How routine testing can help end AIDS

published on July 19, 2016 by JULIO MONTANER, in The Globe and Mail

Dr. Julio Montaner is the director of the BC Centre for Excellence in HIV/AIDS.

An older gentleman comes to visit the hospital complaining of a number of symptoms. While he doesn’t fit the typical risk factors for HIV, he is given a routine test that reveals he is HIV-positive. When his wife is later tested, she is also shown to be HIV-positive.

Similar situations are happening in a number of B.C. hospitals where routine HIV testing has been offered since 2012 to patients (between the ages of 18 and 70 who receive blood work). As of 2015, thousands of such tests have been administered, representing 18 per cent of all admissions, and 73 new HIV cases found. Routine HIV testing, if expanded across Canada, can help to identify and treat new HIV cases in an effort to eliminate new HIV infections.

While HIV is no longer portrayed in the media as the deadly threat of the 1980s and 90s, Canadian regions are seeking spikes. Per-capita rates in some areas in the Prairies are edging toward those seen in sub-Saharan Africa. To put this into perspective, there has been broad media coverage of the Zika virus while few cases have been seen in North America.

The end of AIDS can be seen only through widespread testing and treatment. According to the Public Health Agency of Canada, about one in five of the more than 75,000 Canadians currently living with HIV are unaware of their positive status. Stereotypical assumptions about who is at risk could be hindering efforts in engaging those living with HIV in care and treatment.

A Canada-wide study from the BC Centre for Excellence in HIV/AIDS (BC-CfE) found that 48 per cent of participants living with HIV initiated antiretroviral therapy when they already had weakened immune systems (as result of advanced HIV infection). These gaps mark failures in ensuring positive health outcomes.

They also cost more money: Direct health-care costs in the year following HIV diagnosis have been documented in excess of 200 per cent higher for patients with weakened immune systems.

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How routine testing can help end AIDS

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