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.
Three decades of awareness campaigns have instilled a very clear and consistent message to the public: condoms are the most effective way to prevent an HIV infection. So what happens when a new prevention method emerges – and it is also highly effective? In recent years, multiple studies have confirmed that maintaining an undetectable viral load through the consistent and correct use of antiretroviral treatment (ART) by people living with HIV dramatically reduces the risk of HIV transmission. The reduction is so great that ART can now be offered as a highly effective HIV prevention option.
I recently had the fortune of attending the annual event of the Canadian Aboriginal AIDS Network (CAAN), combining their annual meeting, caucus of Aboriginal people living with HIV/AIDS (APHA Caucus), skills-building conference and “Wise Practices,” the research conference of CAAN’s Aboriginal HIV & AIDS Community-Based Research Collaborative Centre. The event brought together Indigenous people from across Canada involved in the response to HIV and hepatitis C. Although I attend most years, these gatherings never cease to enthrall and move me.
Vancouver is in the limelight again. This year’s International AIDS Society (IAS) Conference may have marked a watershed moment in our HIV response, with some similarity to the 1996 Vancouver AIDS conference when highly active antiretroviral therapy (HAART) hit the world stage.
In response to mounting evidence of the prevention benefits of pre-exposure prophylaxis (PrEP) use by HIV-negative gay and bisexual men, a discussion recently emerged on social media about the perceived exclusion of trans men1 who have sex with men from PrEP research studies. In fact, trans men participate in many HIV prevention research studies, whether or not they are identified as trans when results are reported. Some do not identify as trans, but rather as men of trans experience or transitioned men, and are happy to check the “male” box without qualification. Other studies have explicitly included trans men and...
Recent developments in prevention are pointing to worrying gaps in the community-based approach to HIV prevention in Canada. Perhaps we have been used to having only a single prevention technology on our books for so long – think condoms – that our ducks are not always in a row when new ones like PrEP come along. Thus potholes in our response become apparent – and none leap in to fix them. After a series of somewhat inconclusive PrEP trials, whose results were marred by adherence issues, the results of more stringent trials like the PROUD and IPERGAY studies are in,...
