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hiv/aids

hiv deaths down in u.s., but cases are up in canada

poor data collection, inequalities in drug access and cuts to patient groups 'unfathomable.'

by laura hensley

nov 23 2020

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4 minute read

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hiv deaths down in u.s., up in canada

there are issues with data when it comes to hiv-related deaths in canada. getty

hiv-related deaths dropped in half in the u.s. between 2010 and 2017, according to a recent report released by the u.s. centers for disease control and prevention.

reductions were seen across sex, race and age, but certain populations saw less of a decline in deaths than others, including black people, women, and people of multiple races. this disparity highlights gaps in healthcare and a need to further improve early diagnosis and treatment for all.

“the decline in hiv-related deaths proves that investments in hiv testing, care, and treatment are paying off, but we should also protect people from getting hiv in the first place,” dr. jonathan mermin, director of cdc’s national center for hiv/aids, viral hepatitis, std, and tb prevention, said in a statement .

the cdc credited the drop in hiv-related deaths to earlier hiv diagnosis which helps patients start on lifesaving treatments right away. from 2010 to 2018, the number of americans who knew of their hiv status increased from 82 per cent to 86 per cent.

“in that same period, the percentage of people with diagnosed hiv who had a suppressed viral load (a measure of the amount of hiv in a person’s blood) increased from 46 per cent to nearly 65 per cent,” the cdc wrote.

in canada, the number of reported hiv cases are increasing.

a report released in late 2019 by the public health agency of canada (phac) said there were 2,561 hiv diagnoses in 2018, which was an eight per cent increase from the year prior and an overall increase of nine per cent in the last decade.

phac says the uptick could be due to several factors including an increase in hiv testing, changes in reporting practices and/or an increase in the number of hiv-positive people migrating to canada who are either testing positive for hiv for the first time in canada or are re-testing in canada.

the canadian aids society estimates more than 68,000 individuals are currently living with hiv in canada, and says the increase in cases comes during a time of significant funding cuts to community-based hiv organizations.

when it comes to hiv-related deaths in canada, there are serious issues with federal data collection making it hard to know exactly how many people are dying from aids across the country, says gary lacasse, executive director of the canadian aids society .

“there are inequalities in how b.c. does their data, versus quebec, versus ontario, versus atlantic canada,” he says.

“we do know that people are still dying of aids across canada. at what rate? that’s the big problem because a lot of death certificates are signed off as [hiv being] a comorbidity only, and not hiv or aids-related illness [being the cause of death].”

what is known, however, is that african, caribbean, black women and indigenous people are disproportionately affected by hiv in canada, lacasse says. this is largely because of the systemic health disparities that exist. research shows that racism results in poorer health outcomes for many black, indigenous, and people of colour, and can act as barrier to care.

dakarayi chigugudhio, toronto hiv/aids network peer coordinator, says,”comorbidity is another critical issue, where black women not only experience inequalities, but also experience other forms of illnesses such as high blood pressure, diabetes, and cancer which are fuelled by virtue of having hiv. ”

testing positive for hiv, the virus that causes the disease aids, is no longer the same death sentence it once was for people who have access to treatment. medical advancements and ongoing drug treatment can lower a person’s viral load , which can make hiv undetectable in someone’s blood and help them live a healthy life.

“we do know now if you are on sustainable medication throughout your life and you get to a point where your [viral load] is undetectable, you can’t transmit the disease sexually anymore,” he says. “we’re trying to get everyone there.”

however, not every canadian has access to these treatments. across the country, provinces and territories have different hiv drug coverage plans , lacasse says, leaving those who often need it the most left out. in quebec, people need to pay a deductible, and “some people can’t afford it, so they come off their meds.”

“the less you have access to drugs, the less you have positive health outcomes,” lacasse says. “it’s really unfathomable what’s happening at the moment in canada and it’s compounded by covid-19.”

laura hensley is a writer with healthing.ca.

if you or someone you care about is living with hiv, connecting with a support network can help to not only learn ways to better manage their health, but also share experiences with others. some canadian resources include the canadian aids society, realize canada, the canadian aboriginal aids network and the black coalition for aids prevention.

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