an overview of specific communities affected by hiv/aids in canada canadian global stakeholders’...
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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
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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.
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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
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UNAIDS report on MDG (2015)
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Trends in new HIV casesPublic Health Agency of Canada, 2014
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HIV diagnosis rate per 100,000 population, 2013. PHAC (2014).
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HIV diagnosis rate per 100,000 population, 2009-2013. PHAC (2014).
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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%)
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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
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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%
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Ethnicity by exposure categoryPublic Health Agency of Canada, 2014
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Beneath the surface
12
HIV infections
Biological factors
Individual factors
Social factors
Structural or policy factors
are determined by:
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BC Provincial Health Officer Report. HIV Stigma and Society: Renewing HIV prevention for Gay and Bisexual Men (2014)
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Lifetime experiences of marginalization among MSM Sex Now Survey, 2011
Ferlatte et al. AIDS Behav (2014) 18:1256-1263.
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Evidence of a syndemic (<30 years)
Number of Marginalization experiences
Ferlatte et al. AIDS Behav (2014) 18:1256-1263.
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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.
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What are the implications for an HIV cure?
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What are the implications for an HIV cure?
18
HIV infections
Biological factors
Individual factors
Social factors
Structural or policy factors
are determined by:
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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:
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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.