World AIDS Day: Nine things you should know about HIV in Canada

published on December 1, 2014 in The Globe and Mail

As the globe marks World AIDS Day on Monday, we turn our attention to HIV/AIDS here at home with nine surprising facts about HIV in Canada.

1. A person is infected with HIV in Canada every three hours.

In Saskatchewan, where the prevalence rate is three times the national average, a person is infected even more frequently.

2. Twenty-five per cent of HIV-positive people in Canada don’t know they’re infected.

The proportion of heterosexual people who don’t know they’re infected is even higher (34 per cent).

3. There’s already a drug that could prevent transmission – but Health Canada hasn’t approved it.

Truvada, a drug usually prescribed as a first-line treatment for HIV-positive people, is now being heralded as the first “HIV prevention pill.” The idea is that someone without HIV can take a daily dose of Truvada and if they are exposed to the virus, their chances of being infected are significantly reduced. Some say it’s the beginning of the end of HIV in North America but others worry that it will discourage condom use. The U.S. Food and Drug Administration approved Truvada for preventative use in 2012, but Health Canada has yet to give it the go-ahead. A clinical trial is under way in Toronto to test its effectiveness for gay and bisexual men.

4. You can find out if you are one of very few people who is almost completely immune to HIV.

An extremely small percentage of people (fewer than 1 per cent) are almost completely immune to HIV. There are companies that offer genetic testing to see if you have the particular genetic mutation that may make you immune, but the practice is controversial. In November, 2013, the U.S. Food and Drug Administration prohibited a California company, 23andMe Inc., from marketing its at-home DNA testing device because of concerns over “the public health consequences of inaccurate results.” In Canada, you can order a testing kit from Delta-32 in downtown Toronto for $199.

5. In Canada, it’s is illegal for HIV-positive people to have sex without disclosing their status.

A 1998 Supreme Court decision determined that having sex that poses a “significant risk” of HIV transmission without disclosing your positive status constituted fraud. But “significant risk” has not been clearly defined and some subsequent lower court cases have prosecuted people for non-disclosure even when a condom was used. A more recent Supreme Court ruling stated that a person living with HIV does not have to disclose their status before having vaginal sex if a condom is used and the person has a low viral load. By the end of 2013, more than 145 people have been charged.

6. Canada is one of the top 10 countries in the world for arrests and prosecutions over non-disclosure of HIV status.

As of 2012, Canada was second only to the U.S. in terms of prosecutions and convictions of people living with HIV for not disclosing their status. With an estimated 48,100 people living with diagnosed HIV in Canada and 146 prosecutions for non-disclosure, Canada comes in around eighth for per capita arrests and prosecutions (3.03 per 1000). Topping the per-capita list are Sweden, Norway and New Zealand.

7. In 2006, Canada became the first country to prosecute mother-to-child transmission.

A woman whose child tested positive for HIV in 2005 was sentenced to a six-month conditional sentence and three years probation in Hamilton for hiding her HIV status from her doctors and transmitting the virus to her newborn. She pleaded guilty to a charge of failing to provide the necessaries of life after additional charges – aggravated assault and criminal negligence causing bodily harm – were dropped.

8. The first and only preventative HIV vaccine is being developed in Ontario, but it still has a ways to go.

A team of scientists at the University of Western Ontario got approval to test their HIV vaccine on humans in December, 2011, after nearly two decades of research. Preliminary clinical trial results appear positive but there are still many hurdles to overcome, including manufacturing and regulatory approval. Sumagen Co., the South Korean biotech firm sponsoring the vaccine, says that it won’t be commercially available for at least five years, likely longer.

9. Today, a young person with HIV in Canada is expected to live nearly as long as an uninfected person.

…provided they are diagnosed early and can access proper treatment.

Tara Peterson
The Globe and Mail
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