|AIDS IN CANADA
The Canadian Epidemic
The first case of AIDS was reported in Canada in 1982.
Twenty five years later, the epidemic is estimated to have claimed more than 20,000 lives.
Almost 58,000 people living in Canada are currently infected with HIV, approximately 1/3 of who don’t know they’re infected.
Due to improved drug and therapy programs the rate of AIDS deaths has been constant for the last three years, at 1,500, however new infections continue to rise. The epidemic is growing: In 1996, there were an estimated 40,000 people living in Canada with HIV, in 2001 there were 49,000 and at the end of 2003 there were 56,000. In 2002 there were between 2,800 and 5,200 new infections, alone.
The HIV/AIDS epidemic exists differently in different populations within Canada:
Aboriginal peoples and Blacks are increasingly overrepresented in the population living with HIV in Canada. In 2001, Aboriginal peoples accounted for 3.3% and Blacks, 2.2% of Canada’s population. In the same year, they respectively accounted for 5.5% and 15.3% of AIDS cases and in 2002, these proportions were 12.9% and 18.3%. People from countries where HIV is endemic accounted for 6 – 12% of new infections in 2002.
Recent gains in ARV treatment, however, have virtually eliminated new perinatal infections. The proportion of infected babies born to HIV-infected mothers has decreased from 50% in 1996 to 2% in 2002.
High Income Countries and HAART
Highly Active ARV Treatment (HAART) can be very effective at suppressing levels of virus and increasing CD4+ cell count to fight infection. Advances in HIV/AIDS treatment have led to more people delaying progression to AIDS and living longer and healthier lives. However, with the HI virus’ adeptness at mutating or changing key sequences in its genome, resistant strains of virus that cannot be killed by ARVs have evolved. A recent study in the U.S. showed that 53% of patients being treated with HAART after 6 months failed treatment, with levels of circulating virus rising to detectable or even to pretreatment levels. ARV-resistant strains of HIV are now being transmitted in the population. The overall prevalence of primary drug resistance to at least one ARV drug in Canadians infected with HIV is 7%. This figure is similar in other countries where HAART is widely used.
While ARVs have significantly reduced the number of AIDS-related deaths in high-income countries in recent years, the number of new infections has not decreased. New infection levels have remained constant at ~40,000/year in the U.S. and ~4,000/year in Canada. The epidemic is growing, in part, due to risky behaviour because widespread access to ARV treatment is fuelling a dangerous myth that AIDS has been defeated. In the U.S., one-quarter of the people living with HIV do not know they are infected and in Canada, it is one-third. Within Manhattan, almost 2% of the adult population is infected with HIV.
The number of people initiating HAART in high-income countries is increasing steadily and important lessons are being learned for application to the rest of the world where massive treatment initiatives are being launched in countries where the burden of the HIV/AIDS epidemic is felt the most.