Why do First Nations, Métis and Inuit in Canada carry such an unfair burden of hepatitis C in Canada? It is estimated that hepatitis C among Indigenous people is five-times higher than non-Indigenous Canadians. In particular, Indigenous women represent almost half of all hepatitis C cases in their communities, a much higher proportion than among the non-Indigenous Canadian population. Young Indigenous people (24 years and under) represent 70% to 80% of hepatitis C infections among people who inject drugs in Canada.
Canada has signed on to global targets to eliminate HIV and hepatitis C as public health threats by 2030. While ambitious, these targets are now a realistic possibility thanks to the effectiveness of modern medications. HIV treatment can suppress the virus so successfully that HIV-positive Canadians who start treatment early can have life expectancies similar to their HIV-negative peers. This also prevents the transmission of HIV to their sexual partners. And most Canadians treated for hepatitis C are now cured within weeks.
As doctors specializing in the clinical care of women living with HIV, we often get questions about breastfeeding and the transmission of HIV.
Here’s just one e-mail we received from an infectious disease specialist outside Ontario:
“I am seeing a young African woman as a patient who is HIV positive, had advanced disease, but now is suppressed. She is pregnant and had two deliveries in Africa, where she was encouraged to breastfeed. She is still quite adamant about breastfeeding despite my counselling otherwise. How do you manage these situations and what is your approach to this?”
Harm reduction and gay men’s HIV prevention could be considered two historic elements in our HIV response that have long stood separate from one another. Traditionally, HIV prevention with gay men focused on sexual risk, while harm reduction focused on risks associated with injection drug use. Both approaches have evolved over the decades and some might argue that safer sex is a form of harm reduction, but in the context of drug use, there has been little focus given to harm reduction in the context of gay men’s sexual health.
The CATIE Blog hosts the views and opinions of people and organizations working and volunteering in Canada’s response to HIV and hepatitis C.