world aids day 2024: how is canada performing in the global aids effort?
canfar has ramped up initiatives around awareness and education of hiv and aids needed to break through barriers to care.
8 minute read
canfar has ramped up initiatives around awareness and education of hiv and aids, most recently with two guinness world records. – one for the most awareness red ribbons made in one hour by one team and the other for the world's largest awareness ribbon mosaic made of awareness ribbons, pictured.
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“hiv is still here” is the headline emblazoned across the campaign by canfar, the canadian foundation for aids research, to mark world aids day on december 1, 2024. the human immunodeficiency virus (hiv) – a sexually transmitted and blood-borne virus – is still a global pandemic with 1.3 million new cases worldwide in 2023 and on the rise in canada. we saw a 25 per cent leap in new cases in 2021 to 2022 as people emerged from the covid-19 shutdown and had renewed access to testing for the virus.
almost 40 per cent of new cases in canada are from heterosexual contact. youth make up about one-quarter of new cases every year. part of the problem is that people who are at risk don’t view themselves as at risk, experts say. hiv can affect anyone regardless of sexual orientation, race, ethnicity, gender, age, or where they live. the chances of contracting hiv increase in communities that are most impacted by new cases, including indigenous communities, black and racialized communities, and newcomers who are either testing upon entry or becoming positive. the communities that are the least served from a system infrastructure standpoint are the ones that continue to be the most impacted.
what happens in hiv? the virus weakens the immune system by destroying your t-cells until you are unable to fight off even minor illnesses. if left untreated, it can progress to acquired immunodeficiency syndrome (aids), the most serious stage of hiv infection.
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roxanne ma, vice president of national awareness programs at canfar, worked previously in hiv and aids outreach programs in malawi in southeastern africa. she brought her deep commitment to ending stigma and increasing access to care in canada when she joined canfar nine years ago. “working in the hiv space is advocating at the intersection,” she says. “it’s about learning how to get the attention of people from across different sectors to understand how addressing housing or poverty or stigma against lgbtq+ folks is advancing the rights for all these different communities and can help advance the hiv cause.”
public funding, support and investment in the hiv/aids sector has waned over recent years and many hiv community organizations have closed, ma explains. so, canfar has ramped up initiatives around awareness and education of hiv and aids, most recently with two guinness world records, one in toronto on november 12 for the most awareness red ribbons made in one hour by one team (previous record: 5,471; the new canfar record: 11,255). the second was unveiled in ottawa on november 13, setting a new record for the world’s largest awareness ribbon mosaic made of awareness ribbons.
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where are we at in canada when it comes to delivering the global directives for world aids day 2024 supported by the world health organization? healthing.ca talked with ma about the key initiatives:
healthing: health is a human right. everyone should have access to the health services they need, including hiv prevention, treatment and care. how is canada performing?
ma: this is a statement that we can obviously get behind but the reality is canada really loves to sell the world on a universal healthcare system. but we’re actually one of the only socialized healthcare systems that doesn’t have universalized pharma care. so that presents the challenges when it comes to hiv prevention and prep. [prep is pre-exposure prophylaxis for people who don’t have hiv but are at risk of getting it. prep is medicine by a pill that you take every day or a long-acting injectable taken in as few as six injections a year.]
we know that there are barriers to accessing services and specifically pharma care, so drugs and medication. and it’s difficult because, even though i think canadians will agree that health is a human right, our healthcare system is run by provincial governments. we don’t have a unified healthcare system or approach to help within canada. that definitely leaves communities behind both from a regional perspective and from a community perspective.
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healthing: prevention empowers and protects. so, how are we doing when it comes to empowering individuals with access to hiv prevention tools and education services that protects not only their health but also their rights and equal access.
ma: this is the key to stopping new infections. given that our cases are continuing to increase, i would say we’re not doing so well on the prevention front. this is the area that i work in, primarily with youth where sex education is always such a hotly debated topic. but i would argue that sex ed is a human right. sexual health education is so important for young people before they enter the world of dating, relationships, having sex, looking at all of those things which looks so much different for young people today than even 15 years ago.
the advent of cell phones and apps and that digital communication is something that is now an integral part of the fabric of their social lives. so young people are exposed, especially when it comes to dating and relationships and sex and safety, there’s so many things coming at them. we created the resource sexfluent.ca that is our modernized approach to sex ed where we openly talk about things like pleasure, dating apps, navigating sexual health conversations with a stranger. we talk about pornography as well which is a reference point that a lot of young people are getting around how to navigate sex. we talk very openly about porn as a performance that’s tailored to an audience and not realistic.
