HIV and AIDS in Canada

Compilation : A. H. Serdar

I. What Does “AIDS” Mean?

II. Sexual Risk Behaviors of Canadians

III. Canada Statistics by Year and Age

 

I. What Does “AIDS” Mean?

AIDS stands for Acquired Immune Deficiency Syndrome:

* Acquired means you can get infected with it.
* Immune Deficiency means a weakness in the body’s system that fights diseases.
* Syndrome means a group of health problems that make up a disease.
AIDS is caused by a virus called HIV, the Human Immunodeficiency Virus. If you get infected with HIV, your body will try to fight the infection. It will make “antibodies” — special molecules to fight HIV.

A blood test for HIV looks for these antibodies. If you have them in your blood, it means that you have HIV infection. People who have the HIV antibodies are called “HIV-Positive.
Being HIV-positive, or having HIV disease, is not the same as having AIDS. Many people are HIV-positive but don’t get sick for many years. As HIV disease continues, it slowly wears down the immune system. Viruses, parasites, fungi and bacteria that usually don’t cause any problems can make you very sick if your immune system is damaged. These are called “opportunistic infections.

How does one get HIV and AIDS?

HIV is passed from person to person through body fluids such as

* Blood

* Semen

* Vaginal fluid

* Breast milk

Methods of infection include:

* Sexual contact

* Unwashed sexual devices

* Contaminated needles

* Mother to child

* Blood products or transfusions

HIV infection is NOT passed by:

* Casual contact, such as shaking hands

* Hugging, or kissing

* Being coughed or sneezed on

* Sweat or tears

* Swimming pools

* Toilet seats or telephones

* Sharing bed linens, towels, eating utensils, or food

* Insect or animal bites

 What are the symptoms of HIV and AIDS?

In most cases, symptoms similar to the flu— including swollen lymph glands in the neck and groin, fever, headache, aching muscles, and fatigue—often develop about two to eight weeks after being infected with HIV, and generally last two to three weeks.

The next stage, asymptomatic infection, is a symptom-free period that may last up to 10 years or more. Some people, however, progress to the symptomatic HIV infection stage within a few months.

The following symptoms may appear:

* Skin rashes

* Diarrhea

* Unintentional weight loss

* Short-term memory loss

* Swollen and/or bleeding gums

* Fungal infection in the mouth and/or throat

* In women, persistent and severe vaginal yeast infections

* Sores on the genitals and/or mouth caused by herpes

Treating HIV and AIDS

Treatment for HIV/AIDS has come a long way in the past 20 years. Anti-HIV medications reduce the levels of HIV in the blood. This helps the immune system to partially repair itself. As a result, many people with HIV/AIDS in Canada are living longer, healthier lives. However, it is important to know that anti-HIV medications are not a cure for HIV/AIDS.

How can one avoid getting HIV and AIDS

There is no vaccine to prevent HIV infection. Therefore, the best prevention is to reduce the risk of infection:

* Not participating in unprotected sex unless one is absolutely certain that their partner is HIV-negative.

* Using a new latex condom

* Use clean needles

* Be careful when traveling. Not all countries screen blood and blood products for HIV.

* Talk to your doctor if you are HIV-positive and pregnant.

* Do not breast-feed if you are HIV-positive.

 Living with HIV and AIDS

The following healthy lifestyle tips will help to ensure quality of life for as long as is possible:

* See your doctor regularly.

* Take medication as prescribed.

* Get flu and pneumonia vaccines.

* Keep your hands clean.

* Do not smoke or take illegal drugs.

* Eat a healthy diet.

* Get plenty of rest.

* Exercise regularly.

 

II. Sexual Risk Behaviors of Canadians

Unprotected sexual intercourse is one of the main modes of HIV transmission in Canada. Therefore, it is important to understand sexual behavior at the population level to assess the potential for the spread of HIV and to help target and evaluate prevention programs.

* A recent Canadian survey indicated that among adults aged 20 to 45 years, 8.4% of men and 6% of women reported having two or more sexual partners within the previous year.

* In a survey, of those who reported sexual intercourse with a non-regular partner in the year prior to being interviewed, only 26% of men and 19% of women indicated that they always used condoms with non-regular partners.

* In a school-based survey conducted in Nova Scotia, approximately 61% of grade 12 students (ages 17 to 18 years) reported having sexual intercourse in the year prior to the survey. Of those grade 12 students who were sexually active, only 32% always used condoms, and 40% indicated that they had had two or more partners in the past year.

