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AN OVERVIEW OF SPECIFIC COMMUNITIES AFFECTED BY HIV/AIDS
IN CANADA
Canadian <-> Global Stakeholders’ Engagement Workshop
Mark Gilbert, MD, FRCPC
Director, Applied Epidemiology Unit
Ontario HIV Treatment Network
July 2015
Acknowledgements
I wish to acknowledge the ancestral, traditional and
unceded Aboriginal territories of the Coast Salish Peoples,
and the Squamish, Musqueam, and Tsleil-waututh First
Nations on whose territory we stand today.
10 things about Canada that shock first time visitorswhenonearth.net
1. We have milk in bags
2. We say “Eh?”
3. Moose Alert Signs
4. We’re a multicultural nation
5. Hockey is everywhere
6. We line up properly
7. Canada is huge
8. Canadians say “sorry” a lot
9. We love to talk about weather
10.We’re patriotic but we don’t like to admit it
UNAIDS report on MDG (2015)
Trends in new HIV casesPublic Health Agency of Canada, 2014
HIV diagnosis rate per 100,000 population, 2013. PHAC (2014).
HIV diagnosis rate per 100,000 population, 2009-2013. PHAC (2014).
Canada is a settler countryNational Household Survey, 2011
Immigration:• 6.8 million (21%) foreign-born • 5.7 million (17%) second generation• Higher proportion in major urban centres
Ethnic origin:• 1.4 million (4%) Aboriginal (First Nations, Métis, Inuit)• Canadian, English, French, Scottish, Irish, German, Italian,
Chinese, Ukrainian, Dutch and Polish
Visible Minority: • 6.3 million (19%)
New HIV cases by Ethnicity, Canada, 2013Public Health Agency of Canada, 2014
White49%
Black17%
Aboriginal16%
Asian 6%
Latin American6%
South Asian, West Asian, Arab4% Other
1%
9
New HIV cases by Exposure Category, Canada, 2013Public Health Agency of Canada, 2014
MSM 49%
MSM-IDU3%
IDU13%
Heterosexual HIV endemic, 10%
Heterosexualnon-endemic, 20%
Other6%
Ethnicity by exposure categoryPublic Health Agency of Canada, 2014
Beneath the surface
12
HIV infections
Biological factors
Individual factors
Social factors
Structural or policy factors
are determined by:
BC Provincial Health Officer Report. HIV Stigma and Society: Renewing HIV prevention for Gay and Bisexual Men (2014)
Lifetime experiences of marginalization among MSM Sex Now Survey, 2011
Ferlatte et al. AIDS Behav (2014) 18:1256-1263.
Evidence of a syndemic (<30 years)
Number of Marginalization experiences
Ferlatte et al. AIDS Behav (2014) 18:1256-1263.
Syndemics as driver of HIV risk
Number of Psychosocial health
problems
Relationship to Condomless Anal Sex with Unknown Status
Partner
Odds Ratio (95% CI)
None REF
One 1.2 (0.9-1.7)
Two 1.6 (1.2-2.2)
Three or more 2.0 (1.5-2.7)
34Ferlatte et al. AIDS Behav (2014) 18:1256-1263.
What are the implications for an HIV cure?
What are the implications for an HIV cure?
18
HIV infections
Biological factors
Individual factors
Social factors
Structural or policy factors
are determined by:
What are the implications for an HIV cure?
19
HIV cures
Biological factors
Individual factors
Social factors
Structural or policy factors
will be determined by:
Thank you [email protected]
National surveillance data taken from:
Public Health Agency of Canada. HIV and AIDS in Canada: Surveillance Report to December 31, 2013. Minister of Publlc Works and Government Services Canada; 2014.
