Dr. Gilchrist.

Thank you, Mr. Chairman. The levels of sexually transmitted diseases in the NWT have, over the past many years, been much higher than the national levels. At some stages it is, approximately, ten times the levels. Those figures are a little bit deceptive in the sense that they are not age adjusted. In other words, if we were to compare our population in terms of age to a southern population probably the difference would not be as great. Nevertheless, even if you do conduct an age adjustment on the figures, our rates have always been higher than they have been in southern Canada. The 1,000 figure which Mr. Lewis is referring to is a drop of approximately 200. The number of the previous years was approximately 1,200, so, it is down that much, but it remains considerably higher than the rates which one would see in southern Canada.

Thank you. Mr. Lewis.

We have been told that one of the problems we face is that there seems to be an absence of frank discussion on the nature of the problem because these kinds of subjects tend to be taboo and people tend to want to handle them in a very careful manner. I suppose, by forcing us to discuss this in the Assembly, we are in a sense, being asked to deal with one of these taboo subjects in a way that is perhaps more blunt and forthright than usual. On the basis of the statistics that we have gathered, it seems the population of the Northwest Territories has always been at greater risk with regard to sexually transmitted diseases than the general population of the country. Is that what we are saying? For some reason, because of the way we behave, our population is somehow different to the general population of Canada. Is that what you are saying?

Thank you. Madam Minister.

Thank you, Mr. Chairman. I will let Dr. Gilchrist respond to that.

I think that, Mr. Chairman, the answer is clearly, for whatever reason, our NWT people are generally at greater risk and have been for quite some time. We talked about differences yesterday in terms of the way HIV is transmitted. In the NWT, it is largely by male to female, female to male transmission as compared to southern Canada. That was a difference. I would say that, yes, Mr. Lewis, it looks to me like there are differences which indicate that the risk of picking up an STD in the NWT is higher than it is in the rest of Canada.

Thank you. Mr. Lewis.

We were given a paper by the department, Tabled Document 92-12(3), HIV and AIDS in the NWT in 1993, which provides us with a profile and a great deal of information in just four pages. The movement toward a solution you have given is summed up in three phrases. It says, "Still, HIV can easily be stopped if people stay with one sex partner, always use a condom and do not use injection needles." Are you saying that part of the solution would be if people were to be, to some degree, monogamous? In other words, once they agree they have chosen a partner, that will be one way of preventing the spread of this sickness. Does it also mean that partner also has to use condoms, even when you decided that you are going to stick with one partner? Do you always do that?

Thank you. Madam Minister.

Thank you, Mr. Chairman. I will let Dr. Gilchrist respond to that.

Mr. Chairman, we are touching on an area where morality blends in with issues of sexual health and other issues. I guess the answer is, it takes two to tango. In other words, there are two partners involved. If both partners are absolutely faithful to their spouse, neither partner is at risk of picking up this infection. If one partner is faithful and the other is not, clearly one introduces a risk for both partners. The situation, in terms of behaviour across Canada, is that some studies have shown, on average, adults in Canada have an average of eight sexual partners in their lifetime. If that is the case, and we do not know if that is the case in the NWT, my feeling is that, in order to be absolutely sure, both partners need to accept the obligation to have safe sex, to either limit themselves only to their one partner, or to use the appropriate precautions, or both. I do not know if that answers the question, Mr. Chairman.

Thank you. Mr. Lewis.

From many people I have talked to about this, there seems to be a general feeling that the problem could be solved if you knew who to avoid. This comes up time and time again. If only we could find the threat and we avoided that threat, we would be safe. The fact that people's behaviour would only be somewhat modified leads me to believe that simply having that information provides you with a sense of false security because, really, just by knowing that one or two people definitely have the HIV infection, is no guarantee that two or three other people you may be involved with do not have it. It is simply that you know for sure these two or three people who are infected should be avoided and then you would be safe, in the sense, at least you are not being infected by those two or three people. There is no guarantee you would not get it from someone else. I am convinced that we are going up the wrong path, if we think we can solve the problem just by knowing who to avoid.

My question is, from your knowledge -- and I have lived in several small communities -- is it not likely that in those communities that most people would know who the problem cases are? Even though we have confidentiality and all the ethical considerations looked after, it is very difficult in my experience in a small community to hide anything. It is almost impossible. In reality, in communities where there are people who are HIV infected, what is the judgement of the department? Do people locally know who is infected, or is it a secret which is kept so carefully and closely guarded it would be impossible for the community to find out?

Qujannamiik. Honourable Minister.

Thank you, Mr. Chairman. I will let Dr. Gilchrist respond to that.

Thank you, Mr. Chairman. Of the 24 infections which we know about and that we have looked at as carefully as we can, some of the people who are infected seem to have had the misfortune to become infected after, perhaps, one exposure. These people then would not be seen by their neighbours, friends or families as being promiscuous, they would not be seen as people who were at special risk. Several of the 24 have been people who are not ordinarily inclined to abuse alcohol. They do not get drunk on a regular basis, and my expectation is that most people would not think that they were likely to be infected. Of the 24, I believe that probably less than one quarter would ordinarily be suspected by their friends, neighbours or family.

Thank you. Mr. Patterson.

Thank you, Mr. Chairman. I am very glad we are having this debate. The previous Assembly had a very good debate in committee of the whole on this issue when the AIDS crises was developing. I would like to think that it helped lead to the so-called AIDS project, which I think did some very good work over three years in alerting our population to this staggering problem.