* A survey in western Canada found that 55% of 17 year-old boys and 52% of 17 year-old girls had had sexual intercourse. Of these, 33% of boys and 30% of girls had had four or more partners. Of those who were sexually active, only 57% of boys and 45% of girls in this age group used a condom the last time they had sexual intercourse.

* In a survey, girls aged 15 to 19 years had the highest rate of reported chlamydia and gonorrhea infections in Canada.

* Among MSM (Men who have sex with men), a national survey showed that 15% of respondents had engaged in unprotected receptive anal intercourse in the past year.

* In a study of bisexual males in Ontario, 50.9% of all respondents reported at least one episode of unprotected sex with a regular female partner, and 9.9% reported at least one episode with a casual female partner in the year prior to the study. Further, 12.7% of respondents reported having unprotected sex with a regular male partner on at least one occasion, and 7.6% admitted to at least one episode of unprotected sex with a casual male partner in the 12 months before being interviewed.

* In a Vancouver study of IDUs(injection drug users), 60% to 80% of respondents did not always use a condom in the past six months when having sexual intercourse with opposite-sex regular partners.

* Recent studies of street youth indicate that 85% to 98% have had sexual intercourse, with over 60% having had their first sexual intercourse before the age of 13. In addition, 52% to 78%of street youth have had six or more lifetime sexual partners, and many report inconsistent condom use.

 

III. Canada Statistics by Year and Age

Positive HIV tests and AIDS diagnoses by year

Year	AIDS diagnoses			Positive HIV test reports
	Adult male	Adult female	Total, all ages	Adult male	Adult female	Total, all ages
Until end 1996	14,840	1,117	16,145	30,113	3,852	38,649
1997	604	104	723	1,862	480	2,477
1998	541	100	645	1,696	471	2,304
1999	459	87	555	1,593	512	2,194
2000	436	57	498	1,542	487	2,112
2001	344	71	418	1,614	540	2,226
2002	340	61	404	1,809	621	2,491
2003	301	77	381	1,824	626	2,493
2004	252	60	315	1,829	656	2,542
2005	252	71	329	1,831	626	2,515
2006	191	61	255	1,810	698	2,558
Total	18,560	1,866	20,669	47,523	9,569	62,561

Trends in HIV diagnoses

The annual number of reported positive HIV test results increased between 2000 and 2004, following a steady decline since 1995. This rise may be partly due to changes in immigration policies that were introduced in 2002. HIV tests are now part of the routine assessment for immigrants and most provinces and territories include these results in their reports.

Women have accounted for around a quarter of adult HIV diagnoses reported with known gender in each year since 2000.  

Trends in AIDS diagnoses

Since the beginning of the epidemic in the early 1980s, there have been 20,669 AIDS diagnoses reported to CIDPC (Centre for Infectious Disease Prevention and Control). The number of annual diagnoses peaked at 1,827 in 1993 and has since declined to fewer than 400. A major factor in the initial, dramatic decrease in cases was the delayed or prevented onset of AIDS due to highly active antiretroviral therapy (HAART).

AIDS cases by ethnic status and year of diagnosis

Ethnic status	2001	2002	2003	2004	2005	2006	Total
Aboriginal	22	38	38	34	23	22	605
South Asian/ West Asian/Arab	9	8	10	4	5	1	170
Asian	12	11	13	9	6	2	276
Black	54	50	44	37	16	10	1,537
Latin American	10	11	8	1	4	6	273
White	231	193	158	129	90	48	13,377
Other	4	5	3	4	1	1	111
Not reported	76	88	107	97	184	165	4,320
Total	418	404	381	315	329	255	20,669

The proportion of AIDS cases with known ethnicity reported among white people declined from 91% in 1988 to 62% in 2005. Over the same period, there were steep increases in the proportions attributed to aboriginal and black people. These two groups are now highly overrepresented.

In the 2001 census, aboriginal and black people accounted for 3.3% and 2.2% of Canada’s population respectively. In the same year, these groups respectively reported 6.4% and 15.2% of AIDS cases with known ethnicity. In 2005, these proportions were 15.9% for aboriginal people and 11.0% for black people. However it should be noted that in many cases ethnicity is not reported.

