hiv/aids in canada: stats, facts and figures
9 minute read
modern medicine, in the form of antiretroviral drugs, has eased some of physical burden on patients and allowed them to live normal lives with viral loads that are undetectable and untransmittable.
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despite the fact that an hiv diagnosis is no longer the death sentence it once was, many people are blissfully unaware of the progress that has been made in fighting the once deadly disease.
a recent poll of 1,000 canadians found that just one in five were aware that a person with hiv who is taking medication can no longer sexually transmit the virus to others. one in four respondents wrongly believed that an infection can be spread through kissing and more than half believed — just as incorrectly — that a pregnant mother who is taking medication for hiv can still transfer the disease to her child.
a lot has changed since the first cases of hiv began to emerge in the early 1980s. new forms of treatment, particularly antiretroviral therapy, have been effective at decreasing a patient’s viral load to the point it becomes undetectable and they are no longer able to infect others.
the success of these new therapies prompted the un to release a report that says there is a clear path to ending the aids epidemic by the year 2030. whether or not that happens remains to be seen but, in the meantime, it’s clear canada and a host of other countries can do better when it comes to educating people on where things stand.
what is hiv/aids?
human immunodeficiency virus (hiv) is a retrovirus that infects and weakens the body’s immune system and prevents it from warding off other forms of disease and illness. if the immune system becomes severely weakened, the infection can progress to its final stage of infection, a condition commonly known as aids. hiv is a sexually transmitted and bloodborne infection that is acquired through contact with the blood, semen, vaginal fluid, rectal fluid or breast milk of an infected individual. engaging in unprotected sex or sharing needles during drug use are the most common ways the infection spreads. without the help of treatment, almost every person who contracts hiv will eventually develop aids, usually within 10 years.
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hiv attacks the immune system by infecting and destroying a type of white blood cell known as cd4+ cells (or helper t cells). if too many of these cells are eliminated, the body begins to lose its ability to defend itself. once this happens, patients become vulnerable to other forms of infection that normally would not make them sick.
in the early (or acute) stage of an hiv infection, a person may experience flu-like symptoms, such as chills, fever, fatigue, joint pain, headaches, muscle aches, a sore throat and swollen lymph nodes. after this, the virus enters a chronic stage where it can lie dormant for years while it is actively killing off white blood cells. this is followed by the third and final stage of infection, progression to aids. symptoms of this stage can include fatigue, unexplained weight loss, chronic diarrhea, unexplained fever or recurrent chronic yeast infections. patients can experience many other symptoms at this point that are not caused by the infection itself but by other illnesses that are taking advantage of the body’s weakened immune system.
current hiv/aids statistics in canada
although hiv can affect any person regardless of age, sex, gender, race, ethnicity or sexual orientation, certain populations carry a greater share of the burden in canada. the common thread among these groups, which include sexual minorities and racialized communities, is that they face social and structural barriers that can make it difficult to receive equitable health care. however, the fact that there are so many people living with hiv today speaks to success current medications have had in treating the infection and extending lifespans.
it is estimated that there were 62,790 people (or 170 cases per 100,000 people) living with hiv in canada by the end of 2020. around 10 per cent of this group, or 6,590 people, were unaware of their status. of those living with hiv in 2020, just under one-quarter, or 15,470, were female.
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there was an estimated 1,520 (or four per 100,000) new hiv diagnoses in 2020, a slight decrease from the 1,760 new infections in 2018, with the majority of new infections among the country’s most vulnerable populations. one-fifth of new infections were among indigenous people.
a study by the university of british columbia found that while covid-19 may have reduced social interactions (and, therefore, hiv infections) in the spring of 2020, it also prevented patients from accessing therapy or viral load testing. the study calls for the implementation of new measures in the future to prevent one health crisis from worsening another.
of the 62,790 people living with hiv in 2020, an estimated 53.1 per cent (or 33,335 cases) were among gay or bisexual men. (this estimate includes 31,589 gay and bisexual men who had sex with men and 1,746 who had sex with men and also injected drugs.) another 32.8 per cent, or 20,597 people, acquired hiv through heterosexual sex. it is estimated that 16.1 per cent, or 10,084 others, acquired the virus through injecting drugs. (this estimate includes 8,338 people who injected drugs and 1,746 people who injected drugs and had sex with men.)
provincially, the highest number of new infections in canada in 2020 were in ontario (507), quebec (410) and saskatchewan (214). this was followed by alberta (149), b.c. (108), manitoba (85), the atlantic provinces (45) and the territories (2).
impact of hiv/aids on canadian society
unfortunately, there has been little reliable research into the economic impact hiv/aids has had on canada over the years. a 2011 report that attempted to rectify the situation estimated that the economic losses that could be attributed to those recently infected to be in the neighbourhood of $4-billion, or $1.3-million per person. this was, however, based on a patient population that was much smaller than it is now and patients today live much longer than they did 20 years ago.
