Globe & Mail Article: The AIDS Epidemic Is Exploding In Aboriginal & Immigrant Communities In The Province Of Saskatchewan!
André Picard Public Health Reporter
Vienna — From Friday’s Globe and Mail Published on Thursday, Jul. 22, 2010 12:51PM EDT Last updated on Friday, Jul. 23, 2010 12:42PM EDT
The number of annual cases of HIV-AIDS in Canada has risen back to 1982 levels, which is when the epidemic began ravaging the gay community.
But those being infected today are increasingly intravenous drug users, aboriginal people and immigrants in Canada, an epidemiological shift illustrated by the fact Saskatchewan is now the hotbed of HIV-AIDS in Canada, delegates at the International AIDS Conference heard Thursday.
“The epidemic has changed,” said Steffanie Strathdee, associate dean of global health sciences at the University of California, San Diego.
She noted that, a decade ago, virtually all HIV-AIDS cases were found in the big three provinces: Ontario, Quebec and B.C. But now “the Prairies are catching up.”
The incidence rate – the number of new cases per capita – is twice as high in Saskatchewan as Ontario.
The Saskatchewan Ministry of Health confirmed the rates of HIV-AIDS are the highest in Canada: 20.3 per 100,000 population versus 9.3 per 100,000 national average. A spokeswoman said the facts behind the numbers are unique in the province, with a staggering 75 per cent of the cases among IV drug users, and aboriginal and Métis women accounting for a large number of the cases.
The Minister of Health, Don McMorris, said in a written statement that Saskatchewan has allocated $2.5-million to a three-year HIV-AIDS strategy and it will target those high-risk groups.
“HIV and AIDS is a very serious issue for our province,” he said. “It’s vital that we work collaboratively with First Nations
and Métis and health and community based partners. This issue needs to be addressed on many levels.”
Dr. Strathdee said while the patterns of HIV-AIDS have changed notably, the response has not.
“I’m a proud flag-waving Canadian but I’m ashamed that the Canadian National AIDS Strategy has withered,” she said. “We can and should do better.”
Her views were echoed by Ron Rosenes, vice-chairman of the Canadian Treatment Action Council, who said: “We have developing world conditions in pockets of our country and it’s reflected in our AIDS statistics.”
He said domestic spending on HIV-AIDS has been cut back, to about $74-million a year, “so we don’t have the money to engage in targeted prevention programs.”
Trish McAlaster/The Globe and Mail
Source: Public Health Agency of Canada
In her address to the conference, Dr. Strathdee presented a detailed epidemiological portrait of the epidemic in the U.S. and Canada.
There are approximately 65,000 people living with HIV-AIDS in Canada and 1.1 million in the U.S.
Those numbers are growing with approximately 3,300 new infections annually in Canada, compared with 56,300 in the U.S.
Infections are rising steadily in Canada, while they have leveled off in the U.S, the researcher said. That is just one of many differences between the neighbouring countries.
What they have in common, however, is a remarkable drop in deaths since the introduction of antiretroviral drugs in 1996. In Canada the number of annual deaths from HIV-AIDS has fallen to about 500 a year from a high of almost 1,800; in the U.S. the number of annual deaths has gone from more than 50,000 a year to fewer than 18,000.
Another common trait in Canada and the United States is how the impact of the epidemic has shifted to poor, minority communities.
“Inequities are clear drivers of the epidemic,” Dr. Strathdee said. These include inequities of race, ethnic group, gender, sexual orientation and immigration status.
“All this translates into unequal access to prevention and care,” she said.
Another problem common to the two countries is the large number of people infected with HIV-AIDS who do not know their status. It is one in four in Canada and one in five in the U.S., Dr. Strathdee said. That is particularly troubling because treatment is readily available that can keep the illness at bay.
In her presentation, Dr. Strathdee said while the HIV-AIDS epidemic is following the same overall pattern in Canada and the U.S., it is actually evolving differently when you dig deeper into the data.
In the U.S., more than half of all new infections (54 per cent) are occurring among men who have sex with men. In Canada it is 44 per cent.
In contrast, 36 per cent of new cases in Canada are among heterosexuals, compared to 32 per cent in the U.S.
One of the most notable differences, however, is among intravenous drug users. In Canada, 17 per cent of new cases are among IV drug users, compared with 11 per cent in the U.S.
“Our federal government has dropped the ball on harm reduction,” Mr. Rosenes said. “We are increasingly imprisoning people for drug use instead of getting them the help they need.”
The ethnic portrait of HIV-AIDS sufferers is also markedly different in the two countries. In Canada, the highest incidence rates are, by far in immigrants from sub-Saharan Africa and the Caribbean, followed by aboriginals. (It should be noted, in Canada, immigrants and refugees undergo mandatory HIV testing.)
In the U.S., African-American men are far and away the hardest hit group, followed by Latinos, Pacific Islanders and American Indians.
The data Dr. Strathdee presented are from the Public Health Agency of Canada and the U.S. Centers for Disease Control and Prevention.
Last week, U.S. President Barack Obama unveiled what he called a comprehensive national strategy to fight HIV-AIDS in the United States.
The plan promises to reduce infections by 25 per cent within five years, and increase the number of infected people who are aware of their HIV-positive status, and those who are treated.
Canada’s strategy does not have hard targets for reducing the number of HIV infections.
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