Positive HIV tests and AIDS diagnoses by age group, until end of 2006

Age group	AIDS diagnoses			Positive HIV test reports
	Male	Female	Total	Male	Female	Total
Under 15	123	114	237	332	230	577
15-19	56	16	72	438	361	868
20-24	497	128	625	10,742	3,152	14,911
25-29	2,249	327	2,576
30-34	4,024	430	4,455	18,724	3,528	23,589
35-39	4,110	324	4,436
40-44	3,246	254	3,500	10,550	1,525	12,696
45-49	2,099	142	2,241
50-54	1,094	68	1,162	4,346	676	5,275
55-59	616	73	690
60 or older	569	104	673
Total	18,685	1,980	20,669	49,864	9,976	62,561

References

1.        Houston S. HIV Risk Behaviours Among Canadians: An Inventory and Synthesis. Division of HIV Epidemiology, LCDC, Health Canada, 1998.

2.        Division of HIV Epidemiology, LCDC, Health Canada (unpublished data from Canada Health Monitor, January 1997), and Houston, S, Archibald, CP, Adrien A, Blanchard J, Fisher, W, Maticka-Tyndale E, Warren, W, Sutherland, D. Development of a standardized set of questions to assess levels of HIV-risk behaviour among the general population. 6th Annual Canadian Conf on HIV/AIDS Research, Ottawa, May 1997; Can J Inf Dis 1997; 8 (Suppl A):37A, #256.

3.        National Population Health Survey 1994-1995, Statistics Canada (unpublished data).

4.        Strike C, Archibald C, Browne J, Sutherland D. Patterns of condom use among Canadians with multiple sex partners. Fifth Annual Canadian Conference on HIV/AIDS Research, Winnipeg, June, 1995 (Abstract 348).

5.        Poulin C. Nova Scotia Student Drug Use 1996: Technical Report. Drug Dependency Services Division, Nova Scotia Department of Health and Dalhousie University, 1996.

6.        King A, Beazley R, Warren W, Hankins C, Robertson A, Radford J (1988). Canada Youth and AIDS Study. Social Program Evaluation Group, Queen’s University, Kingston, Ontario.

7.        McCreary Centre Society (1993). Adolescent Health Survey: Province of British Columbia. Prepared by Larry Peters and Aileen Murphy. Investigators: Roger Tonkin, David Cox, and Ruth Milner. Vancouver, BC.

8.        Yan P, Huntley J, Sutherland D. Estimation of the historical age-specific HIV incidence in Canada. XI International Conference on AIDS, Vancouver, July 1996 (Abstract Tu.C.573).

9.        Health Canada. Sexually Transmitted Diseases in Canada: 1996 Surveillance Report. Division of Sexual Health Promotion and STD Prevention and Control, LCDC, HPB, Health Canada, 1996.

10.     Myers T, Godin G, Calzavara L, Lambert J, Locker D, and the Canadian AIDS Society. (1993). The Canadian survey of gay and bisexual men and HIV infection: men’s survey.

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12.     Sexual and testing behaviour of bisexual men in Ontario. Myers T, Allan D, Strike C, Calzavara L, Major C, Bullock S, Millson P, Graydon M, LeBlanc M. Proceedings, 6th Annual HIV Epidemiology Meeting. Division of HIV Epidemiology, LCDC, Health Canada. Quebec City, November 20-22, 1997 and Myers T (personal communication, April 1998).

13.     Patrick DM, Strathdee SA, Archibald CP, et al. Determinants of HIV seroconversion in injection drug users during a period of rising prevalence in Vancouver. Int J STD AIDS, 1997; 8:427-435.

14.     Parent R, Alary M, Hankins C, Noel L, Blanchette C, Claessens C et al. HIV among IDUs: Second surveillance year of the SurvIDU network. 6th Annual Canadian Conference on HIV/AIDS Research, Ottawa, May 1997; Can J Inf Dis 1997; 8 (Suppl A): 27A, #220 and Parent, R (personal communication, April 1998).

15.     Frappier J-Y, Roy E. HIV seroprevalence and risk behaviours study among adolescents with maladaptive and social problems in Montreal. Final report prepared for NHRDP, July 1995

16.     McCreary Centre Society (1994). Adolescent Health Survey: Street youth in Vancouver. Prepared by Larry Peters and Aileen Murphy. Principal investigator: Roger Tonkin. Burnaby, BC.

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