Pubdate: Mon, 23 Nov 2015
Source: Guardian, The (CN PI)
Copyright: 2015 The Guardian, Charlottetown Guardian Group Incorporated
Contact:  http://www.theguardian.pe.ca/
Details: http://www.mapinc.org/media/174
Author: Laurie Edmiston
Note: Laurie Edmiston is executive director of CATIE, Canada's source 
for HIV and hepatitis C information.
Page: A7

TIME FOR HIV LEADERSHIP IN CANADA

It's a question I often hear on World AIDS Day (December 1), when 
much of our attention turns to the global HIV epidemic. Many of us 
think of HIV/AIDS as an issue affecting other countries. But an HIV 
epidemic in Canada?

More than 70,000 Canadians are living with HIV and on average seven 
to eight new infections happen every day. While these numbers are 
concerning, Canada's overall rate of new infections is still lower 
than the global average. What these numbers don't show, however, is 
that HIV has reached epidemic levels in key populations across the country.

In certain communities across Canada, the virus is more prevalent 
than in countries hardest hit by the HIV epidemic. In the Ahtahkakoop 
First Nation in Saskatchewan, for example, 3.5 per cent of the 
population is living with HIV. In Toronto, an estimated one out of 
every five gay and bisexual men is HIV-positive. And in Vancouver's 
Downtown East Side, an estimated 27 per cent of people who inject 
drugs are HIV-positive.

At this year's International AIDS Society conference in Vancouver, we 
heard success stories from around the world as countries scale up 
their efforts to meet ambitious new testing and treatment targets set 
by UNAIDS, the United Nations agency responsible for coordinating the 
global HIV response. Modelling studies show that achieving these new 
targets will result in the end of the epidemic spread of HIV by 2030. 
With new targets at the global level and new federal leadership in 
Canada, now is the time to renew our own HIV response and catch up 
with the rest of the world.

Over the past decade, Canadian harm reduction programs were strongly 
opposed by the previous federal government, despite clear evidence 
that they save lives and prevent the spread of HIV. An estimated 11 
per cent of Canadians who inject drugs are HIV-positive. In 
Australia, where the early and consistent adoption of harm reduction 
initiatives such as needle syringe programs was supported by their 
government, fewer than two per cent of people who inject drugs are 
HIV-positive.

In Canada, a large proportion of people living with HIV do not know 
their status because they have not been tested. We may be able to 
learn from other countries that have a strong focus on testing, 
including the use of new testing technologies and strategies. By 
similarly expanding access to testing, we can help diagnose more 
people living with HIV, giving them an opportunity to start treatment 
and take care of their health and prevent further transmission to others.

With no national pharmacare plan, access to treatment is inconsistent 
for Canadians living with HIV. In fact, HIV treatment access is 
estimated to be greater in Botswana, where a national program 
provides free treatment to two-thirds of people with HIV in the 
country, improving health and reducing deaths. And partly due to the 
fact that treatment also greatly reduces the chance of transmitting 
HIV to another person, new infections in Botswana fell 70 per cent 
over the 10 years following the introduction of their program.

Canada's national HIV strategy was written over 10 years ago and 
doesn't include actions related to any of the new scientific 
developments that should be guiding our coordinated, national 
response. These new developments include the fact that people who 
start treatment soon after infection stand a good chance of living a 
near-normal lifespan and of not being infectious to others. Great 
news - but you need to get tested to know if you need HIV treatment.

 From preventing transmission, to testing and treating HIV, Canada 
has a lot to learn from countries around the world; including some 
low- and middle-income countries. This World AIDS Day is a perfect 
opportunity for us to think globally and act locally. Let's create 
our own ambitious strategy to address HIV in Canada.
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MAP posted-by: Jay Bergstrom