March 4 Vancouver Sun, a shorter version of which ran in the Victoria Times Colonist and Edmonton Journal today (and perhaps other publications - those are just the ones I'm aware of) on HIV/AIDS prevalence among "female sex workers" in Vancouver. I tracked down the original study and the error begins there, as the information they wrote about came from three studies of survival sex workers in the Downtown Eastside, yet the language they use makes it sound as though the findings are representative of Vancouver sex workers overall.

So here's my letter to the editor that I've fired off in various directions this morning, followed by the Sun article. I've got the original study as well if anyone wants me to send them a copy - e-mail me at patersoncommunications@gmail.com. Thanks for caring.

Letter to the editor
Re: “One quarter of female prostitutes HIV-positive,” March 5
I’m writing to correct a blatant error in the reporting of findings from a B.C. Excellence in HIV/AIDS study.
This study was essentially a review of existing literature around HIV/AIDS prevalence among high-risk populations in Vancouver, including survival sex workers in the Downtown Eastside. However, the reporting of it wrongly extrapolated its findings to include all sex workers - the vast majority of whom are indoor workers (escorts, erotic massage, independents) who were never among the groups studied.
One of the primary myths around sex work is that those who do the work are vectors of disease. For those who work in the frequently miserable conditions of outdoor survival sex work, HIV/AIDS is obviously a risk due to high addiction rates and perhaps more unwillingness to turn away customers who refuse to use a condom.
Indoor sex work is a very different industry, however - one that has gone virtually unstudied and unreported on in Canada.
An estimated 80-90 per cent of Canadian sex workers are indoor workers. The limited studies that have been done on the tens of thousands of Canadians who work in the indoor industry have found dramatically lower rates of HIV/AIDS, violence, coercion and misery. Yet this group of workers is routinely lumped in with survival street workers for the purpose of sweeping statements on the fate and health of sex workers overall.
Sex workers are extremely stigmatized as it is, and feel the tremendous impact of that on their lives every single day. Research and reporting that overlooks the numerous differences between indoor and outdoor sex work can only perpetuate that.

Jody Paterson
Victoria, B.C.