Mr. Chairman, I think the information we have been given should tell us that there is still a great cause for alarm. As I understand it, the random blood sampling which was done showed much higher rates of HIV infection than the national average, although I understand it was a limited sample and therefore may not be statistically as valid as if it would have been a larger sample. I also noted we have a higher proportion of heterosexual infection in the Northwest Territories than in the rest of Canada. These are very alarming indicators, Mr. Chairman, and I think it means that the problem should be treated as a matter of the most urgent priority by the Minister and the Department of Health.

Mr. Chairman, Tabled Document 91-12(3), which is a review of the so-called AIDS project, is a very useful document. I would like to note, in my view, it contains some excellent recommendations. Some of those recommendations touch on the issues Members have raised this morning. I would like to touch on a few of them. One of the recommendations on page v, suggests there should be discussion promoted in the Legislative Assembly which will bring AIDS and the need for a new campaign to the forefront. We are doing that and I am happy that we are doing that now.

Mr. Chairman, another recommendation I noted is that there should be funding secured to provide each regional health board with a person year for a health promotion officer whose main responsibility will be AIDS education. I understand the philosophy of the department has been that responsibility should take place, should be given to deliver these programs at the regional and community level because each region is different and these boards do have the capability to reach into the communities. I think this makes sense, but I also think they need the resources and materials to do the job. So, it seems to me that even in these times of scarce funds, the recommendation of having health promotion officers dedicated to this issue available in each region will be a critical response to public concern or the Members' concern about this.

On the moral issue that Mr. Gargan and others have discussed, I note that recommendation 24, and there are many recommendations about media and television, suggests that elders could participate in a video to discuss life-style issues, such as spirituality, values, choices, personal and community growth. Life-styles that have a positive image as role models could be presented. I think this, too, would be very helpful. We have this fantastic tool for communication in Television Northern Canada in aboriginal languages. It is an existing, very expensive system. It is there, all we have to do produce the material and we can have access, and it goes to every home whether you are a cable subscriber or not. This is a fantastic opportunity to do mass education awareness.

It has also been suggested that there be a comprehensive sexual practices survey, recommendation 31, to examine cultural mores surrounding sexual practices in the Northwest Territories. We need to know more about our people, when and how they engage in sexual activities. I suspect we will find that most of the dangerous unprotected sex occurs in the context of alcohol use. If that is the case, then perhaps this is where we should target our distribution of condoms and our education programs.

In general comments, Mr. Chairman, I would like to say that I believe the perception is that after an intense activity, where people went door to door, there were a great deal of promotional materials, there seems to have been less emphasis on this issue. There is a bit of a perception growing that perhaps the problem is reduced and perhaps everything is all right. The information we have got this morning from the Minister and her officials is that it is not all right, there are some very alarming indicators and perhaps we need to revive the issue through this discussion and through other initiatives.

In closing, I would like to ask the Minister whether, and I know this was recommended by the Standing Committee on Finance which she was a Member of, there should be a targeted priority on AIDS and whether, in fact, the department has a strategy and will make it a priority to respond to, at least, some of the recommendations in this evaluation. I think it has many sensible recommendations. Will it be the Minister's priority to respond to this report with a plan and with dedicated resources? Thank you.

Thank you. Madam Minister.

Thank you, Mr. Chairman. With AIDS being a serious disease, it would be very negligent of the department if they did not implement the recommendations which are stated in the review. It remains to be the priority of the department because of the nature of the disease. I will encourage the department to work on the recommendations and have some responses made and perhaps have a strategy developed from those recommendations. Thank you.

Thank you. Mr. Patterson.

Thank you, Mr. Chairman. I am very pleased to hear that. I will say again that a simple and fast thing would be to have more accessibility to free condoms. I think that could be done relatively quickly. Mr. Chairman, I would like to ask one other question relating to policy on disclosure. The information provided by Dr. Gilchrist indicates that cases are now wide spread in the regions of the Northwest Territories. I fully respect the sensitivity of any suggestion that will disclose names. I think we want to encourage people to come forward to be tested knowing that they will not be risking exposure by name. However, I would like to ask the Minister, now that the epidemic, or disease, is spreading and seems to be present in many regions of the territories, I wonder whether consideration should be given to change the disclosure policy -- that would be disclosure of cases by region, not names.

The reason I suggest this, Mr. Chairman, is we had a very brave woman from Iqaluit who came forward, talked about her disease, went to schools and did her very best in the last month of her life to warn others about this terrible disease. She talked about the dangers of unprotected sex and how drunkenness can lead to carelessness. I believe this had a big impact in our region and, perhaps, in other regions. I believe, and I talked to people about it even in the bars, they started thinking about the issue as being a real issue because this brave young woman identified herself.

I think there are other regions where the penny may not yet have dropped. If the Minister of Health was to consider amending the policy to state that we have around 34 cases of AIDS/HIV in the territories and they are located in the following regions, for instance, the Inuvik region has a case or several cases. I think people, who may be pretending that everything is all right in their region and that it is just the Baffin or Iqaluit, may start to think it is closer to home than they might otherwise think. This may require Cabinet consideration, but I would like to ask the Minister if consideration could be given to regionally revealing case numbers statistics, but, of course, not names. I think this was something the Baffin health board had taken upon themselves to do a number of years ago. At that time, it was felt premature, perhaps because there were so few cases and it was felt it might possibly lead to identification of individuals in that region, but those days are over. From what I have heard, there is enough of a proliferation throughout the territories, that it may be timely and may help the public become aware if the policy was reviewed in that direction. Can the Minister at least entertain that idea? Thank you.

Madam Minister.