hiv rates rising in canada: how canfar and partners aim to end epidemic by 2025
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"… testing is key in canada for us to try and get our hiv rates under epidemic levels," said alex filiatrault, ceo of canfar.
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in canada, the number of people living with the human immunodeficiency virus (hiv) continues to rise significantly. between 2021 and 2022 alone, the rate of positive cases rose by nearly 25 per cent. these numbers, although not unprecedented, are a considerable cause for concern, especially for those in marginalized groups who experience health inequalities.
the canadian foundation for aids research (canfar) aims to make real fundamental changes for those affected by hiv and those who could avoid it altogether if they had access to proper testing, sexual education, and care.
alex filiatrault, ceo of canfar and lbgtq2s+ advocate, has been working tirelessly with medical professionals and other partners to create an action plan to end the hiv epidemic in the country by 2025.
“it’s an exciting opportunity that we have when you consider all the tools that are at the disposal of canadians,” he said. “what we’re trying to do is fill the gap, and not only on the communication and awareness sides, but we’re trying to develop a model where we can help support organizations across canada that are in the community to have access to the tools.”
“the pandemic put a lot of stress or strain on the healthcare system, which really limited the capacity or the access to testing, and testing is key in canada for us to try and get our hiv rates under epidemic levels. you have to have huge access to testing, which did not happen during the pandemic. so, these numbers as they relate to 2022 as we were coming out of the pandemic, canadians started having access to testing once again.”
dr. sean b. rourke, a clinical neuropsychologist and expert on hiv neurobehavioral complications, has built a working relationship with canfar since the beginning of his career. since then, he has continued to advocate and work toward helping further progress the mission to end hiv in canada in a way that helps canadians overall, but specifically those in select communities most affected by the spread of hiv.
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“we’re trying to reach people in communities that are really hidden, and it’s not because they’re hiding,” he said. “it’s because they’re not connected in the system for a variety of reasons—stigma, discrimination, black racism, colonizations. all these things are barriers for them to get connected.”
the strategic plan set forth by canfar includes three key areas of importance: national awareness, access to testing and care, and funding new research that can open new doors toward an hiv-free future.
striving for change through national awareness
the stigma surrounding hiv continues to forge ahead, leaving a wake of individuals who need care in its path. filiatrault, alongside experts at canfar and partners, such as dr. rourke, aims to reduce the negative outcomes experienced by people who are still subject to discrimination surrounding hiv stigma, as well as those who are the most impacted by hiv, including indigenous and black people, racialized women, and people who use injectable substances.
“having proper awareness campaigns, proper communication about the state of hiv in canada in every geographic area in canada, province, city, non-city—it has really been a struggle to maintain a very high level of awareness throughout the past few years especially leading into the pandemic and then with the pandemic, the focus completely shifted,” said filiatrault.
the covid-19 pandemic changed the way people view and experience the healthcare system. outside of contracting covid, many other infectious and non-infectious diseases and the efforts to combat them were put on the back burner. that said, when everything had been said and done, the pandemic may have provided some consolation in the way of hiv testing.
“covid taught us a lot about testing,” dr. rourke said. “remember when you had to line up to get testing? all of a sudden, there was a self-test that happened, and you could take it home and make decisions about your health, about your well-being, about your family, whether you went to work or not—and the empowerment of having that test, that was a silver lining of covid because we’ve been really trying to educate people more and bring more awareness around testing.”
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through their outreach programs, canfar will continue to work with communities and groups to support and empower those who are at a higher risk of hiv.
the avoidable epidemic: hiv advanced treatment and future testing avenues
back in the 80s, when a person was diagnosed with hiv, it was a death sentence. the virus attacks white blood cells, specific cells that work as part of the immune system to keep the body healthy from pathogens and other diseases, leaving the person’s immunity heavily compromised. when the immune system is no longer able to put up a fight, the body is forced to throw in the towel.
today, however, that has changed drastically. there have been many advancements in medicine and medical technologies that foster long and relatively healthy lives for those who have hiv.
“we have 1 in 10 people who have hiv, living with hiv, but they don’t know it, so they’re not benefitting from the remarkable scientific breakthroughs that have happened with treatment, from one pill a day to now having a shot that you can have antiretroviral treatment,” dr. rourke said.
because of the scientific breakthroughs made through the years regarding hiv treatment, more people with the viral infection can avoid the worst outcomes—if only they had the proper access to testing and care.
