World AIDS Day

 The COVID-19 pandemic made the policy aspects of fighting epidemics more visible. Clear public health measures and communication thereof, empowering populations to be proactive in spread prevention are some of those aspects that have been made front and centre over the past few months. 

But COVID-19 is not the only global epidemic the world has to tackle. The Human immunodeficiency virus (HIV)/ Acquired immunodeficiency syndrome (AIDS) is another disease that affects the global population. While the novel coronavirus was discovered in 2019, HIV/AIDS has been the concern of epidemiologists and public health officials since 1981. 

And, just like COVID-19, HIV/AIDS has impacted individuals differently, depending on sex/ gender, ethnicity, geographic location, socioeconomic status, and sexual orientation. 

Data shows that women in certain regions of the world have been disproportionately affected by HIV/AIDS, and there has been an increase in the infection rate of women. In 2017, young women and girls were twice as likely as men and boys to become HIV-positive. In sub-Saharan Africa, adolescent girls accounted for 20% of new HIV infections among adolescents. In Eastern Europe and Central Asia, where HIV infection rates were more common among men (transmission being driven via unsafe drug injection), there is a rise in infection rates among women. 

Data also shows that women victims of intimate partner violence are almost 1.5 times more likely to contract HIV.  

In Canada, the number of new HIV cases has increased by 25.3% over the past four years. In 2018, there were 68,000 Canadians living with HIV, 23% of which were women. While the diagnosis rate of men is twice as high as women’s, the transmission rate among women is on the rise, whereas men’s transmission rate is declining. This data having been published in late 2019, the causes and the significance of an increased transmission rate among women remains to be studied and understood. 

The HIV/AIDS situation in Canada is also a lesson in accountability. The government has committed itself to meet the UNAIDS targets, including the goals of having 90% of all living with HIV know their status, 90% of those diagnosed receive treatment, and 90% of those receiving treatment achieve viral suppression by 2020 and of eradicating HIV as a threat to public health by 2030. To this day, Canada is not meeting its 2020 objective and is projected to be behind its 2030 goal. With infection rates on the rise in Canada, the questions of what the government does to effectively combat HIV and the consequences for not meeting its commitments need to be addressed. 

In 2019, the government of Canada released a five-year national action plan to combat sexually transmitted and blood-borne diseases. This plan was welcomed by organizations, but the Canadian AIDS Society (CAS) has identified significant areas for concern. To CAS, the action plan lacks priorities pertaining to the care of HIV-positive individuals and specific domestic public health measures, overlooks the importance of supporting community-based prevention and education initiatives, and contains only vague commitments to filling the current gaps. 

Additionally, the gendered aspects of HIV transmission and treatment need further scrutiny. Considering that Canada ranks 105 out of 153 countries on the equal access to health care between genders, the question of whether women are receiving appropriate treatment and achieve viral suppression remains open. Broadening that question by taking into account intersectional identities to account for socio-economic status, race and ethnicity, disability, sexual orientation, and gender identity is important. The data is lacking, and hopefully we will get preliminary answers once the 2019 data is available. 

HIV prevention is possible, and you can access resources to educate yourself here.