Many Canadians likely think of HIV as a challenge experienced by other parts of the world, such as Sub-Saharan Africa. And they're correct. But it's also true Canada faces its own HIV epidemic-- a reality to be reminded of on World AIDS Day (December 1) and throughout the year. The most visible face of our HIV epidemic is the 75,000 Canadians living with the virus. Less visible, but perhaps equally significant, is the widespread lack of knowledge about new advances in HIV prevention. If more of us knew about these news ways to prevent HIV, we would have fewer new infections in Canada.
Let's start with how HIV treatment is actually a form of HIV prevention. Did you know that, for people living with HIV, being on successful HIV treatment can virtually eliminate the chance of HIV transmission? This year clinical studies provided convincing evidence that if an HIV-positive person on treatment has an “undetectable viral load” (meaning that the amount of HIV in their blood is so low that routine tests can't find it), they have a negligible risk of passing HIV on to sexual partners. Reaching and maintaining an undetectable viral load requires good adherence to treatment and regular medical visits. For people with HIV (and their intimate partners) this news will likely have a positive impact on the way they view themselves and their sex life. And it provides a further reason why we need to end the stigma and discrimination people with HIV still face in our society.
Next up is oral pre-exposure prophylaxis (or PrEP for short), which involves an HIV-negative person taking HIV drugs in order to lower their chance of getting HIV. In February 2016, Health Canada approved a drug called Truvada for use as oral PrEP. It is recommended for daily use by HIV-negative adults at high risk for HIV infection, to reduce the risk of sexual HIV transmission, in combination with safer sex practices. When PrEP is used as an HIV prevention strategy with high adherence and regular medical check-ups, it is rare for HIV to be passed on during sex.
Finally, condoms and harm-reduction programs continue to be the cornerstone of HIV prevention. Condoms help to prevent not only HIV but also other sexually transmitted infections (STIs) and unplanned pregnancies. Harm-reduction programs, like needle and syringe exchange programs and safer injection sites, are also highly effective strategies for preventing HIV transmission (as well as hepatitis C transmission).
To maximize the impact on the epidemic, we must increase our awareness, uptake and proper use of these approaches. Increased knowledge of these highly effective HIV prevention approaches has made health professionals optimistic that we can turn the tide on HIV. In this 20th year since the advent of effective HIV treatment, there is renewed hope and excitement that we will see the end of this disease.
Let's get the word out as broadly as we can. People's lives depend on it.
Laurie Edmiston is executive director of CATIE, Canada's source for HIV and hepatitis C information 1-800-263-1638