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the cost of hiv treatment is also affected by a number of variables, including whether brand name or generic drugs are used, whether a patient’s condition has become resistant to less expensive drugs and whether there are other conditions that must be treated at the same time. one study estimated that the cost of treatment can range from $2,400 to $6,000 every month for a patient’s lifetime.
a recent study by a team of researchers at st. michael’s hospital found that the amount of money people with hiv are required to pay for their medication — also known as antiretroviral drugs — varies wildly from province to province. “we found that because each jurisdiction, province or territory makes their own decisions about how drugs are covered, patients face different realities across the country,” said dr. deborah yoong, the study’s lead researcher.
the canadian government currently spends $33.4-million per year on the hiv and hepatitis c community action fund and the harm reduction fund. this money is used to aid organizations that work to improve the treatment of all sexually transmitted and bloodborne infections. in 2022, the government vowed to put aside another $17.9-million to make hiv testing more widely available.
social impact of hiv/aids on relationships, crime rates, substance abuse
although an hiv diagnosis is no longer the death sentence it once was, the stigma that surrounds the virus remains. modern medicine, in the form of antiretroviral drugs, has eased some of physical burden on patients and allowed them to live normal lives with viral loads that are undetectable and untransmittable.
but the enduring stigma, which is rooted in rooted in misinformation, reduces the quality of life of patients through prejudice, discrimination and isolation. it also makes it more difficult for canadians to access treatment and support, including testing and information on hiv prevention. the best way to reduce this stigma is to refrain from judging others and to offer compassion and respect when discussing the subject.
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the effects of this stigma are difficult to quantify but a 2017 study found that internalizing these negative emotions can lead to a decline in self-esteem and an increase in depressive symptoms and self-blame. it can also cause patients to become less trusting of social workers and doctors and less likely to follow their treatments.
it doesn’t help that, in canada, people who do not disclose their hiv status to a partner before having sex can still be sent to prison in certain situations (despite the risk of transmission having been effectively eliminated by medication). the country has one of the highest rates of hiv criminalization in the world but this may be slowly changing. in 2018, canada’s then-attorney general acknowledged that there was an “over-criminalization of hiv non-disclosure” and federal lawyers were instructed to stop prosecuting people who maintain a supressed viral load (or in situations where risk was vastly reduced, such as through use of condoms). although this federal guidance applies only to the northwest territories, yukon and nunavut, the provinces are slowly catching up and ontario, b.c., alberta and quebec have now sent similar instructions to prosecutors.
resources and support available for hiv/aids in canada
there are a host of organizations in canada dedicated to providing support to people who have been diagnosed with hiv/aids. the bruce house maintains a list of active groups across the country that offer a range of services to people at all stages of their hiv journey or to those who are interested in learning more about the virus. these resources include help getting access to testing, counselling services, housing, health care and other support.
the future of hiv/aids in canada
the fact that only around 87 per cent of canadians with hiv having been diagnosed with the disease means there are another 13 per cent of infected individuals out there who are currently unaware of their status. a big part of changing this lies in providing quick and easy access to testing. researchers at st. michael’s hospital in toronto are currently testing oraquick, an oral self-test that takes around 20 minutes to determine if a person has been infected by the virus.
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if approved by health canada and made readily available, the test, which the manufacturer claims has a 92 per cent accuracy rate, should go a long way toward lowering the number of infections in canada simply by making people aware of their status. around $8-million of the $17.9-million the federal government is directing to hiv testing will go toward making such at-home tests available to community groups. a program in ottawa that is currently delivering another form of free take-home test to underserved communities is being hailed as a “game-changer.”
in terms of therapy, new forms of effective antiretroviral medication that come in a long-acting injectable have proven to be almost 100 per cent effective at preventing hiv in clinical trials. the new drug, which has been approved in the u.s., is not yet available in canada.
it’s clear that educational and funding efforts in canada are lagging behind technological advances in the fight against hiv. the stigma surrounding the disease is rooted in misinformation and fear and the only way to bring about change is to pull back the curtain and let a little light in. reducing some of the mental anguish and isolation that can come with an hiv diagnosis will only be possible through compassion and education.
canada has taken some meaningful steps down this road but if the country wants to be a leader on the world stage — and help bring about an end to the epidemic — now is the time to redouble its efforts and ensure that the organizations that are doing the heavy lifting have access to the funding and technology they need to help those who need it most.
on a personal level, if you know someone who has been affected by the epidemic, try approaching them from a place of empathy and understanding and letting go of the misinformed misconceptions of the past. if you yourself have been diagnosed with the disease, hopefully you can find some solace in the knowledge that it is no longer the death sentence it once was.
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effective treatment is available and a return to a normal life is possible. it all begins by having a conversation with your doctor or healthcare worker and becoming part of the solution.
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