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world aids day: why are hiv activists concerned about young, rural canadians?
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canadians aged 15 to 29 make up a sizeable portion of hiv diagnoses, according to the canadian aids treatment information exchange (catie). getty
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young canadians who live in rural or semi-rural areas face unique barriers when it comes to hiv transmission, activists say.
education and testing centers specializing in hiv (or stis in general) may be difficult to get to from remote communities, especially if the person doesn’t have reliable access to a car or other forms of transportation, according to a report by the ontario hiv treatment network. rural areas may also have more conservative or traditionalist values, which may contribute to stigma experienced by the patients.
small, tight-knit communities also potentially mean that it is close to impossible to feel anonymous when seeking testing or treatments, explains shamin mohamed jr., founder of letsstopaids. even though health information is protected by strict privacy laws in canada, if the medical administrator is a family friend or neighbour, it could turn off younger patients from sharing sensitive information.
“at the end of the day, if it’s your family or a friend of a family, it’s within your circle and just that fear that they may tell someone is enough to make testing be difficult,” says mohamed.
addressing these barriers is complicated — especially since each community is different in terms of resources and population dynamics making a “one-sized-fits-all” solution to rural areas not feasible, as reported by the the ontario hiv treatment network.
raising awareness on preventing hiv on world aids day
canadians aged 15 to 29 make up a sizeable portion of hiv diagnoses — 27 per cent in males and 23.4 per cent in females in 2019 — according to the canadian aids treatment information exchange (catie). and while this younger cohort isn’t safe from contacting hiv, they also appear to be unaware of measures designed to protect them.
only 26 per cent of canadians aged 18 to 24 have knowledge of pre-exposure prophylaxis (prep, a preventative medication that can help protect someone from contracting hiv) the sex lives report 2022 found, a representative survey of more than 1,000 young canadians commissioned by letsstopaids. the report also found only 20 per cent of youth surveyed know about post-exposure prophylaxis (pep), a medication that can prevent hiv from establishing in the body after exposure.
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youth may also have different levels of health literacy, impacting their ability to understand their unique risks and challenges. (a 2019 report by the teresa group defines health literacy as “the capacity to understand and obtain basic health information.”) to be accessible, the teresa group explains, hiv educational materials need to use simple language, be available in multiple languages, and be paired with visual aids.
pandemic changed how young canadians approach sexual health
the pandemic has also greatly impacted young canadians’ behaviour when it comes to sexual health.
the amount of sexually-active respondents who said they never use condoms doubled from the start of the pandemic — from 16 per cent in 2020 compared to 32 per cent in 2022, the report found. thirty-four per cent of respondents also said they were more likely to have sex on a first date, due in part to the fact that pandemic-era dates had to occur in private versus public spaces. some also communicated they spent more time texting potential partners before the first date, and dated fewer people over all.
thirty-two per cent of respondents who were diagnosed with an sti between april to june 2022 also did not receive treatment. gonorrhea was the most reported sti diagnosis, at 54 per cent, with chlamydia in second at 11 percent, hepatitis b at 11 per cent, and hiv in fourth at eight per cent.
but while the pandemic introduced these barriers to testing and education, it also ushered in an era of telemedicine and at-home testing, says mohamed. this could be the answer to giving young canadians — especially in remote locations — the anonymity and access they need to engage in the prevention and treatment process.
“i think this is important because there’s reliable information, and information can be processed in so many different methods,” he says. “it’s great to know about prep, but if your local pharmacy doesn’t have it and they only get shipments in once a month, if you come at the end of that month, you have to wait four weeks.”
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pandemic closures of sexual health centres means murky data
there was a 21 per cent decrease in newly diagnosed hiv cases in 2020 compared to 2019, a surveillance report by the government of canada found — the greatest year-over year decrease in ten years, according to the agency. but that doesn’t mean canada has suddenly found that eureka approach that can lead us out of the crisis. instead, the report notes it is likely to do with the temporary closure of in-person sexual health testing and treatment centres during the pandemic: fewer opportunities to get tested mean fewer diagnoses.
previous to the covid-19 pandemic, there was a four per cent increase in the number of hiv diagnoses from 2014 to 2019, according to catie. this led to activists sounding the alarm bells as canada was “the only g7 nation with increasing hiv rates.”
rates of hiv infection shifted from 5.4 canadians per 100,000 in 2015, to 6.2 per 100,000 in 2018, and then 5.5 per 100,000 in 2019, according to canadian hiv surveillance data. from 2011 to 2020, men were two to three times the risk of developing hiv than women, with ages 30 to 39 being the greatest at-risk age group for all canadians.
emma jones is a multimedia editor with healthing. you can reach her at emjones@postmedia.com or on instagram and twitter @jonesyjourn.
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