Ottawa can’t be complacent about AIDS

Despite medical advances, the disease has had a devastating impact, writes Dr. Vera Etches.

World AIDS Day, which takes place on December 1 every year, is a time to reflect on what we have achieved in the local, national and global response to HIV and AIDS and the challenges we continue to face, including the largest threat we currently face in Canada: complacency.

The theme of the 2011-2015 World AIDS Campaign organization is ambitious: getting to zero. That goal includes zero new HIV infections, zero discrimination and zero AIDS-related deaths. Despite the tremendous advances in the medical treatment of AIDS-related illnesses, the global impact of AIDS continues to have a devastating impact on millions.

According to the Gap Report from UNAIDS, 1.5 million people worldwide died of AIDSrelated illnesses in 2013. By the end of 2013, an estimated 35 million people globally were living with HIV. On a national scale, in 2011, an estimated 71,300 Canadians were living with HIV, with more than 3,000 new HIV infections occurring that year.

In Ottawa, we have seen a decrease in HIV rates over the last decade, with the HIV rate declining from 10.8 per 100,000 people in 2008 to 6.4 per 100,000 in 2013. This decline may also be leading to a sense of complacency, which has become a new enemy in the ongoing struggle against HIV.

Considering that HIV is a preventable infection, even one case is too many. This year alone, 55 people in Ottawa have been diagnosed with HIV. There’s a pervasive perception that HIV only happens to men who have sex with men, to people from countries where HIV is endemic, to people who inject drugs or to aboriginal peoples.

This perpetuates a dangerous misconception among many that HIV happens to others only. A 2012 Public Health Agency of Canada HIV/ AIDS attitudinal tracking survey found that awareness about HIV/AIDS has dropped over the last decade, with fewer Canadians able to correctly identify some of the main ways that HIV is transmitted. We are concerned that this lack of knowledge about HIV/AIDS among youth between the ages of 15 to 29 is contributing to high-risk sexual behaviour.

We know that the science of HIV is constantly evolving. Every year we learn more about the virus and research keeps giving us new tools to prevent, test and treat it. While these important medical advances have brought life-changing impacts to those diagnosed with HIV, many view the risk of HIV/AIDS with a false sense of security, seeing it as a chronic illness with few consequences.

We cannot become complacent about safer sex. We know that condoms are one of the most effective strategies for HIV prevention, but they’re only effective when they’re used consistently and correctly. A 2012 Canadian literature review on condom use showed that the incorrect use of condoms is surprisingly common, with problems including breakage, slippage, leakage and delayed application. Ottawa Public Health’s Sex It Smart campaign, where residents can order free condoms online, reaches youth and other high-risk groups with these important prevention messages.

Testing for HIV, especially for people most at risk, is also a top priority, considering that about 25 per cent of Canadians with HIV do not know that they have HIV. Ottawa Public Health offers anonymous and express testing for sexually transmitted infections throughout Ottawa.

Our Sexual Health Centre and Gay Zone also offer treatments such as post exposure prophylaxis (PEP), a month-long course of drugs that may prevent a person from becoming infected with HIV if they begin treatment within 72 hours of potential exposure to the virus.

The progress achieved to date to prevent, test and treat HIV/AIDS saves lives. However, we are far from getting to the goal of zero new HIV infections, zero discrimination and zero AIDSrelated deaths — and our collective complacency stands in the way.