Original article from Vancouver Sun, March 4

One-quarter of Vancouver’s female sex trade workers infected with HIV
Pamela Fayerman, Vancouver Sun
Published: Wednesday, March 04, 2009
VANCOUVER - Twenty-six per cent of Vancouver's female sex trade workers are infected with HIV, as are 17 per cent of the city's injection-drug users, a new B.C. study shows.
The study, by researchers at the B.C. Centre for Excellence in HIV/AIDS and published in the Harm Reduction Journal, is the first in Canada to estimate the per-capita prevalence ranges for high risk groups, using United Nations/World Health Organization software, 2006 Statistics Canada data and other sources such as population surveys.
Gay men, the local population of which is said to be 20,000, including male sex trade workers, have an estimated HIV prevalence rate of 15 per cent.
The overall prevalence of HIV in Vancouver is about 1.21 per cent, six times higher than the national rate.
"Drugs and sex are the preferred routes for transmission. Female sex trade workers get paid more money for having unprotected sex with johns," explained co-author Dr. Julio Montaner, who is president of the International AIDS Society and head of the division of HIV/AIDS at the University of B.C.
There are up to 520 female sex trade workers in Vancouver. Montaner, asked if the high HIV prevalence among prostitutes should trigger a warning to visitors during the 2010 Olympics, said:
"I don't want to jump on the Olympics bandwagon with this. There should be public advisories everywhere about this, not just because of the Olympics. People who avail themselves to this industry should know you better watch out.
"At home, tourists and transients may behave like star citizens and then, when people go to places like Vancouver, Vegas or Thailand, they party it up," he said.
Dr. Patricia Daly, chief medical health officer for Vancouver Coastal Health, said she had not yet read the report, so she couldn't say whether a targeted public health campaign for those who pay or trade for sex is required.
"Our message has always been that you should assume sex trade workers are HIV positive," Daly said.
"It is a high-risk activity for all kinds of infections and therefore you need to practise safe sex.
"During the Olympics, we are going to be distributing 100,000 condoms to athletes and hotels along with educational information. Whether it will specifically mention the sex trade I cannot say at this point," she said.
The high prevalence of HIV among female sex-trade workers is an emerging trend, given that in the 1980s, most infections were among gay men and in the second wave of the epidemic, injection drug users were hit hard.
"We always knew we had a significant problem, because of factors like our benign climate causing people to drift here, being a port city, and having so much poverty and so many homeless people on the Downtown Eastside," Montaner said, adding that it is difficult to know if men who buy sex from infected prostitutes are also getting infected.
"We don't have any way of accessing the johns to ask them those questions," he said. "And if we see them in our clinics, it's not like they volunteer if they got it that way. They would be more likely to report that they got it through having casual sex, or with multiple partners."
Montaner said HIV experts have made a pitch to the provincial government to "seek out and treat" HIV-infected individuals who are not on medications. It's estimated there are about 13,000 B.C. residents infected with HIV - 11,000 males and 2,000 females - but fewer than a third of them are taking such medications.
Montaner believes the number on medications should be more like 7,500. He said that would reduce the number of new infections each year from 400 to 300.
"The premier, the health minister and other government officials have been very supportive about this kind of progressive approach.
"But now with the economic downturn, we are in a waiting mode. We need an outreach program that brings treatment to the people, to make it more accessible," he said, referring to his vision of clinics in high-risk neighborhoods where such medications would be distributed.
Currently, the drugs are not taken by HIV-infected patients until their immune systems have deteriorated to a certain level. The delay-until-you-can-no-longer-delay approach is intended to save money and stall the potentially unpleasant side effects of medications. But it also means that untreated HIV patients can transmit infections.
Under another proposed strategy by Montaner's group, the "highly active antiretroviral therapy" (HAART) medications would be taken by infected patients far earlier in their disease process, so they wouldn't get the opportunity to transmit the disease.
HAART is said to be nearly 100-per-cent effective at preventing HIV by suppressing viral loads to undetectable levels and preventing people from developing full-blown AIDS by boosting the immune system. A report from the B.C. Centre for Disease Control shows that in 2007, there were only 61 full-blown AIDS cases in B.C, the lowest number since 1994, largely because of the availability of such lifesaving medications.
Sun Health Issues Reporter
pfayerman@vancouversun.com

Health authority's detox rules block access for street users

We met over coffee last week, each with our own reasons for being there.
I was there to find out why the region’s new 14-bed detox unit is virtually unavailable to people from the street community. He wanted to know why the media always fixate on the negative.
We talked for an hour and a half. I’m not sure that either of us fully understood the other one’s points by the end of it all. But at least we heard each other out, and I appreciated his frankness.
As the director of addiction services for the Vancouver Island Health Authority, Dr. Laurence Bosley is an important man when it comes to addressing some of the immense problems on our streets.
Addiction certainly isn’t the only reason why people end up homelessness. But it’s a major reason for why they get stuck out there. So when the health authority opens a new detox with policies that essentially exclude most of the several hundred people with addictions on our streets, I’d like to understand why.
But first to Dr. Bosley’s point about the media, because I do get what he means. We desperately needed the new detox and seven “stabilization” beds that opened this month, and it’s a beautiful facility in a time of scarce resource.
So I understand Bosley’s unhappiness at having media hone in on two “negative” angles on the story: That the facility isn’t available for stimulant users (people addicted to cocaine or crystal meth); and that it goes against the health authority’s own addiction-treatment policy by prohibiting smoking anywhere on site.
But like I told an audience of young activists at the youth-organized Change Conference this past weekend, you don’t fix a hole in the roof by talking about the 90 per cent of it that isn’t leaking. We won’t address what’s wrong in this world without talking about the problems.
Detox is the first step in getting out from under an addiction. It’s essentially five to seven days of care and prescription-drug therapy to help people through the most immediate withdrawal effects of whatever drug they were using.
Bosley rightly notes that it’s a pretty minor step, all things considered. But it’s the first one nonetheless. None of the steps that come after - treatment; spiritual healing; finding new ways to cope; drug-free housing; new friends and places to go; the hard, hard work of staying sober - can begin without detox.
So when policies at the new detox shut out the most prominently addicted people in our region, that’s one heck of a leak in the roof. The dominant drugs on the street right now are crack cocaine and crystal meth, so the no-stimulants rule alone has huge implications. But add in the no-smoking policy for a population for whom tobacco is the sole saving grace of life, and you’ve shut out the people who most need the help.
Bosley applies a cost-benefit analysis to the issue. The health authority has a limited amount of money to spend, and unrelenting demand for all its services. It’s making choices all the time in terms of who’s getting care.
On the detox front, Bosley points out that withdrawing from heroin or alcohol can kill you, and must be done under medical supervision. Withdrawing from cocaine or crystal meth is unpleasant, but not life-threatening. VIHA’s mandate is to provide medical care, not to give away expensive beds to people who really just need a place to lie down and sweat it out.
Except people on the street don’t have a place to lie down. No bed to sleep in for five straight days, that’s for sure. No way to get away from the sellers and the users. No place to detox, and thus no way to even begin the long journey out of addiction.
Bosley also notes that it makes little sense to give someone who’s homeless a detox bed for five nights and then just release them back to the streets. On that point we definitely agree. He wonders if we try too hard to “cure” everyone, when some people’s problems simply may not be curable.
I would argue that we’ve barely tried at all in terms of the street community. The significant successes of the three VIHA-led integrated outreach teams in keeping people supported and housed this past year underline how much can be accomplished when we do get down to the business of dealing with people’s real needs.
As for smoking, Bosley says he can’t believe anyone is surprised at that decision: “That’s just good clinical care.” I guess I see it as picking your battles. What good can come of denying people care for their addiction just because they can’t quit smoking?

