There are a lot of new test technologies in the pipeline: both new types of tests in the works, such as rapid syphilis tests or point-of-care HIV viral load testing, and new ways to use existing tests, such as self-testing or online testing.
As testing options increase, we need to think about where they will have the most impact. I learned about this from helping implement a new test technology called pooled nucleic acid amplification testing (pooled NAAT) at six clinics in Vancouver in 2009, as part of a research study to determine the impact of this new type of test on gay men’s lives. With pooled NAAT, blood samples that are negative on a routine screen for HIV antibodies are automatically tested for HIV RNA. This shortens the HIV window period to 10-12 days and means that individuals with very early or acute infection – when HIV viral load and chances of transmission are high – can be diagnosed at a time when standard tests are negative.
Hepatitis C is curable, reads the script; time and time again I hear this said, have read it, and say it myself. This is great news and a reality for more people than ever before.
Does this mean that the job is done? I suppose it depends on one’s perspective. As I listened to members of the science research community speak recently, it is “done and dusted.” “Problem solved,” the headlines will read. Okay, maybe no headlines but a mention on page 4 with a minor piece in the late evening news, even though this may be the biggest news in medical science in decades.
There is a quiet tension that exists surrounding HIV and infant feeding. Although practices and recommendations vary around the world, breastfeeding is not recommended for infants born to an HIV-positive woman or trans man in Canada. Instead, HIV-positive parents are counselled to feed their infants with formula.
But I don’t think it is by any means a closed case, even in Canada. The truth is, the debate about HIV and infant feeding (particularly in Canada) has never been more complex. Like so many discussions related to HIV today, scientific advances are changing the way we talk about and consider possibilities. New questions about treatment as prevention, pre-exposure prophylaxis (PrEP), and even levels of ‘risk’ seem to emerge every day.
On December 1, World AIDS Day, The Hon. Dr. Jane Philpott, Canada’s Minister of Health, declared that our country endorses the UNAIDS treatment targets that look to seeing an end to the global AIDS epidemic by 2030. On the same day, Prime Minister Justin Trudeau issued a statement that, in part, declared “we are now at a point where we can envision a future free of this terrible disease.”
How many people are infected with HIV every day in Canada? What do HIV infection rates look like in specific populations?
Every year, surveillance reports tell us how many Canadians have been diagnosed with HIV. But since a large fraction of HIV-positive Canadians have not been diagnosed, these numbers don’t give us the full picture.
The CATIE Blog is written for people and organizations working and volunteering in Canada’s response to HIV and hepatitis C and hosts the views and opinions of frontline service providers.