It was an agonizing wait, Crystal Kay says.
“I gave natural birth to my kids, right? And there’s blood involved, too. That’s what kind of made me scared to pass it on to them.”
Kay, who is HIV positive, said she had trouble accessing prenatal care and didn’t know her viral load before giving birth in Regina. She had to wait days to get her results after taking the test in the hospital, she recalled.
Now, Saskatchewan health-care workers are implementing a new HIV viral load testing program to help mothers like her and their babies.
The test is called Xpert HIV-1 VL XC, made by Cepheid. It isn’t new, but the way Sask. doctors are using it is.
It’s typically been used to determine viral loads in people, but now health-care workers are using it to help babies in Sask.
It can determine the viral load of a mother with HIV on site within about two hours, rather than waiting days for results from a central facility, said Dr. Ninad Mehta, a clinical microbiologist with the Saskatchewan Health Authority. The test provides enough information that an immediate treatment decision can be made.
Another test is done later to confirm the results.
The new practice is already in use in hospitals in Regina and Saskatoon, and it’s being rolled out in Melfort and other, more remote communities, Mehta said.
“Anywhere in the province that will deliver a baby eventually will have this test,” Mehta said.
A representative of the test manufacturer said Saskatchewan is the first province to use the test in a widespread way — and one of the first in the world to use it to help quickly determine the best treatment for newborns based on viral load data from mothers.
Kay said she hopes it will help moms avoid going through what she did.
“It would have helped me then, too,” she said. “Better than waiting for days and days.”
Dr. Ninad Mehta says the new test is being rolled out to the rest of the province. (University of Saskatchewan)
Mehta said the test is “a way for us to decentralize some testing and get it closer to the mothers.”
The program helps health-care workers provide the right care, he said, adding that staff use it as a screening test and also perform a traditional test later.
“If somebody comes in without prenatal care, while we have some of these tests on site, we can at least help provide the care providers, the physicians and the nurses, with an answer sooner so that they can make decisions about care.”
Before this, physicians might not initially know the exact viral load of an HIV-positive woman and could risk giving her and her newborn more medication or a longer hospital stay than necessary, out of caution.
“The fact that we can discharge them sooner so that they can be with their family, they don’t need to get an extra antiviral dosage, those things are important,” Mehta said.
Saskatchewan health-care workers got special permission to use the new test in 2022 and Health Canada approved it for the rest of the country in 2025.
Mehta said the new effort has involved a wide range of people, from nurses to lab technicians.
A demonstration of the new technology. (Cepheid)
Dr. Scott Sugden, the senior director of medical affairs at Cepheid Canada, said Saskatchewan’s innovation should help the province’s high HIV rate.
“Not only were they forerunners, but they’re actually creative and avant-garde thinkers in the way they’re using these tests,” he said.
The only other similar use he knows of is in Tanzania and Mozambique, Sugden said.
“I’m happy that people like Dr. Mehta and others are out there trying to find the solution.”
Lack of prenatal testing, says advocate
Katelyn Roberts, executive director and co-founder of Sanctum Care Group, said many pregnant women don’t know their HIV viral load — or don’t know they have HIV in the first place — for a variety of reasons.
“Testing is really important, but not all people have access to testing and not all individuals want to go into health-care settings where testing is available,” she said.
Katelyn Roberts says mothers frequently don’t know their viral loads. (Tammy Zdunich Photography)
Her group runs Sanctum 1.5, a home specifically for pregnant women who inject drugs.
“I think what makes women reluctant to engage in health care is actually not the HIV itself. The HIV is really easy to manage. I think it more has to do with the stigma,” she said, adding that resources for pregnant women with HIV have improved.
In 2024, Saskatchewan had a first-time HIV diagnosis rate three times the national average, second only to Manitoba, according to Statistics Canada.