Best bet for ending gang violence is to remove the profit

A UVic student I met last fall when I was teaching a journalism course let me read an interview he’d done with a Vancouver gang member - a childhood friend of his.
It was an extraordinary read. Everybody’s got an opinion on why gangs have become such a deadly problem in B.C. and how we’ll get a handle on things, but it was fascinating to get a take on the issue from the point of view of a former gang member.
Like a lot of the young people caught up in Vancouver’s gang scene right now, this kid had grown up as a generally happy and well-cared-for child in a financially comfortable family. Boys emerging from impoverished, troubled childhoods are still the primary recruits for a lot of Canadian gangs, but the rise of a new kind of gang culture in Vancouver points to more complicated risk factors that we’ve barely begun to understand.
This particular young man was drawn into gang life after meeting another teen a couple years older than him who had it all going on: Money; cars; girls; drugs; stature among his peers. The older teen asked the boy if he wanted to earn a little money selling marijuana to his secondary-school classmates.
Within months, he was making more money than he’d ever imagined. He’d also undergone a transformation among his peers: From the quiet kid at school who nobody noticed, to the one whom everybody wanted to hang out with.
He had a cool car, lots of girls interested in him, and access to the best drugs. Heady stuff when you’re an invincible 16-year-old.
Neither this boy nor anyone he worked with in the gang seemed to worry too much about running afoul of the law. So I’d counsel that we think twice before assuming that more policing and tougher jail sentences will solve Vancouver’s escalating problems. Things are always much more complex than that.
The boy was eventually invited to be a truck driver for the gang, moving drugs back and forth over the Canada-U.S. border. The older teen he’d first met continued to be a mentor of sorts, even inviting the boy to room with him for a while after he fought with his parents over the source of his lavish new lifestyle. The parties at the new place were non-stop.
In his eight years in the business, he never got caught. He made a ton of money. The only reason he even left gang life was because guys above him in the hierarchy started getting killed by rival gangs, and he knew his time would be coming soon if he didn’t get out. He’s back at university now, studying to be a pharmacist.
A word like “gang” has a great deal of emotional charge, but at its essence a gang is an organization that’s in the business of buying, selling or producing something that’s illegal.
The product can be just about anything; I remember reading a few years ago about U.S. gangs who specialized in hazardous waste, because there was a lucrative business at that time in illegal dumping. Here in B.C., it’s mostly drugs, the trade of which we are superbly placed to handle due to our long coastline, proximity to the U.S., and sophisticated network of marijuana operations.
Were the product anything but illegal drugs, the B.C. government would be bragging about the runaway success of a local industry. Like it or not, it’s an immensely successful industry, albeit one in which murder is an acceptable corporate strategy for resolving rivalries and personal slights.
Gangs exist because many, many people in the mainstream community want to do illegal things, and go looking for someone to provide it. So either we’re going to have to stop buying anything illegal, or we’re going have to make more things legal in hopes of cutting into gang profits.
We obviously don’t want to be legalizing every criminal activity. But it seems to me we could make significant progress by starting with drugs and sex. Decades of bad law haven’t done a thing to curb demand or supply of either of those products, so it’s not like we’d be abandoning a winning strategy.
It’s the buying habits of the mainstream community that fuels gang activity. Any real solution has to involve making gang life less profitable.
Yes, we also need enforcement, and meaningful tools for understanding the small segment of privileged, middle-class boys who end up attracted to the egocentric and anti-social world of gangs. But we’ll get to the root of the problem only by taking the money out of it.

