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 t's
been 20 years already since the first case of AIDS in Canada was reported.
In the time since, an estimated 20,000 people have developed the disease.
Another 54,000 Canadians have become infected with HIV, the virus
that is the precursor to AIDS. And every day, according to Health
Canada's Bureau of HIV-AIDS, a dozen more people become infected.
In fact, after several years of stability, the number of reported
HIV infections is increasing once again.
Why the increase?
Why would this be happening with a disease that
is so preventable? There are many factors, according to those people
who are involved in AIDS-related work: a new generation with
a different attitude, too little information and support for people
not typically considered at risk, the success of AIDS treatments and,
yes, maybe even some complacency about safer sex practices-a
feeling that it couldn't happen to me.
The new faces of AIDS
"What we're seeing is diversity,"
says Paul Lapierre, executive director of the Ottawa-based Canadian
AIDS Society. "For many years I was working in Winnipeg and the
numbers we were seeing were almost an equal split between heterosexuals,
intravenous drug users and homosexuals. But the rate of infection
has moved beyond the traditional populations we?ve been working with," to heterosexual women and the aboriginal community , among others. That being said, he adds, "There isn't really a decrease
in the numbers of men getting infected."
Many of us over a certain age have had friends or loved ones who have
died of AIDS. We remember life before the virus and we remember
how it changed everything. Over the course of HIV's first decade,
the average age for testing positive for the virus dropped to 23 from
32. "I think the new infection rates that are showing up in younger
people in particular are a result of a population who does not see
this as a huge interruption in their lives," says Edmonton's
Bob Mills, a former teacher who lives with AIDS and who devotes his
time to countless local and national HIV- and AIDS-related committees.
"We have a young population who have grown up with AIDS as you
would grow up with any illness, like cancer. While it may be new for
those of us who've been around for more than 20 years, to them it's
just another danger of life in the millennium."
High risk groups are missed
AIDS experts also feel that AIDS-prevention information
isn't reaching everyone it needs to nor is the infrastructure in place
to support prevention strategies in the broader sectors of
society. Trevor Gray is project coordinator of HIV prevention at East
Metro Youth Services in Toronto, where he works with street-involved
kids. "If you live in a shelter, I do not really think safer
sex is something you'd be thinking of all the time," says Gray.
"If you have no housing or proper clothing or food, you may have
to do certain things to get them. And if you have to buy either a
loaf or bread or a condom, which would you buy?"
Experts including Gray also feel that until HIV education is addressed
in all sectors of society, including the church and at schools, many
risk groups will continue to be missed. "If the onus is on AIDS
organizations, then people will think they have no connection with
this community and therefore are not at risk," Gray adds. For
example, he notes that pregnant women are strongly advised to have
an HIV test. "They say, 'I'm pregnant, I live with my partner
and we're in a monogamous relationship,' " he says. "But
sometimes it's an illusion to think that people don't actually have
sexual indiscretions."
The reality of treatment
The face of AIDS has also changed in other ways,
thanks to the success stories about AIDS research and breakthroughs
in treatment. "People don't see it any longer as a threat,"
says CAS's Lapierre, "and they let go of their guards."
In fact, for people who have had access to the best treatments, both
quality and length of life have improved dramatically. Mills wasn't
supposed to see 40; in January, he will celebrate his 50th birthday.
Treatment isn't just about popping a few pills and getting on with
life, as we might wish to believe. "We need to show that when
we take these drugs, they are doing some horrendous things
to our bodies," says Mills. "Many are altering the chemical
makeup of our brains. There's no long-term study on what they're going
to do to us."
How to have safer sex
So it comes back to the message and how important
that message is for everyone: AIDS is not curable but it is preventable.
Health professionals, including Kelli Dilworth, a health educator
with the Ottawa-based Planned Parenthood Federation of Canada, tend
to present AIDS education in terms of different levels of risk:
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"Some examples
of safer sex would be kissing, hugging, touching, rubbing, masturbation
alone or with a partner, massage," explains Dilworth, "where
there's no exchange of bodily fluids" such as semen, vaginal
fluids or blood. |
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Contact without the
exchange of bodily fluids with the penis, vagina or anus are
not risky behaviours in themselves unless you have open cuts
or sores that might allow infection into the bloodstream. |
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Oral sex is considered
among the lower-risk (but still risky) activities as long as
you have no cuts or sores. |
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Vaginal and anal intercourse
are both high-risk activities, particularly when a condom is
not used. Latex or polyurethane condoms?if they are used properly?help
to prevent transmission of the HIV virus. |
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Use condoms on sex toys
in any relationship, homosexual or heterosexual. |
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Only water-based lubricants
can be used with condoms as oil-based lubricants will weaken
the latex. |
"I have one clear message to anybody who asks
me," says Mills. "If you don't share body fluids, you
have nothing to worry about. And they can decide what they consider
body fluids. It's a message that doesn't come across as preachy."
Some spermicides may increase risk
One very commonly used spermicide, Nonoxynol-9,
which is found in certain brands of condoms, foam and other contraceptives,
was once thought to help protect against transmission of HIV during
either vaginal or anal intercourse. Recently, however, the World Health
Organization reported that use of the spermicide may actually increase
the risk of HIV transmission. One possible reason, according to
the researchers, is that Nonoxynol-9 may irritate the lining in the
vagina or the anus, making it more vulnerable to infection. Many alternatives
to the spermicide are currently under investigation.
Change is steady-but too slow
In the end, 20 years in the life of a disease is
not much, Gray notes, and tremendous strides have already been
taken. "If prevention messages weren't working, there would be
millions more people who'd be infected," he says. "We go
to places and we hear people talk about usage of condoms, we hear
people being more autonomous about their sexual lives."
The fact remains that every year, 5,000 new HIV infections are reported
in Canada. And that sticks in the craws of every person in the field
of HIV and AIDS education. "There's a way to prevent it,"
says Lapierre, "and we know it."
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Date published: November 15, 2002 |
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 This article was prepared by Nora Underwood for CHN. Nora Underwood is a journalist living in Toronto. |
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