A Health Surveillance Update on Canadian Children and Youth

HIV Infection and AIDS

Although children and youth currently account for a small proportion of the total number of HIV infections and AIDS cases, they represent an important aspect of the epidemic that must be addressed.

Since human immunodeficiency virus (HIV) testing programs became available in 1985, Canadians have been gaining knowledge of their HIV status.⁽¹⁾ Although children and youth currently account for a small proportion of the total number of reported HIV infections and acquired immunodeficiency syndrome (AIDS) cases, they represent an important aspect of the epidemic that must be addressed. Access to HIV testing services has been through either confidential testing through a doctor or anonymous testing sites, where available. The positive HIV test data are based on non-nominal, confidential HIV testing information provided by all provinces and territories in Canada, with duplicate tests for individuals removed to the degree possible.⁽¹⁾

For the period November 1, 1985 to December 31, 1998, 43,347 positive HIV tests had been reported to LCDC as of February 26, 1999.⁽²⁾ Of these, 563 (1.5%) were among 15-19 year olds and 630 (1.6%) among those less than 15 years of age. A total of 16,236 AIDS cases had also been reported to LCDC up to February 26, 1999. However, because of reporting delays the true figure is likely to be above 20,000.⁽¹⁾ Of the reported AIDS cases, 78 (0.5%) had been diagnosed among those aged 10-19 years. An additional 2,704 (16.7%) cases had been diagnosed among those 20-29 years old. Given the long latency period between HIV infection and the diagnosis of AIDS, many of these young adults were probably infected as youth. Figure 1 presents the number of positive HIV test reports and reported AIDS cases among youth aged 15-19 years in Canada from 1995-1998.

* data reported to LCDC as of February 26, 1999
Note: Because of different age groupings reported by Alberta, the AIDS data prior to 1998 for the 15-19 year age group include Alberta cases in 10-19 year olds.
Source: Bureau of HIV/AIDS, STD and TB, LCDC⁽¹⁾

The mode of HIV infection varies by age among children and youth. In those less than 15 years of age, perinatal transmission and exposure to blood and blood products accounted for over 90% of the positive HIV tests in the years 1995-1998. In contrast, as depicted in Figure 2, 61% of 15-19 year olds with positive HIV tests reported exposure categories as either men who have sex with men or heterosexual contact/endemic (persons who were born in a country where the predominant means of HIV transmission is heterosexual contact, as well as persons who report heterosexual contact with a person who is either HIV-infected or who is at increased risk for HIV infection).

* data reported to LCDC as of February 26, 1999
Note: Data for test reports with no identified exposure category were excluded from analysis.
MSM = Men who have sex with men; IDU = Intravenous Drug Use
Source: Bureau of HIV/AIDS, STD and TB, LCDC⁽¹⁾

Data limitations
The positive HIV test data presented provide information only on those people who have been tested for HIV. Therefore, the data do not represent the total number of people who are infected with HIV in Canada. At the end of 1998, it was estimated that 15,000 Canadians were infected with HIV and unaware of their infection.⁽¹⁾ As well, positive HIV test data may change as an artifact of testing patterns (who comes forward for testing at what time), because of improved removal of duplicate tests and/or as a result of reporting delays.

Summary
HIV and AIDS affect many sub-groups of the Canadian population, including children and youth. Despite limitations in the availability of data in the 15-19 year age group, risk behaviour information clearly indicates that these youth are at risk for HIV infection. Information on the incidence and prevalence of HIV infection as well as on the determinants of HIV-related risk behaviour in this age group is required to guide and evaluate prevention and intervention programs for Canadian youth.

Unless referenced otherwise, HIV/AIDS statistics were obtained from the Bureau of HIV/AIDS, STD and TB, LCDC⁽²⁾

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