Any more lean years for non-profits a potential disaster

The lesson that lingers the most for me from my three years of heading up a non-profit is how very hard you have to work just to keep the doors open.
Whatever else may be happening on a given day, the one constant for anyone running a non-profit is the endless hustle for money. Barely a moment went by in my time at PEERS Victoria when I wasn’t working at least a dozen different angles to make sure we’d have enough money to keep going.
And that was in the good times. In bad times - well, I guess we’ll see. Nationally, expectations are that as many as a fifth of Canada’s 60,000 non-profits will close as a result of the economic downturn. Small non-profits walk a razor edge when it comes to survival, so that number sounds frighteningly accurate to me.
Non-profits rely almost exclusively on governments, investment-rich foundations and generous citizens for their funding. None of those groups have much interest in spending at the moment.
That’s a scary development for a sector that generally lives by the seat of its pants even in boom years. It’s an equally scary development for what it will mean for the tens of thousands of British Columbians who rely on the myriad services and programs run by non-profits. B.C. agencies are awaiting Tuesday’s provincial budget with particular trepidation, as the province provides the bulk of their funding.
“How do you do the work you do if you don’t have any profit?” a UVic student once asked me after I’d told her PEERS was a “non-profit.” The label is fairly baffling, I agree, and “not-for-profit” no better.
What’s possibly worse for the sector is that both terms call to mind a kind of begging state, a place where there’s never any money to be had . That’s certainly how it is for a lot of small non-profits, but you know what they say about how a label can hold you down.
Essentially, the sector does the work of government - most importantly, the human-service work essential to a civil society. The private sector doesn’t set up shop unless it can turn a profit, so a typical western democracy like Canada turns to non-profits to do all the other work that would otherwise go undone.
That’s the reason why it’s PEERS and not a private business providing outreach on the local prostitution stroll. It’s the reason why poor people in the downtown are fed and cared for by non-profits, and why the work of holding families together is mostly done by neighbourhood houses and other small agencies.
The people who need those services don’t have the money to pay for them, which means the work is all cost and no revenue. That’s the kind of service that’s either going to be provided by the non-profit sector or not at all.
British Columbians count on a very long list of non-profit-run services to be there when they’re needed. Sexual-assault counselling; programs for children with disabilities; job training and placement; legal advice; support for troubled teenagers; seniors’ care; on and on - were it not for all the work done by B.C. non-profits, this province would be a much sicker, sadder and less productive place.
But it’s one thing to be thankful for the work of non-profits, and quite another to fund them with any kind of consistency. Unstable funding that rarely keeps up with cost-of-living increases has been the norm even under governments professing interest in looking after vulnerable citizens, but has become much more of a problem in the past decade as governments moved to reject responsibility for the social health of citizens.
In B.C., those shifting ideologies placed the non-profit sector firmly on the outside looking in during the economic boom. Having gone hungry for several years now, many are in poor shape to withstand whatever might be coming now that the economy has collapsed.
Obviously, we need to be worried in B.C. about lost construction jobs and dried-up industrial contracts, because that’s where the recession has shown its face first. But there’s big trouble on the horizon that will rock the non-profit sector as well, at a time when it’s weak from years of underfunding and facing even greater demand for services due to the crashing economy.
Perhaps it’s the nature of the work - not nearly as visible as a broken arm or a cancerous lung, not nearly so easily measured as a graduation certificate or an overcrowded classroom. But it will be our grand mistake if we underestimate the importance of keeping our non-profits in fighting shape for the hard work that lies ahead.