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to not have sex ed as standardized, mandatory and not something that you can opt out of in public education is a huge barrier to prevention for young people. how can we believe that young people can participate or be empowered to prevent hiv if they’re not getting the education around it? if these topics are still in 2024 considered taboo, that’s a huge challenge.
healthing: stigma and discrimination undermine the fight against aids, but how does canada address these issues that ultimately break down barriers to access treatment?
ma: the general public likely does not know what happens when you have hiv and the fact that if you take hiv medication, you’re on effective treatment. it’s working for your body and you can very quickly, within a few months, get to “undetectable,” which means you can’t detect the hiv virus in your blood and there is zero risk of transmitting hiv sexually when you are undetectable.
that’s a huge part in terms of addressing stigma and discrimination because i think some people still view hiv as a very severe illness. there is no cure, but once you get on treatment, it’s honestly very manageable. i know folks living with other chronic health conditions, whether it’s celiac or diabetes or whatever it is, those impact their daily lives far more than hiv.
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there’s still a ways to go when it comes to addressing stigma and discrimination. we still criminalize hiv non-disclosure. that creates an institutionalized barrier in terms of stigma for people to come out with their status safely in the workplace or in healthcare. there are folks who talk about going to health services like the chiropractor and they often have to fill out an intake form and disclose that they have hiv. but a lot of healthcare practitioners don’t know that there’s no risk. i’ve heard stories about doctors doubling up on gloves or disclosing hiv status loudly in a room where other people can hear. there are still a lot of those hidden barriers that are not being talked about in the public domain.
healthing: prioritize and reach vulnerable and key populations is another global mandate that is critical to ending the hiv epidemic. are we moving in that direction?
ma: in canada, this looks like reaching the indigenous communities, the african black and caribbean communities and newcomer communities where there are so many barriers, whether that’s language or settlement. for indigenous communities, there’s a different way of engaging with indigenous communities where canfar is working with catie (canadian aids treatment information exchange) on translating the knowledge and scientific advances in hiv with indigenous world views and their schools of thought.
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healthing: championing access to life-saving treatment to achieve hiv viral suppression or zero risk status can change lives. early diagnosis and consistent antiretroviral therapy means that people with hiv can lead long, healthy lives. are we getting there?
ma: we’re still seeing gaps in canada. essentially one in 10 people living with hiv are not diagnosed or are unaware of their status. a huge barrier is getting people tested. that awareness of even their status is very critical and then the second piece is getting them linked to care. there’s still a gap there that’s even lower: 85 per cent of those diagnosed are actually on treatment. linkage to care is something we really need to address in canada. and that can look like a lot of barriers, whether these are folks who may not be accessing public health services because they may not have secure housing or stability in their life that would allow them to continue accessing the healthcare system and the medication and checking in with the hiv specialist and a physician. but i will mention that there are new advancements in treatments coming out and a positive in canada is that 95 per cent of people who are on hiv treatment are able to attain viral suppression or become undetectable which is zero-risk.
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healthing: and the big one, are we advancing toward an aids-free future?
ma: this is the goal. but i think in order to get to an aids-free generation, there are a few things that coincide with our mission at canfar. we’re continuing to invest in research, whether it’s a vaccine or cure or any type of innovation. that investment into hiv research is needed if we want an aids-free future. we also know that ramping up prevention is so important. it’s getting all of those people who are living with hiv tested, diagnosed and then immediately linked to treatment. and then the new generation needs to be empowered to prevent hiv. it’s also working with the communities that are most impacted because they’ll know how to reach people. those are the strategies that we will need to end hiv.
there’s a tendency in the public to feel like ‘this is not our issue, it’s not in our communities.’ i genuinely believe that ending hiv has to be the responsibility of everyone together. we need to break into more of the public domain, raising public awareness and consciousness around hiv. that will address the stigma and ramp up prevention, all of those things that we talked about to move forward to end the epidemic.”
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