About 16,000 Canadians are living with HIV and don’t know it, according to statistics from Canada’s Public Health Agency (PHAC).
That figure has prompted health experts to call for increased testing and more proactive treatment to reach people who haven’t been diagnosed and prevent them from spreading the illness to others.
Dec. 1 marks World AIDS Day. Earlier this year, the World Health Organization embraced a made-in-Canada approach to tackling HIV/AIDS. But Canada has yet to adopt treatment-as-prevention outside British Columbia.
It starts with changing the way people view HIV screening and their level of risk, says Laurie Edmiston, executive director of the HIV resource website CATIE.
“We need to make testing more accessible and less intimidating for people,” Edmiston told Global News.
“Right now people get tested because they identify that they have been at risk. … We need to reach this pretty significant population of people who are living HIV and don’t know it.”
Edmiston says that men who have sex with men, injection drug users, the homeless and aboriginal Canadians are disproportionately affected by HIV/AIDS. An estimated 6,850 Aboriginal people were living with HIV at the end of 2014, a 12.1 per cent increase from the 2011 estimate of 6,110.
Injection-drug users, on the other hand, have seen a decrease in HIV infection rates, Edmiston said. PHAC attributed 270 new HIV infections in to injection drug use in 2014 – lower than the 384estimated for 2011.
“We believe this is because of all the targeted efforts such as needle syringe exchanges,” Edmiston said.
Adrienne Chan, a researcher in infectious diseases at the University of Toronto, says addressing the HIV rates in First Nations communities requires both “political will and active engagement.”
“The gateway to HIV-related care is HIV testing,” Chan said in an email. “Access to HIV testing has to be improved, both from a patient perspective as well as a provider perspective, in particular in remote communities.”
At the same time, she said, we need to address the social determinants of health – poverty, unemployment, incarceration, addiction, mental illness – that make Aboriginal-Canadians more likely to be infected with HIV and less likely to seek out health care.
“We won’t be able to bring down HIV rates without supporting this approach”
During a September UN General Assembly, world leaders set a target of ending the AIDS epidemic by 2030. This new framework includes a “90-90-90” goal that has been set for 2020: 90 per cent of people who are HIV-positive become aware of their status by getting tested; 90 per cent of those people get treatment; and 90 per cent of those people get antiretroviral therapy.
UNAIDS estimates that 17.1 million of the 36.9 million people living with HIV worldwide do not know they have the virus.