“there are more people out there who are undiagnosed who are not going to come forward to their doctor or to a clinic to get tested, so we have to go to them. that’s been a problem—the undiagnosed,” said dr. rourke.
according to a fact sheet published by canada’s source for hiv and hepatitis c information (catie), roughly 10 per cent of people who have hiv are unaware of their status. this isn’t likely to be caused by avoiding testing, but rather feeling as though there is no safe space for them to turn to get the proper testing.
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“we have to go reach out and be embedded in communities and working with people that live the experience up front that can actually help build that trust and that culturally safe space. that is so important for re-engaging people in taking care of their health with testing and care,” said dr. rourke.
to ensure that more people in marginalized communities have the access they need to proper testing, canfar aims to tackle the issue of lack of access to testing by:
- implementing a healthbox vending machine, which provides hiv self-testing kits, making it easy for people to check their status in the comfort of their own homes
- launching mobile clinics in underserved communities where access to testing is virtually non-existent
- funding new healthcare clinics that are compassionately designed to help people who belong to marginalized groups receive the care they need
these new initiatives are designed to not only help people self-test but also provide easier access to confirmatory testing in communities across the country that require it most. one such clinical technology, known as the canfar rapid test laboratory at hq, has already made a significant difference for those affected by hiv since its inception in july of 2022.
“from july of 2022 to now, which is basically a year and a half since the clinic opened, they’ve done over 100,000 tests, and that represents about 11,000 individuals,” said filiatrault before continuing, “it’s a huge impact for us to be able to reach 11,000 individuals with over 100,000 tests. it speaks volumes for this type of model. the self-testing kits are great, but for confirmation, it’s important to be able to access confirmatory technology, whether it’s mobile or not.”
opening the doors to an hiv-free canada through fundraising for three priority areas
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canfar is a leader when it comes to funding research for hiv in the country, which has led to the discovery that while new technologies are here to make living with hiv easier, there are still gaps in the research that need to be filled. by implementing new funding cycles continuously, canfar and their partners, such as dr. rourke, can address the hiv pandemic from all angles—and for all groups affected.
the main goal of the funding is to help create solutions for communities affected by hiv more substantially.
“we take the funds we raise annually, and we spend it in three key areas of priority: awareness, research, which is what we’re known for and which we’ve been doing for over 35 years, and we continue doing,” said filiatrault. “we’ve developed this new space, which is called a strategic implementation strategy, of investing in exactly what we’ve been talking about today whether it’s technology, whether its mobile technology, any technology that is there that can be made readily available for a larger portion of the community is where we want to invest.”
privately funding for hiv research can go a long way in helping people, but the government also plays a role in how the infectious disease takes hold in specific communities. while the government only has so much money to throw around in the healthcare system, they must remain on the same team during canfar’s initiative to end the hiv epidemic by 2025.
“there’s no one funder that is going to solve all the problems. so, identifying where the space can mobilize in the business community and connecting that with … to look at how we bring together money from other foundations, from other research funders, from public health—bring that all together to think about those solutions. often, nowadays, it isn’t just about money for … discovery alone but thinking about, ‘okay, we have the solution,’ it’s now about implementing and scaling and showing that it works,” said dr. rourke.
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while canfar and partners like dr. rourke work tirelessly to help those affected by hiv and the prevention of more cases, to really make a change, it has to be a group effort.
“i think we’re in a current climate where everybody is sort of recognizing the disconnects in our health and public health systems and the economic situations. we’re working very hard to reach people who need the support that they need in this space,” said dr. rourke. “if we provide these cultural safe spaces and engagement, it’s going to not only deal with hiv but the other things that are actually going on in their lives. we need everybody to be aware of that so that they can take care of themselves in this space to get tested for hiv and know about their status so they can make really good decisions about their health and wellbeing.”
filiatrault added, “hiv’s been around for almost 40 years, and it’s been an epidemic in canada for all these decades, and i think we don’t want people to forget that. so, i think for us, our messaging in this bold action paper is to remind people that it has been around all these decades. it has been at the epidemic level. we need to bring down those numbers because the pressure on the healthcare system is so high from every side. if we can alleviate a little bit of that pressure by lowering cases, which is completely doable in the next short-term few years—if we can bring down those rates, it’ll elevate all of our communities, and it benefits everybody.”
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